Client Contact Research Articles

IMPACT OF DIGITALISATION ON BANKING SECTOR

The banking sector has been substantially changed by the fast development of digital technology. The effect of digitalisation on general financial services, client contacts, and banking operations is investigated in this article. In banking, digitalisation has brought about the automation of formerly manual procedures, therefore improving client happiness, efficiency, and operating expenses while lowering running costs. Offering 24/7 access to financial services from anywhere in the globe, services such internet banking, smartphone apps, and digital payment systems have transformed the way consumers connect with banks. Furthermore, digitalisation has helped fintech to emerge, therefore undermining established banking structures and encouraging more innovation and competitiveness. Advanced technologies such artificial intelligence (AI), machine learning (ML), and blockchain have been embraced by banks to guarantee better security in transactions, provide tailored services, and help to guide decisions. Although digitalisation has many advantages, it also brings problems like cybersecurity threats, data privacy issues, and the necessity of large technological infrastructure investment. This study also addresses its function in financial inclusion by enabling underprivileged groups to use banking services. Banks have to strike a mix between innovation and regulatory compliance, risk control, and client confidence as the digital revolution unfolds. The results of this research imply that banks must embrace digital transformation if they are to stay competitive in an economy becoming more and more digital and also meet the changing demands of tech-savvy customers.

Court Navigators and Opportunities for Disseminating Overdose Prevention Strategies.

Objective. Describe how navigator programs from three New England states (Connecticut, Maine, and Massachusetts) function to connect individuals using court services to community-based treatment and services. Hypothesis. Implementation science frameworks can be used to analyze how multiple court programs function to inform replication and address gaps in the use of overdose prevention strategies. Method. The Template for Intervention Description and Replication (TIDieR) Implementation informed semi-structured interviews as part of an exploratory mixed-methods analysis of court navigator programs. Analysis of interviews based on the TIDieR and administrative data on client contacts (n = 436) were analyzed. A subsample of clients with additional background information (n = 249) was used to examine court navigator recommendations. Results. The TIDieR revealed court navigator programs shared basic intervention characteristics but varied dramatically by resources and organization contexts. Nearly half (46.5%) of clients were self-referred and more than two-thirds (69.1%) approved follow-up but varied by program. Of those allowing follow-up, more than one-third (35.7%) had previously experienced an overdose. Court navigators were significantly more likely to refer clients with a history of overdose to locations where they can receive naloxone (the opioid overdose antidote) though only one program had naloxone on hand. Conclusion. Navigators are employed by community organizations with access to courthouses to provide resources to those passing through. These efforts can be implemented to support linkages to treatment and services but there is a significant gap in the allocation of overdose prevention strategies in court settings and court navigator programs have the potential to address this unmet need.

Exploring barriers and facilitators to addressing hazardous alcohol use and AUD in mental health services: a qualitative study among Dutch professionals

BackgroundHazardous alcohol use and alcohol use disorder (AUD) are highly prevalent among clients in mental health services, yet significant gaps remain in the adequate assessment of alcohol use and provision of appropriate alcohol interventions. The aim of this study was to conduct an exploration of (i) alcohol intervention elements used in mental health services and (ii) professionals’ reported barriers and facilitators in identifying and intervening with hazardous alcohol use and AUD.MethodsQualitative data were obtained by conducting semi-structured interviews among a purposive sample of 18 professionals from 13 different Dutch mental health services organizations (i.e., five integrated mental health organizations with addiction services, five mental health organizations without addiction services, and three addiction services organizations without mental health services). Transcripts were qualitatively analyzed using inductive thematic analysis.ResultsIdentified alcohol intervention elements included conducting assessments, brief interventions, treatment, referrals of clients, collaborations with other parties, and providing information to professionals. Professionals mentioned nine barriers and facilitators in the identification and intervention with hazardous alcohol use and AUD, including three aspects of professionals’ behavior (i.e., professionals’ agenda setting, knowledge and skills, and attitudes), actions related to identification and intervening, client contact, collaboration with other parties, and three factors in a wider context (i.e., organizational characteristics, organizational resources, and governmental aspects).ConclusionsAlthough diverse alcohol intervention elements are available in Dutch mental health services, it remains unclear to what extent these are routinely implemented. To better address hazardous alcohol use and AUD in mental health services, efforts should focus on enhancing alcohol training, improving collaboration with addiction services, providing appropriate tools, and facilitating support through organizational and governmental measures.

