AppHealthCare

KATE sCan

Katie Dungan, Anna Fletcher, Emily Herman, Trey Thompson,

Caroline Westmoreland, and Casey Young

Campaign Book

COM 4318-101: Public Relations Campaigns, Department of Communication, Appalachian

State University
Dear Jennifer Schroeder and AppHealthCare,

The communication team behind this project, KATE sCan, has created a campaign plan that came

with the greatest enthusiasm. We were inspired by your care and attention for the opioid crisis in the

local area and were inspired by the excitement AppHealthCare showed toward Naloxone and the

progress toward obtaining a pharmaceutical distribution license.

In our campaign plan, you will see the results of in-depth research and the strategies inspired by our

interview data. KATE sCan conducted several interviews with residents of Watauga County from

which we have created content that will be the most effective in reaching the local population. Our

primary focus is on Naloxone and public awareness of the antidote in through social media.

We concluded that the best way for AppHealthCare to succeed in spreading awareness of Naloxone

is by utilizing the existing Facebook and by creating an Instagram. KATE sCan will provide the

essential strategies in our Campaign Plan section of the book.

Thank you for taking the time to read through our materials, and we hope that you will implement

these strategies and tactics to further your SaveALifeNC Campaign.

Kindly,

Caroline Westmoreland

KATE sCan Account Manager

katescan19@gmail.com

(336) 816 – 4830

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TABLE OF CONTENTS

I. CAMPAIGN PLAN & RESEARCH 3

Executive Summary 4
Situational Analysis 6
RESEARCH REPORT 15
Campaign Plan 26

II. TACTICS / COLLATERAL MATERIAL 36

Implementation Materials 37

III. Appendices 43

Research Instruments 43
Transcripts 48

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I. CAMPAIGN PLAN
& RESEARCH

3
Executive Summary
This campaign book combines all aspects of the #Knowloxone campaign extension, created

to work in conjunction for AppHealthCare based on their current ‘You can SAVE a Life’ campaign.

KATE sCan evaluated all aspects of AppHealthCare’s current campaign, conducted and analyzed

research, and formulated a campaign plan based on the target public of AppHealthCare: adult

residents of Watauga County.

Within the Situational Analysis, KATE sCan found that AppHealthCare was not using their

social media presence in the most effective way possible. Due to a lack of funding for anti-opioid

operations, it was determined that AppHealthCare cannot allocate resources to effectively publicize

their “Save a Life Campaign” on social media. The lack of publicity for the campaign hinders the

advancement of AppHealthCare’s mission concerning accessibility and health education. As an

information resource and service provider for residents of Watauga County, AppHealthCare is

unable to educate on the opioid overdose antidote Naloxone.

KATE sCan evaluated which publics would be the best to address for a campaign and

determined that AppHealthCare’s should address the residents of Watauga county. KATE sCan

created messages for residents of Watauga county within the research in order to find out what they

knew about Naloxone, AppHealthCare, and addiction

in general. All the research questions were based on

the idea of addiction and how AppHealthCare’s

message could be strengthened with further

knowledge of their public audience.

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 The research was used to construct a campaign plan for AppHealthCare to help further

develop their current ‘#SaveALifeNC’ campaign. After the research was analyzed, it was determined

that the goals of the campaign would be to have a more active social media presence and to be a

credible online resource. These goals are to be achieved through more consistent postings across all

social media platforms and to keep the website as up to date as possible with relevant information

for the target public.

To assist AppHealthCare in implementing these tactics, KATE sCan created a calendar and

budget. This include weekly posts on Facebook and Instagram with schedule updates, flyers and

other relevant information as determined by AppHealthCare. The budget includes detailed

information as to how AppHealthCare should spend money on social media advertisements,

printing, and video content creation for the AppHealthCare website and social media platforms.

With the goals laid out in detail in the above sections, KATE sCan believes AppHealthCare

will achieve its goal of spreading awareness about Naloxone by using all of the information gathered

for the sake of this campaign and implementing it alongside their current ‘You can SAVE a Life’

campaign. KATE sCan concludes that AppHealthCare can further its mission in the most effective

way by implementing the discussed strategies and tactics in this campaign book.

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Situational Analysis

PROBLEM STATEMENT

Due to a lack of funding for anti-opioid operations, AppHealthCare cannot allocate

resources to effectively publicize their “Save a Life Campaign” on social media. The lack of publicity

for the campaign hinders the advancement of AppHealthCare’s mission concerning accessibility and

health education. As an information resource and service provider for residents of Watauga County,

AppHealthCare is unable to educate on the opioid overdose antidote Naloxone.

INTERNAL FACTORS

As stated on their website, AppHealthCare’s mission is “to promote safe and healthy living,

prevent disease, and protect the environment.” They are dedicated to: providing accessible,

comprehensive, high quality, professional health care, and health education as well as access to

preventive services to all area residents regardless of social, cultural, religious or economic status.

Their vision is for everyone in Watauga, Avery, and Alleghany Counties to have access to quality

health care and access to their services and information. Their main values include efficiency,

fairness, excellence, integrity, quality, community, and good stewardship. AppHealthCare has five

main departments of care: clinical services, environmental health, nutrition services, community

services, and dental services (AppHealthCare, 2019).

AppHealthCare’s opioid campaign lies

within their branch of community service health.

