Sage Journals: Discover world-class research

Abstract

This article presents a comprehensive stakeholder analysis within the context of opioid overdose prevention in Boston, showcasing the development and application of an integrated framework designed to address the complex dynamics of the opioid crisis. Utilizing a modified Agency for Healthcare Research and Quality stakeholder analysis tool, this study categorized key stakeholders into four main groups: healthcare providers, law enforcement officers, health policy officials, and community leaders. Through in-depth, semistructured interviews with 15 stakeholders recruited from Boston's Mayor's Task Force for Opioid Remediation, we synthesized insights to map out strategic intelligence essential for policy formulation and enhanced stakeholder engagement. The analysis highlighted the necessity of multisector collaboration and identified critical leverage points that could influence future interventions. The findings underscored the potential of tailored interventions that consider the unique needs and contributions of different stakeholder groups, advocating for policy reforms that support comprehensive public health strategies. The integrated framework represents a proposed implementation model for Boston, demonstrating adaptability for other urban settings. The framework introduces innovative strategies for continuous improvement and adaptation, informed by stakeholder feedback. This research contributes to the field by demonstrating the effectiveness of stakeholder analysis in developing actionable and sustainable public health policies, providing a replicable model for other urban settings facing similar public health challenges.

Keywords

stakeholder analysis public health policy opioid overdose prevention multisector collaboration

Get full access to this article

View all access options for this article.

References

Agency for Healthcare Research and Quality . (2013). Tool 1B: Stakeholder Analysis. https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/pu7.html#TooloneB

Alonge

Sonkarlay

Gwaikolo

Fahim

Cooper

J. L.

Peters

D. H.

(2019). Understanding the role of community resilience in addressing the ebola virus disease epidemic in Liberia: A qualitative study (community resilience in Liberia). Global Health Action, 12(1), 1662682. https://doi.org/10.1080/16549716.2019.1662682

American Nurses Association . (2017, October 19). Opioid epidemic resources. Nursing World. https://www.nursingworld.org/practice-policy/work-environment/health-safety/opioid-epidemic/

American Public Health Association . (2022). An equitable response to the ongoing opioid crisis. APHA Policy Database. https://www.apha.org/policy-and-advocacy/public-health-policy-briefs/policy-database/2022/01/07/an-equitable-response-to-the-ongoing-opioid-crisis

Ashford

R. D.

Brown

A. M.

McDaniel

Neasbitt

Sobora

Riley

Weinstein

Laxton

Kunzelman

Kampman

Curtis

(2019). Responding to the opioid and overdose crisis with innovative services: The recovery community center office-based opioid treatment (RCC-OBOT) model. Addictive Behaviors, 98, 106031. https://doi.org/10.1016/j.addbeh.2019.106031

Blanco

Wiley

T. R. A.

Lloyd

J. J.

Lopez

M. F.

Volkow

N. D.

(2020). America’s opioid crisis: The need for an integrated public health approach. Translational Psychiatry, 10(1), 167. https://doi.org/10.1038/s41398-020-0847-1

Boloori

Arnetz

B. B.

Viens

Maiti

Arnetz

J. E.

(2020). Misalignment of stakeholder incentives in the opioid crisis. International Journal of Environmental Research and Public Health, 17(20), 1–19. https://doi.org/10.3390/ijerph17207535

Boston Public Health Commission . (2024). New data show 38% decline in opioid-related deaths in Boston in 2024, following national trend. Boston.gov. https://www.boston.gov/news/new-data-show-38-decline-opioid-related-deaths-boston-2024-following-national-trend

Brinkley-Rubinstein

Zaller

Martino

Cloud

D. H.

McCauley

Heise

Seal

(2018). Criminal justice continuum for opioid users at risk of overdose. Addictive Behaviors, 86, 104–110. https://doi.org/10.1016/j.addbeh.2018.02.024

10.

Center for American Progress . (2024). Tackling the opioid crisis requires a whole-of-government, society-wide approach. https://www.americanprogress.org/article/tackling-the-opioid-crisis-requires-a-whole-of-government-society-wide-approach/

11.

Chen

Wang

Nielsen

Kuhn

Lam

(2020). A systematic review of opioid overdose interventions delivered within emergency departments. Drug and Alcohol Dependence, 213, 108009. https://doi.org/10.1016/j.drugalcdep.2020.108009

12.

Choi

Rosenbloom

Stein

M. D.

Raifman

Clark

J. A.

(2022). Differential gateways, facilitators, and barriers to substance use disorder treatment for pregnant women and mothers: A scoping systematic review. Journal of Addiction Medicine, 16(3), e185–e196. https://doi.org/10.1097/ADM.0000000000000909

13.

Choudhury

M. H.

(2013). Teaching culture in EFL: Implications, challenges and strategies. IOSR Journal of Humanities and Social Science, 13(1), 20–24. https://doi.org/10.9790/0837-1312024

14.

