# Implementing and evaluating the impact of novel mobile harm reduction services on overdose among women who use drugs: The SHOUT study.

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2022 · $2,289,649

## Abstract

Project Summary
Nearly 92,000 Americans died of drug overdoses in 2020, primarily driven by a lethal drug supply
dominated by synthetic opioids (i.e., fentanyl and fentanyl analogs) and increased stimulant-related deaths. We
have documented the magnitude of this epidemic experienced by women who use drugs (WWUD) (N=385) in
Baltimore City, who reported high rates of experiencing an overdose (28%), witnessing a fatal overdose (35%),
and witnessing a non-fatal overdose (52%) in the past 6 months. We have also documented a number of
structural vulnerabilities (i.e., homelessness, hunger), mental health morbidities (i.e., PTSD, depression),
interpersonal violence, and chaotic drug use patterns (i.e., polysubstance use,) that indirectly and directly drive
women's distinct risk of overdose and other morbidities (i.e., HIV, HGV). Yet WWUD experience numerous
barriers to receiving necessary medical and behavioral services that can reduce their risk of overdose and
other harms, with barriers amplified by the COVID-19 pandemic. We propose conducting the SHOUT
(Sustained Harm reduction OUTreach) study, a type 1 hybrid effectiveness-implementation design to evaluate
the impact and implementation of WWUD-centered, mobile harm reduction services on nonfatal overdose and
clinical care engagement among WWUD (N=400) recruited from Baltimore City and County neighborhoods
new to Mobile SPARC services. Mobile SPARC is an existing low-barrier, outreach program serving other
neighborhood and offers harm reduction supplies (i.e., sterile syringes, naloxone, condoms), necessities (i.e.,
food, clothing), trauma informed micro-counseling, and necessary referrals The study aims to: 1) adapt and
expand Mobile SPARC's services to identify predisposing (i.e., drug use patterns) and enabling (i.e., access to
trusted health services) factors that facilitate or hinder utilization of harm reduction services, employing indepth
interviews with WWUD (N=40) and key informant interviews with Mobile SPARC staff (N=5); 2) evaluate
the impact of expanding Mobile SPARC on nonfatal overdose and clinical service engagement (including drug
treatment) over 18 months among WWUD (N=400) recruited from neighborhoods in which Mobile SPARC will
be newly implemented; and 3) to characterize the implementation of Mobile SPARC using the Reach,
Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework to inform future implementation
and scale up. The SHOUT study will make a significant contribution to the literature in evaluating the impact of
tailored, low-barrier mobile outreach on overdose among WWUD. The study's relevance and sustainability will
be enhanced through its partnership with SPARC, input from a community advisory board, and support of longterm
collaborating organizations and health department stakeholders as well as the cost effectiveness
analysis. This proposal is highly responsive to the RFA DA-22-046's emphasis on replicable harm reduction
service delivery model targeting...

## Key facts

- **NIH application ID:** 10590364
- **Project number:** 1R01DA057655-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Susan G. Sherman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $2,289,649
- **Award type:** 1
- **Project period:** 2022-09-30 → 2025-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10590364

## Citation

> US National Institutes of Health, RePORTER application 10590364, Implementing and evaluating the impact of novel mobile harm reduction services on overdose among women who use drugs: The SHOUT study. (1R01DA057655-01). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10590364. Licensed CC0.

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