Date of Conferral

10-26-2025

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Jeanne Connors

Abstract

Public health nurses are potentially key stakeholders in syringe services program (SSP) implementation in rural areas, where they can act as liaisons between public health, private healthcare, and the community. However, little research reflects an in-depth understanding of how public health nurses perceive SSPs in rural areas. The purpose of this qualitative study was to explore the perceptions of syringe services programs held by public health nurses practicing in rural areas with no existing SSPs in southern states and ascertain their potential roles in facilitating harm reduction for people who inject drugs. This study was guided by a conceptual framework derived from the socioecological model and focused on individual, interpersonal, and community-level factors and their relationships. Semistructured, in-depth interviews were conducted with six public health nurses practicing in rural Louisiana. Four themes emerged: perspectives of harm reduction at the community level, including how such services are accessed and provided; individual level perceptions of syringe services programs regarding their potential utility in rural areas; syringe services programs in rural areas in terms of what similar services exist; and stigma at the individual and interpersonal levels of influence, where nurses detailed the perceptions of stigma from observations in professional practice. This study has the potential to effect positive social change by providing professionals and policy makers with information on the perceptions of SSPs in rural areas of southern states where the magnitude of injection drug use is perceived to be high and hopefully inform strategies to address the increasing risk of harms associated with injection drug use at the community level.

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