Ciccarone

(2021). The rise of illicit fentanyls, stimulants and the fourth wave of the opioid overdose crisis. Current Opinion in Psychiatry, 34(4), 344–350. https://doi.org/10.1097/YCO.0000000000000717

15.

City of Boston . (2024, May 1). $1 million in grant funding available to prevent overdose deaths and expand treatment. Boston.gov. https://www.boston.gov/news/1-million-grant-funding-available-prevent-overdose-deaths-and-expand-treatment

16.

Drainoni

M.-L.

Knudsen

H. K.

Adams

Andrews-Higgins

S. A.

Auritt

Back

Barkowski

L. K.

Batty

E. J.

Behrooz

M. R.

Bell

Chen

Christopher

M.-C.

Coovert

Crable

E. L.

Dasgupta

Goetz

Goddard-Eckrich

Hartman

J. L.

Heffer

McAlearney

A. S.

(2022a). Community coalition and key stakeholder perceptions of the community opioid epidemic before an intensive community-level intervention. Journal of Substance Abuse Treatment, 138, 108731. https://doi.org/10.1016/j.jsat.2022.108731

17.

Forget

Patullo

Hill

Ambekar

Baldacchino

Cata

Chetty

Cox

F. J.

de Boer

H. D.

Dinwoodie

Dom

Eccleston

Fullen

Jutila

Knaggs

R. D.

Lavand’homme

Levy

Lobo

D. N.

Pogatzki-Zahn

Gilbert

(2022). System-level policies on appropriate opioid use, a multi-stakeholder consensus. BMC Health Services Research, 22(1), 329. https://doi.org/10.1186/s12913-022-07696-x

18.

Franco-Trigo

Fernandez-Llimos

Martínez-Martínez

Benrimoj

S. I.

Sabater-Hernández

(2020). Stakeholder analysis in health innovation planning processes: A systematic scoping review. Health Policy, 124(10), 1083–1099. https://doi.org/10.1016/j.healthpol.2020.06.012

19.

Fuhrmann-Berger

(2018). The economic impact of opioid addiction. Strategic HR Review .

20.

Ghertner

Groves

(2018). The opioid crisis and economic opportunity: Geographic and economic trends. ASPE Research Brief, 11, 1–22.

21.

Guest

Namey

Chen

(2020). A simple method to assess and report thematic saturation in qualitative research. PLoS One, 15(5), e0232076. https://doi.org/10.1371/journal.pone.0232076

22.

Handtke

Schilgen

Mösko

(2019). Culturally competent healthcare – A scoping review of strategies implemented in healthcare organizations and a model of culturally competent healthcare provision. PLoS One, 14(7), e0219971. https://doi.org/10.1371/journal.pone.0219971

23.

Hennink

Bailey

Hutter

(2020). Qualitative research methods. Sage Publications Ltd CN - H. http://digital.casalini.it/9781473944251

24.

Kivits

Sawang

(2021). Stakeholder analysis. In Kivits

Sawang

(Eds.), The dynamism of stakeholder engagement: A case study of the aviation industry (pp. 29–43). Springer International Publishing. https://doi.org/10.1007/978-3-030-70428-5_4

25.

Kolodny

Courtwright

D. T.

Hwang

C. S.

Kreiner

Eadie

J. L.

Clark

T. W.

Alexander

G. C.

(2015). The prescription opioid and heroin crisis: A public health approach to an epidemic of addiction. Annual Review of Public Health, 36, 559–574. https://doi.org/10.1146/annurev-publhealth-031914-122957

26.

Kyei

E. F.

Zhang

(2024). Exploring the link: Health insurance coverage and historical substance use patterns among U.S. adults-A NHANES-based analysis. Policy, Politics, & Nursing Practice, 25(2), 103–109. https://doi.org/10.1177/15271544241232588

27.

Levine

Fraser

(2018). Elements of a comprehensive public health response to the opioid crisis. Annals of Internal Medicine, 169(10), 712–715. https://doi.org/10.7326/M18-1757

28.

Massachusetts Department of Public Health . (2024). DPH report: Massachusetts opioid-related overdose deaths decreased 10 percent in 2023. Mass.gov. https://www.mass.gov/news/dph-report-massachusetts-opioid-related-overdose-deaths-decreased-10-percent-in-2023

29.

McGinty

E. E.

Daumit

G. L.

(2020). Integrating mental health and addiction treatment into general medical care: The role of policy. Psychiatric Services, 71(11), 1163–1169. https://doi.org/10.1176/appi.ps.202000183

30.

McGinty

E. E.

Stone

E. M.

Kennedy-Hendricks

Barry

C. L.

(2019). Stigmatizing language in news media coverage of the opioid epidemic: Implications for public health. Preventive Medicine, 124, 110–114. https://doi.org/10.1016/j.ypmed.2019.03.018

31.

