{"doi":"10.1136/bmjopen-2024-083983","title":"Kentucky Outreach Service Kiosk (KyOSK) Study protocol: a community-level, controlled quasi-experimental, type 1 hybrid effectiveness study to assess implementation, effectiveness and cost-effectiveness of a community-tailored harm reduction kiosk on HIV, HCV and overdose risk in rural Appalachia","abstract":"INTRODUCTION: Many rural communities bear a disproportionate share of drug-related harms. Innovative harm reduction service models, such as vending machines or kiosks, can expand access to services that reduce drug-related harms. However, few kiosks operate in the USA, and their implementation, impact and cost-effectiveness have not been adequately evaluated in rural settings. This paper describes the Kentucky Outreach Service Kiosk (KyOSK) Study protocol to test the effectiveness, implementation outcomes and cost-effectiveness of a community-tailored, harm reduction kiosk in reducing HIV, hepatitis C and overdose risk in rural Appalachia. METHODS AND ANALYSIS: KyOSK is a community-level, controlled quasi-experimental, non-randomised trial. KyOSK involves two cohorts of people who use drugs, one in an intervention county (n=425) and one in a control county (n=325). People who are 18 years or older, are community-dwelling residents in the target counties and have used drugs to get high in the past 6 months are eligible. The trial compares the effectiveness of a fixed-site, staffed syringe service programme (standard of care) with the standard of care supplemented with a kiosk. The kiosk will contain various harm reduction supplies accessible to participants upon valid code entry, allowing dispensing data to be linked to participant survey data. The kiosk will include a call-back feature that allows participants to select needed services and receive linkage-to-care services from a peer recovery coach. The cohorts complete follow-up surveys every 6 months for 36 months (three preceding kiosk implementation and four post-implementation). The study will test the effectiveness of the kiosk on reducing risk behaviours associated with overdose, HIV and hepatitis C, as well as implementation outcomes and cost-effectiveness. ETHICS AND DISSEMINATION: The University of Kentucky Institutional Review Board approved the protocol. Results will be disseminated in academic conferences and peer-reviewed journals, online and print media, and community meetings. TRIAL REGISTRATION NUMBER: NCT05657106.","journal":"BMJ Open","year":2024,"id":442005,"datarank":0.37868161189009575,"base_score":2.1972245773362196,"endowment":2.1972245773362196,"self_citation_contribution":0.32958368660043297,"citation_network_contribution":0.04909792528966279,"self_endowment_contribution":0.32958368660043297,"citer_contribution":0.04909792528966279,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":2,"citers_with_citation_signal":1,"citers_with_endowment":1,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9527,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT05657106"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":493609,"name":"Jennifer R. Havens","orcid":"0000-0002-1753-7280","position":1,"is_corresponding":false},{"id":273387,"name":"Hannah L. F. Cooper","orcid":"0000-0002-0521-2438","position":2,"is_corresponding":false},{"id":875199,"name":"Amanda Fallin‐Bennett","orcid":"0000-0001-9491-3908","position":3,"is_corresponding":false},{"id":1029831,"name":"Laura Fanucchi","orcid":"0000-0003-0582-2399","position":4,"is_corresponding":false},{"id":271675,"name":"Patricia R. Freeman","orcid":"0000-0002-4749-6563","position":5,"is_corresponding":false},{"id":325627,"name":"Hannah K. Knudsen","orcid":"0000-0002-0137-9337","position":6,"is_corresponding":false},{"id":337986,"name":"Melvin D. Livingston","orcid":"0000-0002-6327-8910","position":7,"is_corresponding":false},{"id":396777,"name":"Kathryn E. McCollister","orcid":"0000-0003-4336-9791","position":8,"is_corresponding":false},{"id":476551,"name":"Jack Stone","orcid":"0000-0002-4584-0068","position":9,"is_corresponding":false},{"id":301344,"name":"Peter Vickerman","orcid":"0000-0002-8291-5890","position":10,"is_corresponding":false},{"id":928224,"name":"Edward Augustus Freeman","orcid":null,"position":11,"is_corresponding":false},{"id":1052777,"name":"Tasfia Jahangir","orcid":"0000-0001-9642-2379","position":12,"is_corresponding":false},{"id":1255510,"name":"Elizabeth Larimore","orcid":"0009-0001-6270-8288","position":13,"is_corresponding":false},{"id":1255925,"name":"Carol White","orcid":null,"position":14,"is_corresponding":false},{"id":862492,"name":"Chelsi Cheatom","orcid":null,"position":15,"is_corresponding":false},{"id":1255926,"name":"KyOSK Community Staff","orcid":null,"position":16,"is_corresponding":false},{"id":1255927,"name":"KyOSK Design Team","orcid":null,"position":17,"is_corresponding":false},{"id":271669,"name":"April M. Young","orcid":"0000-0003-3969-3249","position":0,"is_corresponding":true}],"reference_count":81,"raw_metadata":null,"created_at":"2026-07-19T02:01:15.932178Z","pmid":"38431295","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}