Socio-medical assessment: an inventory of the Medical Service of the Federal Employment Agency

The Medical Service of the Federal Employment Agency is responsible for socio-medical assessments of clients whose ability to work in the labor market is in question. Data about the Medical Service, its structure, and its performance were previously only available within the Federal Employment Agency. In October 2023, data from the Medical Service containing information on the employee structure, clients, and orders were extracted from three data systems, processed, and analyzed. The number of full-time equivalents (FTEs) in the Medical Service decreased significantly from 2016 (n = 859.1 FTEs) to 2021 (n = 799.0 FTEs). This holds true for the professional groups of physicians, specialist assistants, medical assistants, and externally contracted physicians. The number of female employee FTEs rose significantly during this period from 85.6% (2016) to 87.0% (2021). The part-time ratio also increased significantly from 41.4% (2016) to 50.6% (2021). The number of assignments to the Medical Service was stable in 2017-2019 at around 630,000 but showed areduction in 2020 (n = 518,538) and 2021 (n = 545,289); in particular, the number of assessments with client contact decreased significantly from 2019 (n = 166,980) to 2020 (n = 52,484). Most of the assignments came from the field of job placement (n = 349,346). The size of the Medical Service was in line with the total number of orders, which can certainly be seen as COVID-19-related in 2020 and 2021 and is likely due to the overall shortage of skilled personnel. The proportion of women and part-time employees increased significantly, with anationwide part-time trend emerging not only among women. In order to enable all clients who may be unable to perform in the labor market to receive aquick assessment, it is necessary that the number of employees in the Medical Service does not decrease in the future.

The Role of Comprehensive Customer Relationship Management (CRM) Systems in Achieving High Retention Rates

High client retention rates were crucial for maintaining growth and profitability in today's competitive business world. CRM solutions played a crucial role in facilitating the effective management of client contacts across several channels for organisations. These systems integrate consumer data and streamline procedures, offering a cohesive perspective of customer interactions and preferences. This paper examined how complete CRM systems may improve customer retention via personalised experiences, streamlined sales processes, and data analytics for informed decision-making. Although the advantages of CRM systems are clear, there are still obstacles to overcome, including data integration, expensive installation expenses, and ongoing adaptation and staff training. The research examined a comprehensive knowledge of CRM utilisation and its influence on customer retention. The results emphasised the significance of a well-planned deployment of customer relationship management (CRM) in promoting customer loyalty, enhancing operational effectiveness, and increasing revenue generation. Suggested strategies for firms include allocating resources towards data integration, providing comprehensive staff training, implementing continuous improvement practices, using sophisticated analytics, and cultivating a customer-centric culture. Keywords: Customer Relationship Management (CRM), Customer Retention, Data Integration, Personalised Customer Experience, Sales Force Automation (SFA).

Sexual health beliefs and prevention of sexually transmitted infections among cisgender women sex workers in Colombia.