Noyes

E. A.

Dunleavy

Mail

Plakas

Keyes

Gaeta

J. M.

Obando

Paci

Lent

Regis

Taveras

E. M.

Yule

A. M.

Chatterjee

(2022). Awareness, utilization, and preferences of harm reduction interventions among street-involved young adults in Boston. Substance Use & Misuse, 57(5), 827–832. https://doi.org/10.1080/10826084.2022.2040031

32.

Park

J. U. N.

Rouhani

Beletsky

L. E. O.

Vincent

Saloner

Sherman

S. G.

(2020). Situating the continuum of overdose risk in the social determinants of health: A new conceptual framework. The Milbank Quarterly, 98(3), 700–746. https://doi.org/10.1111/1468-0009.12470

33.

Pergolizzi

Magnusson

LeQuang

J. A. K.

Breve

(2021). Illicitly manufactured fentanyl entering the United States. Cureus, 13(8), e17496. https://doi.org/10.7759/cureus.17496

34.

Reinhart

Scarpati

L. M.

Kirson

N. Y.

Patton

Shak

Erensen

J. G.

(2018). The economic burden of abuse of prescription opioids: A systematic literature review from 2012 to 2017. Applied Health Economics and Health Policy, 16(5), 609–632. https://doi.org/10.1007/s40258-018-0402-x

35.

Richardson

Richard

Gunter

Cunningham

Hamer

Lockett

Wyeth

Stokes

Burke

Green

Cox

Derrett

(2020). A systematic scoping review of interventions to integrate physical and mental healthcare for people with serious mental illness and substance use disorders. Journal of Psychiatric Research, 128, 52–67. https://doi.org/10.1016/j.jpsychires.2020.05.021

36.

Rigg

K. K.

Nicholson

H. L.

(2019). Prescription opioid misuse among African-American adults: A rural-urban comparison of prevalence and risk. Drug and Alcohol Dependence, 197, 191–196. https://doi.org/10.1016/j.drugalcdep.2019.01.023

37.

Russell

G. E.

Fawcett

(2005). The conceptual model for nursing and health policy revisited. Policy, Politics, & Nursing Practice, 6(4), 319–326. https://doi.org/10.1177/1527154405283304

38.

Saloner

McGinty

E. E.

Beletsky

Bluthenthal

Beyrer

Botticelli

Sherman

S. G.

(2018). A public health strategy for the opioid crisis. Public Health Reports, 133(1_suppl), 24S–34S. https://doi.org/10.1177/0033354918793627

39.

Sorra

J. S.

Dyer

(2010). Multilevel psychometric properties of the AHRQ hospital survey on patient safety culture. BMC Health Services Research, 10(1), 199. https://doi.org/10.1186/1472-6963-10-199

40.

Testa

P. F.

Moffitt

S. L.

Schenk

(2020). Public preferences for new information on opioids. Journal of Health Politics, Policy and Law, 45(2), 311–339. https://doi.org/10.1215/03616878-8004898

41.

Walker

D. M.

Childerhose

J. E.

Chen

Coovert

Jackson

R. D.

Kurien

McAlearney

A. S.

Volney

Alford

D. P.

Bosak

Oyler

D. R.

Stinson

L. K.

Behrooz

Christopher

M.-C.

Drainoni

M.-L.

(2022). Exploring perspectives on changing opioid prescribing practices: A qualitative study of community stakeholders in the HEALing communities study. Drug and Alcohol Dependence, 233, 109342. https://doi.org/10.1016/j.drugalcdep.2022.109342

42.

Williams

A. R.

Nunes

E. V.

Bisaga

Levin

F. R.

Olfson

(2019). Development of a cascade of care for responding to the opioid epidemic. The American Journal of Drug and Alcohol Abuse, 45(1), 1–10. https://doi.org/10.1080/00952990.2018.1546862

43.

Villani

Davis

Fareed

Harris

D. R.

Huerta

T. R.

LaRochelle

M. R.

Miller

C. C.

Oga

E. A.

(2020). Community dashboards to support data-informed decision-making in the HEALing communities study. Drug and Alcohol Dependence, 217, 108331. https://doi.org/10.1016/j.drugalcdep.2020.108331

44.

Wutich

Beresford

Bernard

H. R.

(2024). Sample sizes for 10 types of qualitative data analysis: An integrative review, empirical guidance, and next steps. International Journal of Qualitative Methods, 23, 16094069241296206. https://doi.org/10.1177/16094069241296206

45.

Yatsco

A. J.

Garza

R. D.

Champagne-Langabeer

Langabeer

J. R.

(2020). Alternatives to arrest for illicit opioid use: A joint criminal justice and healthcare treatment collaboration. Substance Abuse: Research and Treatment, 14, 1178221820953390. https://doi.org/10.1177/1178221820953390

Navigating Complexities: A Comprehensive Stakeholder Analysis for Opioid Crisis Strategies in Boston

Abstract

Keywords

Get full access to this article

References