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Evaluation of the 'Going Over' Video A postal survey carried out by Exchange Campaigns
Introduction The video was commissioned because it is known that many of the people who die each year of drug overdose are seen during the period between taking the drugs and dying. Often people do things to try to help. However, through ignorance or fear that the police will be called the responses often fail to help and can further endanger life. The purpose of this video was to use an innovative approach to harness the desire to help and to turn it into simple lifesaving actions of putting someone in the recovery position and dialling 999 for an ambulance. The key aim is to reduce death from accidental overdose. Exchange worked with the London based media company 'Sledge,' to produce a high quality film aimed at educating people who may witness an overdose on how best to respond. The project was finished on time and within budget. The final phase of the project was to conduct a postal survey evaluation of services who had received the video, which was the first of its kind. This report details the responses to the evaluation questionnaire.
Executive Summary Responses such as: 'Excellent programme greatly assists in reducing OD events' 'The OD campaign has been successful in its message due to the way it was delivered' 'Well produced, straight to the point and factual' Are typical of the feedback given. Producing this information in a short video format also appears to have been highly successful allowing for flexibility of use in a variety of settings. Services reported that 'The video has been really useful not only for clients, but as a negotiating tool with the police to establish protocols for attending overdose scenes with para-medics', 'Good campaign material and video get the message over clearly.' A postal survey such as this cannot scientifically evaluate the impact that this video may have had on reducing drug related deaths however, alongside the accompanying written materials, it has triggered useful discussion that would not otherwise have taken place, and has already been shown to significant numbers of users. The feedback indicates that it has been, and will be, used to enhance training sessions for both users and staff, given the numbers of overdoses witnessed by injecting drug users this is bound to have had a significant impact on responses to overdose and in reducing drug related deaths. Overall, the evaluation gives powerful support from the drugs field for the Going Over video, and targeted campaigns.
Supporting material The briefing paper and comprehensive od booklet which cover all the key issues (including those not covered by the video such as cardio-pulmonary respiration, overdose myths etc.) and provide discussion topics for further use during training or other concentrated sessional work.
Dissemination and distribution of the video and supporting materials 10,000 copies of a CD version of the film and print materials, that allowed people to watch (and use) the film on their computers was manufactured for distribution direct to drug users through magazines such as 'Users Voice', 'Black Poppy', 'Mainliners' and the National Drug Users Development Agency mailing list and to drug workers and others in the field in 'Druglink' magazine.
Evaluation
The production In order to avoid the risk of stereotyping and alienating any section of the diverse community of drug users, a mix of gender, class, age and ethnicity was portrayed in the stories told. There was extensive consultation with drug users and service providers at every stage of production. The five minute video runs on a seamless loop so that people are encouraged to watch it a few times. During each five minute presentation, the 2 core messages of dialling 999 and putting someone in the recovery position are repeated a number of times. However, the stories also show the use of a range of drugs and different scenarios to portray different overdose risks. A range of secondary messages such as the dangers of poly-drug use and the loss of drug tolerance are also incorporated. Using scenarios and situations familiar to drug users, the video illustrates appropriate basic knowledge to enable viewers to act confidently and without fear during an overdose incident. Because the video uses 'real' stories in a short film format with a limited budget it was not possible to reflect all aspects of overdose. However, the most important cause of drug overdose i.e. poly drug use, is clearly highlighted throughout the film.
Evaluation responses
Q 1. Type of service Although the response rate was typical for a postal questionnaire of this kind, the fact that the respondents come from such a wide variety of settings gives us confidence that the findings can be generalised.
Q 2. Do you have a needle exchange?
Q 3. Did the video arrive undamaged?
Q 4. Have you watched the video?
Q 5. Do you think that the video is a useful tool for showing to drug users? This question was asked to guage the response of the field to the video - the response represents an almost unprecedented level of consensus within the drugs field!