The stigma and social discrimination against cisgender women sex workers lead many of them to live in conditions characterized by social inequality, marginalization, persecution, and limited opportunities for sexual health literacy. Consequently, they are often compelled to establish a framework of preventive beliefs with little scientific validity, which they use to identify, mitigate, or avoid sexual health risks arising from their interactions with clients. This study investigates the sexual health beliefs that influence self-care practices aimed at preventing sexually transmitted infections among cisgender women sex workers in Colombia. We conducted a qualitative study framed in Hermeneutic Phenomenology. In-depth interviews and discussion groups were conducted with 34 cisgender women sex workers over 18 years of age in the center of the cities of Bogotá and Barranquilla in Colombia. Seven themes emerged from the reflective and inductive thematic analysis of the narratives: (1) popular habits for the prevention of contagion, (2) ocular assessment of genitals, (3) condom lubrication, (4) suspicion of a hidden infection in the client, (5) saliva and oral contact as a source of contagion, (6) avoidance of semen contact, (7) and trust in God as protection. The findings reflect the need for health and social professionals to promote participatory and inclusive cooperation with sex workers to update the framework of preventive beliefs that help them guide sexual health self-care with autonomy and self-efficacy, strengthening favorable beliefs and negotiating unfavorable ones. It is also essential to have a sex worker-informed sexual health policy that guides the promotion of sexual health that is sensitive to the needs and consistent with the risks of sex work and ensures friendly and non-oppressive preventive care environments for sex workers.

Service Provider Perspectives on the Differences between Place‐Based and Scattered‐Site Permanent Supportive Housing in Los Angeles County after the Onset of the COVID‐19 Pandemic

Background. Permanent supportive housing (PSH) is an evidence‐based solution to chronic homelessness. There are two common PSH models: place‐based (PB) programs where clients live in one building with services provided onsite and scattered‐site (SS) programs, which use community apartments coupled with mobile case management and support. Understanding the relative strengths and weaknesses of PB and SS is important for PSH planning and service delivery. This paper explores homeless service provider perspectives on these two models after the onset of the COVID‐19 pandemic. Methods. Service providers (N = 37) from across 5 PSH agencies in Los Angeles that provided either PB or SS services during the pandemic participated in focus groups. Discussions were recorded, transcribed, and analyzed using template analysis, grounded theory, and inductive techniques. Results. Providers identified four major differences between PB and SS services: (1) challenges in finding placements; (2) managing relationships with landlords/property managers; (3) frequency of contact; and (4) community integration. Advantages of PB included ease of finding units, ease of managing relationships with landlords/property managers, greater ability to serve clients efficiently, more frequent client contact, and more community among residents. SS was seen to provide tenants with more opportunities to grow, live in healthier environments, and develop independence. During the pandemic, finding units for SS clients became more difficult, while differences between PB and SS related to frequency of contact and community integration became more attenuated. Conclusions. PB can be advantageous for clients with higher levels of acuity, whereas SS could be more appropriate for clients who are more stable and independent. PB programs are seen to have practical and logistical advantages, but some providers prefer SS services. Clients and providers should be matched to PSH configurations that best match their needs and preferences, and providers should be aware that public health emergencies may impact PB and SS settings differently.

Clinical outcome of idiopathic juvenile ventricular arrhythmias in 25 dogs

Introduction/ObjectivesJuvenile ventricular arrhythmias in the absence of structural heart disease have been characterized in a small number of canine breeds with limited long-term follow up. The objective of this study was to describe the clinical outcome of dogs with JVA presenting to a university teaching hospital. Animals, materials, methodsTwenty five dogs, less than two years old with idiopathic ventricular arrhythmias were retrospectively identified via a medical record search. Young dogs with ventricular arrhythmias were excluded if they had structural heart disease, systemic illness, or an abnormal troponin (if performed). Electrocardiographic and Holter monitor data was evaluated for arrhythmia frequency and complexity at the time of diagnosis and over time. Long-term follow up was achieved through client and primary veterinarian contact. ResultsBreeds included German Shepherd (eight), Boxer (four), Great Dane (three), mixed breed (two) and one each of the following: Anatolian Shepherd, French Bulldog, golden retriever, Great Pyrenees, Labrador retriever, Shiloh Shepherd, miniature Poodle and Siberian Husky. The average age at diagnosis was 7.9 months (range, 2–22 months). The overall median survival was 10.96 years (range, 1.75–15.66 years). There was an average reduction in the number of ventricular beats by 86.7 % per year (P value −0.0257) based on Holter data. ConclusionIn most cases, idiopathic juvenile ventricular arrhythmias had a favorable long-term prognosis with reduced ectopy over time in this case series. Juvenile ventricular arrhythmias remains a diagnosis of exclusion but can be considered in a broader range of dog breeds than previously described.

