The PHAST Framework and Toolkit can help support jurisdictional efforts to improve and sustain multi-sector partnerships addressing the overdose crisis.
Drug overdose deaths have continued to rise in the United States. The number of overdose deaths increased by 30% from 2019 to 2020 and rose another 15% from 2020 to 2021. A majority of these cases have involved opioids, and recently, the number of cases involving psychostimulants, such as methamphetamine and cocaine, have also risen.
Many experts have suggested that addressing the overdose epidemic requires collaborative multi-sector partnerships between public health and public safety sectors. By coordinating local efforts, communities can bring together diverse perspectives and expertise and improve interventions for example, in harm reduction and linkage to care. In turn, they may be better positioned to leverage existing resources to enhance overdose prevention strategies.
To help jurisdictions better coordinate and share data among public health and public safety partners, the CDC Foundation and the Centers for Disease Control and Prevention (CDC) developed the Public Health and Safety Team (PHAST) Framework and Toolkit. The PHAST Framework, modeled after New York City’s RxStat, provides a broad structure to help partners develop a shared understanding of the local overdose crisis, optimize local capacity to prevent overdoses and monitor their collective progress.
The PHAST Pilot and Follow-up Assessment
To assess the utility of the PHAST Framework and Toolkit, we piloted the first version of the PHAST Toolkit in 2019 with the York Opioid Collaborative (YOC), a multi-sector organization in York County, Pennsylvania established in 2014 to reduce overdose deaths. During the six-month pilot, YOC leaders and partners completed several toolkit tasks and activities to promote multi-sector collaboration and coordination in their efforts to address the local overdose crisis.
In 2021, one year after the pilot concluded, we conducted a follow-up assessment to examine the extent to which the PHAST Framework and suggested strategies had been implemented, sustained or improved. From our interviews with seven YOC partners at the conclusion of the pilot and eight YOC partners during the follow-up assessment period, extensive document review and observation of YOC PHAST monthly meetings, we identified many positive and sustained changes to the YOC PHAST between 2019 and 2021. Specifically, we found that:
- Partner attendance and participation improved. The number of partners participating in YOC-PHAST monthly meetings increased during the pilot period and remained high at follow up. Notably, membership increased among treatment and recovery providers and became more consistent among law enforcement.
- Participating organizations implemented and sustained their existing structures and meetings. Changes to the design of the YOC that were initiated or fully implemented during the pilot were sustained at follow up. These included the launch of a new work group focused on overdose fatality case reviews, as well as administrative and organizational practices during monthly meetings to help improve participant engagement and accountability.
- Data and information-sharing practices improved. Between the pilot and follow up, we found that the YOC-PHAST successfully integrated new data sources into its monthly data reports and presentations. This information provided additional context, details and time trends that enabled more meaningful data interpretation and discussion during meetings. We also observed that changes to meeting agendas and facilitation created more opportunities for active participation in problem-solving and recommending areas for action based on shared data.
Findings from the YOC-PHAST pilot and follow up suggest that application of the PHAST Framework appeared to have contributed to positive and sustained changes to the YOC PHAST. This sheds light on the potential utility of the PHAST Framework and Toolkit, as well as other technical assistance resources, to help local jurisdictions establish more coordinated and sustained public health and public safety partnerships as they address the overdose crisis. The latest version of the PHAST Toolkit, along with additional tools, templates, videos and resources, will be available at www.phast.org in October 2022.
To learn more about the YOC PHAST pilot, read our paper in the Journal of Public Health Management and Practice:
