To identify strategies community pharmacists utilized to support equitable vaccination in their communities. Qualitative, descriptive design. Key informant interviews were conducted virtually via teleconference using a mix of purposeful and snowball sampling of Pennsylvania community pharmacy personnel who participated in COVID-19 vaccination efforts. Interviews were conducted from March until August 2022 when thematic saturation was reached. A qualitative, inductive thematic data analysis was utilized to identify major themes and strategies that emerged from the data. Pharmacists utilized three philosophies: (1) prioritizing trust, (2) meeting people where they are at, and (3) building capacity within their teams and communities to create "safe spaces" for people to receive vaccinations. Nine discrete strategies used in practice exemplify how respondents implemented these philosophies: (1) Build Community Partnerships; (2) Establish Trust to Build Credibility; (3) Address Transportation Issues; (4) Provide Patient Education and Address Health Literacy Barriers; (5) Address Language Barriers; (6) Create a Safe and Accessible Space for Those with Individualized Needs; (7) Provide Patient-Centered and Culturally-Sensitive Care; (8) Train Staff on Health Equity and Patient Engagement; and (9) Advocate for Community Pharmacy Policy and Payment Reform. Definitions for these philosophies and key examples that illustrate how each strategy was employed in practice are provided. The findings highlight unique strategies respondent community-based pharmacy teams use to contribute to equitable vaccination efforts in communities and further emphasizes the importance of their role in public health initiatives.

Sexually transmitted infection (STI) surveillance showed more than 2.5 million cases of chlamydia, gonorrhea, and syphilis nationally in the United States in 2022. Individuals often seek out non-emergency medical care at pharmacies. This makes community pharmacies well-positioned to address rising STI rates by offering services to screen and treat common STIs. A local health department, an independent pharmacy, and a school of pharmacy in Pennsylvania partnered to implement a test-to-treat service for chlamydia and gonorrhea within a pharmacy. This pilot program utilized: (1) patient self-collected test kits for chlamydia and gonorrhea screening and; (2) standing orders for treatment at the pharmacy. One goal of this pilot was to develop resources others can use to implement similar pharmacy-based chlamydia and gonorrhea testing and treatment services. Develop an expert-informed implementation toolkit for a chlamydia and gonorrhea test-to-treat program at a community pharmacy. The "How to Build an Implementation Toolkit from Start to Finish" framework from the University of California at Berkeley was used to design the initial toolkit outline. Toolkit content was triangulated from three sources: (1) comprehensive literature review; (2) pilot program implementation team meetings; and (3) feedback from public health and other experts. Pilot program partners met regularly to review and edit the toolkit. The draft toolkit was then reviewed by outside experts and potential end-users . An 11-item toolkit was developed. Toolkit contents were reviewed by 11 outside experts and potential end-users. Toolkit resources included STI training resources for pharmacy teams, testing and treatment standing orders, pharmacy treatment screening form, marketing strategies, patient education materials, sample workflow, essential supply list, and other key resources. Pharmacies may need additional resources for STI testing and treatment program implementation. Toolkit resources developed from this pilot program may help pharmacies overcome implementation barriers for similar programs.

Context: The Centers for Disease Control and Prevention (CDC) and the US Postal Service (USPS) consider anthrax to be a potential threat to USPS workers. A county health department–owned pharmacy supports local USPS response in the event of an exposure. The pharmacy team identified the need to review and update the local anthrax response plan. Program/Policy: A Pharmacy Point-of-Dispensing Toolkit and response plan for initial 10-day post-exposure antibiotic prophylaxis was developed for use by a local health department in the event of a mass anthrax exposure at a US Post Office sorting facility. The pharmacist's role in medical countermeasures planning for anthrax exposure is also discussed to illustrate how pharmacists' medication expertise can be utilized. Evaluation: The CDC's Public Health Preparedness Capabilities: National Standards for State and Local Planning framework and inputs from an interprofessional stakeholder team were used to develop a Medical Countermeasures Response Plan and Implementation Toolkit for mass point-of-dispensing (POD) in the event of an anthrax exposure. Implementation and Dissemination: Stakeholders attended a USPS Community Partner Training event where additional revisions to the toolkit were made. The toolkit and standing order are now implemented at the local health department to be reviewed and updated on a yearly basis by health department leadership. Discussion: Pharmacists can use their medication expertise and experience with patient education to design emergency response plans focused on increasing patient safety and medication adherence. Pharmacists should be involved in emergency response and medical countermeasures planning that involve medications.

Opioid overdoses in the United States remain a significant public health concern. Opioid use disorder (OUD) is stigmatized, exacerbating negative health outcomes. Reducing stigma in healthcare, including in pharmacies, is critical. The “Let’s Talk Stigma” program was collaboratively developed with two schools of pharmacy, a local health department, and individuals with lived drug use experience. It aimed to reduce OUD-related stigma among pharmacists, pharmacy technicians, student pharmacists, and other allied health professionals. The program included six core components: a podcast, continuing education, a standardized curriculum for student pharmacists, training for pharmacy technicians and medical assistants, pharmacy outreach by student pharmacists, and partnerships with chain pharmacies. The anti-stigma podcast reached a global audience with nearly 22,000 listens, while local sessions engaged over 5000 individuals. These initiatives were integrated into Doctor of Pharmacy curricula, with student pharmacists distributing stigma-reduction kits in local pharmacies. A mixed-methods approach, incorporating qualitative data from participant reflections and quantitative data from surveys, podcast analytics, and attendance records, was used for program evaluation. Participants reported increased awareness of stigma, improved attitudes, and greater professional responsibility to reduce stigma. The program successfully leveraged partnerships, flexible delivery methods, and inclusion of people with lived drug use experience in its design.

Fentanyl test strips (FTS) are harm reduction (HR) tools that allow PWUD to check drug supplies for fentanyl. Pharmacies can be locations to access FTS services given their accessibility in communities; however, many pharmacy teams may not know how to provide this service. There is a need to better understand best practices for the implementation of FTS within pharmacies. The objective of this research was to identify strategies for implementing the provision of FTS in Pennsylvania community pharmacies. This was a pre-implementation, qualitative study. We conducted focus groups with pharmacy teams and HR experts. Participants were selected using a purposeful, mixed heterogeneity and snowball sampling strategy. The discussion guide was informed by the National Harm Reduction Coalition's Principles of Harm Reduction; (2) prior published barriers on HR in the pharmacies; and (3) the Consolidation Framework for Implementation Research (CFIR ) 2.0. Data was analyzed using an inductive thematic analysis and findings were returned to participants for member checking purposes. Seven pharmacy team members and seven HR experts participated in four focus group discussions. Seven strategies were identified: 1) Adopt HR principles in your pharmacy practice prior to FTS implementation; 2) Educate yourself, your pharmacy team, your patients, healthcare providers, and your community about FTS and HR; 3) Partner with organizations and providers to implement FTS and other HR services; 4) Normalize providing drug checking tools, like FTS, and other HR products and services in the pharmacy; 5) Build relationships with people who use drugs (PWUD) and their communities; 6) Offer other health and patient care services alongside providing FTS; and 7) Plan for FTS/HR service implementation and sustainability. Both pharmacists and HR experts supported FTS distribution through community pharmacies. Seven strategies emerged from focus group discussions that provide guidance on FTS service implementation within pharmacies.