Public health staff during the COVID-19 pandemic: a comparison of temporary and permanent staff

Abstract The COVID-19 pandemic posed an enormous challenge on the public health workforce, particularly the need for substantial numbers of temporary staff. Temporary staff may experience poorer working conditions compared to permanent staff. This study aimed to investigate differences in job demands and work functioning between temporary and permanent public health staff during the fourth wave of the COVID-19 pandemic in the Netherlands. This cross-sectional study included temporary (N = 194) and permanent (N = 98) public health staff from a municipal health service and an employment agency respectively. The participants completed a questionnaire with items about quantitative, cognitive, emotional demands (Copenhagen PsychoSOcial Questionnaire, COPSOQ) and work functioning (Work Role Functioning Questionnaire, WRFQ). Differences between temporary and permanent staff were investigated with linear regressions. To investigate differences between temporary staff performing testing, vaccination or client services and contact tracing, exploratory descriptive analyses were performed. Compared to permanent staff, temporary staff had better scores on quantitative (-26.51; 95% CI -30.64 to 22.38), cognitive (-24.31; 95% CI -28.86 to -19.76), emotional demands (-11.67; 95% CI -15.82 to -7.53) and work functioning (7.66; 95% CI 4.20 to 11.30). None of the task groups within temporary staff had consistently higher scores. Temporary staff had better scores on job demands and work functioning than permanent staff. The relatively better scores of temporary staff were not expected, but might be explained by a healthy worker effect and they may be less affected by poor working conditions due to short-term exposures. From a public health perspective, it is important to know how temporary staff experience working conditions when the public health workforce suddenly needs to increase. Our study encourages to not only focus on tasks within the public health system but also on working conditions. Key messages • To our knowledge this is the first study that compared the experienced working conditions of temporary and permanent public health staff during COVID-19. • Employing temporary staff appeared an adequate solution to strengthen the public health workforce during a pandemic, according to our result that temporary staff is not affected by working conditions.

Entrepreneurial skills training for online freelancing: Experimental evidence from Haiti

This paper presents the findings of a randomized pilot experiment in Haiti that aimed to improve online labor market outcomes by training workers in the entrepreneurial skills required to engage with online marketplaces. Despite relatively low completion rates, the program had significant positive impacts on online freelancing outcomes. Treated participants demonstrate increased activity in submitting online proposals and receiving client contacts, leading to improved online employment outcomes with more contracts signed. While the program shows no significant effects on broader labor market outcomes, we find evidence that it increases satisfaction, suggesting positive effects on well-being.

Coordination through HIE allows MH agency to maintain client contact

Real‐time data from the state of Connecticut's Health Information Exchange (HIE) is allowing a local mental health provider organization to maintain critical contact with clients whose health status in the community can rapidly change.

Psychologists and their self-mirror: therapy experiences via videoconferencing

ABSTRACT Objective Changes to psychological practice have arisen in recent times with the rise of services being offered online as an alternative to in-person meetings. Videoconferencing is the most widely utilised form of telehealth used by psychologists, and a unique consequence of videoconferencing is that psychologists can see a synchronous self-mirror image during online sessions with clients. Research is yet to investigate psychologists’ experience of the self-mirror in the context of their online work. Method Semi-structured interviews with 16 Australian psychologists were conducted to explore their experiences of the self-mirror during video-conferencing therapy treatment sessions with their clients. Thematic analysis of the interviews revealed several unique findings. Results Psychologists reported the presence of their self-mirror image during video conferencing sessions increased self-consciousness in relation to their appearance and presentation. Most reported the self-mirror to be largely distracting and disliked the presence of their own self-mirror image during online therapy sessions with clients. Some psychologists reported that the live time feedback was helpful and informative in modifying non-verbal expressions. Further challenges included uncertainty around client eye contact connection and vulnerability with client exposure to personal environments in the videoconferencing background. Conclusions It is recommended that psychologists regularly evaluate the impact of having their self-mirror view on during video-conferencing sessions with clients.

