Using RE-AIM to evaluate the implementation of a social marketing and free product distribution project for fentanyl and xylazine test strips in New York State.

Background: Drug test strips can be used to check for the presence of contaminants, such as fentanyl and xylazine in a person’s drug supply. In 2022, New York State began a media campaign and free drug test strip distribution effort throughout the state to raise awareness of adulterated drugs, help people who use drugs make safer choices, and ultimately prevent overdoses.

Methods: Utilizing the RE-AIM Framework, the objective of this study was to conduct a process evaluation of the implementation of this project and discuss lessons learned to help inform future distribution and media campaigns. The study team utilized operational, public health, and census data to identify specific trends to inform metrics for each construct of RE-AIM. A retrospective analysis was conducted using 22 months of operational data including logistical data and marketing information.

Results: The demand for test strips increased in association with the release of campaigns. The most populous counties in the State were not always associated with the highest concentration of demand. A correlation analysis between county overdose death rates and county orders for test strips indicated a weak positive association ( = 0.0014) which was statistically significant ( =.05). By the end of the 22-month analysis, all counties in the State had adopted the intervention and based on this success the program is now expanding to other methods of dispensation to reach more vulnerable populations.

Conclusions: Mass media campaigns with free product distribution can be effective public health promotion strategies, particularly in acute circumstances. Our evaluation demonstrates an implementation experience for public health practitioners considering similar efforts.