Q 6. Have you shown it to users of your service? Only 32 to date had shown it to their users at the time they completed the questionnaire. However, as can be seen from the large number explanations given (all of which are set out in the appendix), this is largely because overdose is an issue which services are now taking seriously, and the delays were principally due to practical reasons and/or plans to use the video in a concerted way in the future. As anticipated, reasons also included not having a TV/video (or their equipment having been stolen and not replaced!). Many of these services had plans in hand to get a video or to show the video as training aid and at clients homes in the future' - which gives further scope for similar projects in the future. The vast majority of services who were sent it, plan to use the video. Other services are saving the video for use as part of future planned overdose campaigns or training sessions, 'Plan month long campaign during August, will show then,' 'This video will be incorporated and used with our planned programme,' and 'I am currently setting up a course for advice and info for OD and will be using the video' were typical responses.
Q 8. If you have used the video, in which settings have you shown it?
Q 9. Has feedback been positive, negative or mixed?
Q 10. What has been the typical response of clients to the video? typical comments included: 'good - realistic and very informative' 'good that they're real stories' 'message comes over well, settings are realistic' Several respondents commented that their users liked the facts that the film used actual overdose incidents and users voices.' Realistic user involvement - different from the normal health and education videos, excellent because it is the stories of users.' Participants are always very interested in resources that come from the users/ex users viewpoint.' Another positive in terms of the video facilitating drug services in delivering effective and powerful interventions were responses like 'particular issues came up from users including identification with the situations bringing out a lot of sadness and grief,' 'clients have related to scenes in the video and have wanted to share their own experiences,' 'related to the realness of the situations which triggered discussion on personal OD situations.' A number of comments centred on the issue of police attendance at od incidents and stated that the video reassured their users and stimulate a desire for greater knowledge. 'Relief at understanding that police do not usually attend od, greater confidence at dealing with similar events, increasing wish to learn more about od resus.' 'Staff feel it is positive and useful particularly the recovery position and myths about police being called.'
Q 11. Has the video been useful in triggering questions and discussion about overdose?
Q 12. How useful do you think the video is as an educational tool: not useful, useful or very useful?
Q 13. Do you think the 2 key messages in the video (dial 999/the recovery position) are clearly communicated? If not, why not? Given that these were in the light of the overwhelming majority thinking that the video was effective we think this vindicates the decision to have a fast moving video, and to have a number of themes to stop it being boring, and to make it worth watching a number of times.
Q 14. Is the video too short, too long or just right?
Q 15. How many clients from your service do you think have seen the video?
Q 16. Have you left the video playing on a loop in areas where it can be watched by service users? Other comments include, 'playing it on a loop in the waiting area meant that it was seen by many clients however, the drawback is the noise level.' Most services who weren't using it in this way preferred to use the film strategically as part of a targeted campaign or in group work. 'Worked well as a targeted month long campaign aimed at all service users in contact with our nx service.'
Q 17. Would you like to see other topics covered in future videos for service users? All those who responded to this question said they would like to see other subjects covered in future videos for service users.
Q 18. What topics would you like to see covered? 1. hepatitis C; 2. safer injecting; 3. prevention of initiation to injecting; and 4. sharing injecting equipment.
Q 19. Are there any other areas you would like us to develop campaign or other information materials for?
Finally, we gave respondents the opportunity to give One of the central feature of the film is the unusual 'chorus' sequence demonstrating the recovery position. This sequence was supervised by St John's Ambulance , and was filmed by getting a dancer to take himself out of the recovery position, in the correct sequence, and end up as an unconscious casualty, the film of this was then inserted into the video running backwards - resulting in a strange, jerky, puppet like effect. The sequence was intended to trigger discussion as well as clearly cover learning points for the position. Feedback on this aspect of the video was very positive: 'loved the repeats of the man in recovery position' 'eye catching and the repeated dance-like recovery position was very helpful and easy to remember' 'service users particularly liked the recovery position chorus' were a typical responses. An issue that did come up for some was the difficulty of understanding the different accents used in the video. 'The accents were difficult to understand,' 'takes a while to catch the dialogue,' 'Found we had to view the video a few times to understand what was said by the actors - probably just a dialect issue.' We dont' see this as an entirely negative response as it was our intention to produce an educational video that people would want to watch more than once. The music was also an issue that attracted mainly positive feedback: 'some staff found the music annoying, some found it catchy,' 'the music is too loud,' 'the soundtrack is excellent and works well with the diagram of the recovery position' were typical responses. Overall the additional feedback represents powerful support from the drugs field for running information campaigns, and is an important opportunity to improve drug services.
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