Effect of chaperone–client interaction strength on Hsp70-mediated protein folding

Protein folding in crowding cellular environment often relies on the assistance of various chaperones. Hsp70 is one of the most ubiquitous chaperones in cells. Previous studies showed that the chaperone–client interactions at the open state tend to remodel the protein folding energy landscape and direct the protein folding as a foldase. In this work, we further investigate how the chaperone–client interaction strength modulates the foldase function of Hsp70 by using molecular simulations. The results showed that the time of substrate folding (including the whole folding step and substrate release step) has a non-monotonic dependence on the interaction strength. With the increasing of the chaperone–client interaction strength, the folding time decreases first, and then increases. More detailed analysis showed that when the chaperone–client interaction is too strong, even small number of chaperones–client contacts can maintain the substrate bound with the chaperone. The sampling of the transient chaperones–client complex with sparse inter-molecule contacts makes the client protein have chance to access the misfolded state even it is bound with chaperone. The current results suggest that the interaction strength is an important factor controlling the Hsp70 chaperoning function.

The Influence of Information Systems on Tourist Arrival in the Gambia

This paper examines the new futures that develop because of using information systems in the Gambia's tourist and hospitality industries, focusing on the increase in visitor arrivals. Information systems have increased the number of tourists visiting The Gambia by promoting the country, providing information about its attractions and amenities, and making it easier to plan and book trips. This has enabled potential tourists to make well-informed decisions. The study uses the qualitative method with a review of the literature and primary data. According to the study, the functionality of information systems applications offers users data about hotels, travel information, and the allure of recreational products. The Gambia Tourism Authority (GTA) was established in 1982 to promote the Gambia as a tourist destination. It worked with tour operators to create holiday packages and relied on advertising and public relations to promote the Gambia. It participated in international travel fairs and exhibitions to showcase its attractions and culture and engaged in press releases and familiarization trips for travel writers. The Gambia's tourism industry has expanded its marketing efforts with information systems to include digital channels, such as internet websites and social media platforms, to promote the Gambia's natural beauty, cultural heritage, and hospitality. Personalization, localization, user-generated content, and integration can be used to attract tourists to the Gambia. Also, the information system aids in maintaining outstanding client contacts, fostering positive relationships, and ensuring longevity because of the new value chain. The global tourism industry has a complicated value chain, with IBTOs, OBTOs, and travel agencies responsible for overseeing how tourists interact with and experience each tourist site. E-commerce can both change an industry's structure and provide new business options, leading to the emergence of smart marketplaces.

Fundamental and Key Concerns of the Shared Use Vehicle System

Currently, a significant portion of Shared-Use Vehicle Systems (SUVS) providers make use of cutting-edge technologies (such as GPS monitoring, smartcard access and online reservation systems) to improve customer experiences. There is a growing need for interoperability between vehicle operators and suppliers of Shared-Use Vehicle Systems (SUVS) (e.g., smartcard accessibility across different car-sharing businesses) (i.e., transport fare collection via smartcards). Improved interoperability across systems is expected to increase customer satisfaction and adoption, which in turn will expand the market reach of such systems. In a similar perspective, we might expect to see some uniformity develop in areas such as vehicle interfaces, client contacts, and general operating procedures (for example, online reservation systems and insurance policies). However, the idea of SUVS is still in its infancy as a mobility option, therefore a comprehensive push toward standardization has not yet been implemented in the sector. In that case, the purpose of this research is to attempt to catalog a few of the key concerns that will be crucial to future interoperability conversations between SUVS and the establishment of industrial standards. This paper focuses on the fundamentals of operating an intelligent SUVS and details many of the concerns that have arisen throughout the formative stages of SUVS development.

