Motivation to Change and Treatment Participation Among Syringe Service Program Utilizers in Rural Kentucky

Hilary L. Surratt, Janet K. Otachi, Timothy Williams, Jennifer Gulley, A. Scott Lockard, Rebecca Rains

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Purpose: Kentucky experiences a disproportionate burden of substance use disorder (SUD), particularly in rural areas of the state. Multiple factors increase vulnerability to SUD and limit access to services in rural communities. However, the recent implementation and expansion of syringe service programs (SSPs) in rural Kentucky may provide a leverage point to reach at-risk people who inject drugs (PWID). Methods: Data were collected as part of an ongoing NIDA-funded study designed to examine uptake of SSPs among PWID in Appalachian Kentucky. Using Respondent Driven Sampling (RDS), the study enrolled a sample of 186 PWID SSP attenders across 3 rural Appalachian Kentucky counties and conducted face-to-face interviews regarding health behaviors, injecting practices, SSP utilization, and treatment services. Using logistic regression analyses, we examined consistent SSP use, as well as importance and confidence to reduce substance use as predictors of current treatment participation. Findings: For the prior 6 months, 44.6% of the sample reported consistent SSP use. Consistent use of SSPs was associated with treatment participation in the unadjusted logistic regression models. Significant predictors of treatment participation in the adjusted model included high confidence to reduce substance use, and not reporting primary methamphetamine injection. Conclusions: Rurally located SSPs may play an important role in supporting confidence and motivation to change substance use behaviors among PWID impacted by SUD. SSPs may be critical venues for integration and expansion of prevention, health promotion, and treatment linkage services for this underserved population.

Original languageEnglish
Pages (from-to)224-233
Number of pages10
JournalJournal of Rural Health
Issue number2
StatePublished - Mar 1 2020

Bibliographical note

Publisher Copyright:
© 2019 National Rural Health Association


  • injection drug use
  • motivation to change
  • rural
  • syringe service programs
  • treatment

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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