Date of Conferral

7-15-2026

Date of Award

July 2026

Degree

Doctor of Public Health (DrPH)

School

Health Sciences

Advisor

Richard Jimenez

Abstract

Community health workers (CHWs) distributing sterile injecting equipment help reduce infectious disease transmission among people who inject drugs; however, limited research exists regarding their experiences delivering harm reduction services during public health emergencies in rural areas. The purpose of this qualitative study was to explore CHWs’ experiences and perceptions of health risks, operational barriers, and social influences affecting harm reduction service delivery during the COVID-19 pandemic in the Barren River Area Development District. The health belief model guided this study, emphasizing perceived susceptibility, severity, barriers, benefits, and self-efficacy. Data were collected through semistructured Zoom interviews with eight purposively sampled CHWs and analyzed using inductive thematic coding and constant comparative analysis. Findings revealed psychological strain associated with fear of infection, uncertainty, and repeated exposure to COVID-19. Participants also described staffing shortages, limited resources, changing protocols, transportation challenges, and stigma surrounding harm reduction work. Findings further demonstrated that organizational support, commitment, and self-efficacy influenced participants’ ability to sustain service delivery despite ongoing challenges. This study contributes to positive social change by informing public health policies and practices to strengthen harm reduction infrastructure, support CHWs, and improve health outcomes among vulnerable populations during public health emergencies.

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