Individual Resilience at the Heart of Work Design: Public Servants’ Job Satisfaction and Emotional Exhaustion in a Context of Adversity

This study examines individual resilience as a central mechanism between work design and work-related outcomes in a context characterized by high demands and acute or prolonged adversity: child and youth welfare during an ongoing pandemic. Expanding on a survey of 602 German professionals, structural equation modeling is applied to analyze (1) the relationship between work design and individual resilience, (2) the relationship between individual resilience and work-related outcomes, and (3) the role of individual resilience as a mediator. The results reveal positive relationships between two work design factors (social impact and feedback) and individual resilience. Other work design factors that have been much debated in the context of the pandemic (i.e., working from home and client contact) were not related to individual resilience. In turn, individual resilience is favorably related to job satisfaction and emotional exhaustion. The results also confirm the mediating role of individual resilience.

The Role of Oncology Massage in Pain Management

“Oncology Massage (OM) is the adaptation of massage techniques to safely nurture the body of someone affected by cancer or its treatments.” Society for Oncology Massage(S40M) Oncology Massage (OM) is recognized & practiced worldwide. Most noted benefits: reduced pain & anxiety. OM, Esthetician provided Skin Care (ESC) clinically show positive impact on side effects, QOL during cancer therapy, recovery, survivorship. Ability to customize, innovate, services are tailored to individual needs, making OM/ESC suited for Pain Management (PM) integration. Adaptations accomodate for short, long term, late treatment effects, medical devices, medications, radiation, surgery, low blood counts, blood clots, fatigue, bone pain, lymphedema, lymphedema risk from lymph node biopsy/surgery/radiation. Venues: Spa day retreats, infusion centers, hospital-based, in-home, in-office. Clinical research: massage increases natural killer cells, lymphocytes; reduces nausea, pain, fatigue; improves/promotes sleep, body image, greater sense of well-being; eases feelings of isolation. Practitioners remain current with medical advancements. OM trained therapists safely assess, deliver treatment within a clinical framework for those in/with cancer treatment history. Estheticians regularly provide massage applications as part of skin care, plus treating skin conditions. Therapists preserve, promote skins acid mantle through product choices, adjusting bodywork, pressure, stroke direction, to not burden an interrupted/damaged/compromised lymphatic system. Skin treatments soothe, replenish those in treatment; strengthen, restore for those well into recovery. Aromatherapy, acupressure can be incorporated. OM utilizes gentle touch: stationary weightless hand applications; light lotioning; gentle massage. Too vigorous/demanding massage can cause pain, trigger inflammation, damage tissue, cause/aggravate lymphedema or development of systemic side effects such as flu-like symptoms. Best practices: MD release; intake evaluation; informed consent; client contact follow-up, care team feedback. Informed, prepared, communicative therapists understand role, presence importance, provide space to share. OM can safely contribute to care/QOL of PM clients/patients of all ages.

Implementation process and challenges of index testing in Côte d'Ivoire from healthcare workers' perspectives.

A major limiting factor in combatting the HIV epidemic has been the identification of people living with HIV. Index testing programs were developed to face that challenge. Index testing is a focused HIV testing service approach in which family members and partners of people living with HIV are offered testing. Despite the implementation of index testing, there is still a gap between the estimated number of people living with HIV and those who know their status in Côte d'Ivoire. This study aimed to understand the implementation process of index testing in Côte d'Ivoire and to identify implementation challenges from healthcare workers perspectives. In January and February 2020, we conducted a qualitative study through 105 individual semi-structured interviews regarding index testing with clinical providers (physicians, nurses, and midwives) and non-clinical providers (community counselors and their supervisors) at 16 rural health facilities across four regions of Côte d'Ivoire. We asked questions regarding the index testing process, index client intake, contact tracing and testing, the challenges of implementation, and solicited recommendations on improving index testing in Côte d'Ivoire. The interviews revealed that index testing is implemented by non-clinical providers. Passive referral, by which the index client brought their contact to be tested, and providers referral, by which a healthcare worker reached out to the index client's contact, were the preferred contact tracing and testing strategies. There was not statistically significant difference between immediate and delayed notification. Reported challenges of index testing implementation included index cases refusing to give their partner's information or a partner refusing to be tested, fear of divorce, societal stigma, long distances, lack of appropriate training in index testing strategies, and lack of a private room for counseling. The recommendations given by providers to combat these was to reinforce HIV education among the population, to train healthcare workers on index testing strategies, and to improve infrastructure, transportation, and communication resources. The study showed that the elements that influenced the process of index testing in Côte d'Ivoire were multifactorial, including individual, interpersonal, health systems, and societal factors. Thus, a multi-faceted approach to overcoming challenges of index testing in Côte d'Ivoire is needed to improve the yield of index testing.

