Meeting People Where They Are: Building Community-Centered Care with Smartphone-Facilitated Response to Overdoses

We conducted semi-structured interviews with 20 members who engaged in community-based effort to reverse overdoses using a smartphone-based app in an Eastern United States (U.S.) city. Drawing from feminist ethics of care, we identify how the caring practices of community members extend from administering a medical intervention to building trust and support between the care receivers and caregivers in the case of opioid overdose response. Contrary to the predominant patient-centered care paradigm, we emphasize community-centered care, which acknowledges the resistance of individuals and attends to reallocating caring responsibility and building relationships within the community. Our results highlight how trust intersects with social ecologies of care in the highly stigmatized context of opioid overdose and that trustful and less hierarchical relationships are critical sources of care for groups experiencing marginalization. We discuss applying harm reduction principles in designing health technologies for substance use disorders. We also discuss research and design opportunities for community-centered design for marginalized individuals and community caregivers.