Table 2

List of initial contexts, mechanisms and outcomes gleaned from phase 1 data sources

ElementSocial-ecological model level
MicroMesoMacro
Contexts
  • Demographics (eg, HIV/AIDS status, Indigenous ethnicity, unstable housing, criminal justice involvement, low income, low education level)

  • Positive interactions with staff and peer mentors

  • Harm reduction philosophy

  • Patient-oriented approach

  • Focus on clients’ control over their health and end-of-life dignity

  • Holistic care plans

  • Non-judgmental environment

  • HIV-related stigma

  • Community partnerships

  • Funding

  • Geographic location of residence (near multiple resources)

Mechanisms
  • Comfort

  • Empowerment

  • Stability

  • Motivation

  • Self-efficacy

  • Self-worth

  • Belonging

  • Alleviation from chaotic lifestyle

  • Stress reduction

  • Safety

  • Independence

  • Feelings unsafe

  • Feeling isolated

  • Trusting relationships

  • Supportive relationships

  • Social integration

  • Alleviation from social inequity in the community

ElementOutcome level
Short-termIntermediate-termLong-term
Outcomes
  • Knowledge of safe injection drug use

  • Knowledge of wraparound support services

  • Knowledge of health treatments

  • Increased sense of belonging

  • Increased sense of safety

  • Practice safe injection drug use, thereby minimising risky behaviour

  • Confidence and empowerment to manage conditions, thereby improving autonomous self-care

  • Adherence to medical treatments, thereby improving medical indicators of health

  • Improved mental and physical health

  • Increased quality of life

  • Decrease in hospital readmissions and emergency room visits

  • Decrease cost burden on healthcare system