RELATIONSHIP BETWEEN COPING, TRAUMA, JOB DEMAND, JOB RESOURCES, AND BURNOUT FOR SOCIAL WORKERS DURING THE COVID-19 PANDEMIC

One of the primary concerns of not-for-profit organizations is the exceptionally high turnover rates due to employee burnout. During widespread health crises such as the novel Coronavirus 2019 (COVID-19), the demand for the general public to access not-for-profit services usually surges. In such cases, social workers must work around the clock under strict guidelines with no breaks to assist those who are experiencing various crises in their lives. The purpose of this quantitative multiple linear regression study was to investigate how social workers’ job demand and job resources during a pandemic, specifically during the COVID-19 pandemic, impacted their burnout experience working in not-for-profit organizations. The resulting data indicated a significant, negative linear relationship between COVID-19 coping ratings and burnout. As individuals increased their coping strategies, the average level of burnout decreased. Likewise, as individuals reported higher levels of self-efficacy and job autonomy, the average level of burnout dropped. There was also a positive linear relationship between COVID-19 trauma ratings and burnout. As individuals reported higher trauma, the average level of burnout also increased. Similarly, as individuals reported negative workload and negative client contact, the average level of burnout also increased.

A Data-Driven Response to the Addiction Crisis in Hamilton County, Ohio.

Context:For more than a decade, the state of Ohio has been an epicenter of the opioid crisis. Multiple interventions have been deployed to address this crisis and reduce opioid overdoses and overdose deaths in the state. The Hamilton County Addiction Response Coalition (HC ARC) and its strategic, countywide prearrest diversion (LEAD) and deflection (QRT) programs have been at the forefront of this effort in Cincinnati, Ohio. Operating since April 2018, these programs have continued to grow and improve and have been successful in connecting hundreds of citizens to needed treatment and other social services.Program:HC ARC combats overdoses and overdose deaths by utilizing cross-sector planning and collaboration to operate 2 countywide programs: Quick Response Team (QRT) and Law Enforcement Assisted Diversion (LEAD).Implementation:The QRT and LEAD programs leverage partnerships with law enforcement, public health, addiction and mental health services, reentry services, and trained peer supporters. The QRT emphasizes triage, assessment, and connection to appropriate services for people with recent nonfatal drug overdoses and provides outreach and education in hot spot communities. LEAD provides diversion from the criminal justice system into long-term case management for nonviolent individuals with low-level offenses who also struggle with substance use disorder, mental health, homelessness, and/or poverty.Evaluation:QRT and LEAD team members routinely track and record client contacts and outcomes using a centralized electronic case management platform. Data are extracted and analyzed by the evaluation team to examine indices of program success and provide ongoing feedback to the QRT and LEAD teams.Discussion:HC ARC has implemented, tested, expanded, and now standardized its prearrest diversion programming. It has built a sustainable model to improve health and health equity for marginalized individuals whose needs intersect across health care, public health, community-based social services, and the criminal-legal system. Collectively, this work offers a guide for implementation and best practices for the following: detailed planning, policy, and procedure development; identification of key leaders and community partners; and methods to evaluate program operations to make data-driven decisions and real-time program adjustments.