According to Jennifer Schroeder, AppHealthCare’s

Quality of Preparedness Manager, the campaign has

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a budget of $20,000, with most of it being from federal funding, to allow them to reach their goal of

increasing awareness through successful marketing efforts and continue spreading the message for

as long as possible. They have also received a $100,000 grant from the North Carolina Department

of Health and Human Services to help fight opiate and substance abuse (Miller, 2018), separate from

the campaign.

EXTERNAL FACTORS

While AppHealthCare’s focus is on the local opioid crisis within Watauga County and

surrounding areas, there is still a need to pay attention to the statewide and nationwide opioid crisis.

There is competition from other healthcare providers, such as App Regional Healthcare, that can

take away from both their physical location and resources and digitally through their social media

presence and how they are able to reach the largest audience. While the opioid crisis is an extremely

important issue to be aware of, it’s still a challenge to fit in its importance within other health crises

around the area, such as sexual/reproductive health, tobacco use, or mental health.

Additionally, there are conflicts with law enforcement regarding the distribution of clean

needles to prevent communicable diseases as well as the action of providing medical supplies.

Without proper distribution permits, AppHealthCare cannot distribute Naloxone to the greater

community to have in case of an opioid overdose.

RELEVANT PUBLICS

Although AppHealthCare serves Ashe, Alleghany, and Watauga Counties, it was decided to

focus specifically on Watauga County’s opioid crisis and the ways in which AppHealthCare can

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develop their campaign to reach this specific audience. According to Jennifer Schroeder, most

residents of Watauga County are blue collar workers, and many of the opiate-related related

substances are prescribed to people of that working class for work-related injuries.

The North Carolina Department of Commerce stated that the median household income is

$48,417. Many of the residents in Watauga County work for private industries while the rest work

for the government, in utilities, retail, educational services, healthcare, and food services along with

many other areas (NCDA, 2019). According to the United States Census Bureau, there is an

estimated number of 55,121 people living in Watauga County as of July 1, 2017. Of the Watauga

population, 94.9 percent of people living in Watauga County are white while 1.9 percent are Black or

African American (United States Census Bureau, Race and Hispanic Origin). Additionally, 0.4

percent are American Indian and Alaska Native, and 1.6 percent are two or more races. The Asian

population consists of 1.2 percent in Watauga County. (United States Census Bureau, Race and

Hispanic Origin). With that, 4.1 percent of the people living in Watauga County speak a language

other than English while 98.3 percent are U.S. citizens (Watauga County, NC, Data USA, About).

This group is important to the overall campaign because it deals with the various publics that

live in Watauga County. This audience is also important because it is forever changing and

expanding through the college students who move up here for school at Appalachian State

University or Caldwell Community College. It is vital that we include this target audience in our

research because they can also affect the opioid crisis of Watauga County. Especially with so many

of the students moving in and out of Boone, North Carolina each year.

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S.W.O.T. ANALYSIS

Strengths

The campaign website (https://savealifenc.com/) is a strength for the company, primarily

because it is established, functional, and navigational. The existing Facebook page

(@AppHealthCare) is a strength as it is a social media platform that they are on and this has the

potential to allow Facebook users to receive updates on the campaign. Both the website and their

Facebook provide resources to gain information about what their campaign is trying to portray.

AppHealthCare also has the support of their stakeholders, which allows amnesty programs instead

of just getting arrested for possession of opioids. As well as having enthusiasm. Their staff is

educated and on-board with the continuous efforts of the campaign and everything else that

AppHealthCare offers.

● The campaign website - savealifenc.org

● Existing Facebook and website
● Existing online resources accessible to the general public
● Stakeholder support - other healthcare providers/practices, amnesty programs where
overdose witnesses aren’t issued a charge for drug possession or accessory if they call for
emergency medical response
● Enthusiasm (staff is educated and onboard)
● Limitation laws - doctors can’t prescribe it as often

Weaknesses

Some of AppHealthCare weaknesses involve the disorganization of the resources on the

website. This issue can largely be attributed to an overall lack of funding and, therefore, lack of

attention paid to online content production and website construction. It is also hurtful to their

campaign because they are not being consistent throughout the websites that they provide, as well as

social media outlets.

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 An additional weakness lies in the limitations of AppHealthCare’s licensing; the bureaucratic

red tape prevents AppHealthCare from being a distributor of Naloxone (as well as other

pharmaceutical products). Based on current social media activity trends from their Facebook trends,

one of their biggest weaknesses would be online awareness.

● Disorganization of resources on the website

● Lack of permit (stakeholder tensions) to distribute Naloxone
● Lack of funding/resources/ability (to distribute)
● Inconsistent branding
● Awareness - people don’t fully know what an opioid is, or which other common, illicit drugs
are opioids

Opportunities

Some of the opportunities that AppHealthCare has is, the fact that they already have some

media coverage over their campaign. Another opportunity would be to start up an internship

program. AppHealthCare can partner with the local university, Appalachian State, and take

advantage of the existing Communication Department’s resources and capable students. Student-

interns can commit their knowledge of communication strategies to the organization and can

volunteer their time to social media management. Proper management has the potential to reach

additional stakeholders and interact with the surrounding communities.

● Internship program - use students to manage the campaign/social media channels

● Additional/current stakeholder outreach - use stakeholder events as a platform to deliver the
message/be present in the community
● Weather opportunities - outdoor community events

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Threats

Some of the potential threats to AppHealthCare are competitors‒such as App Regional

Healthcare‒as well as the stigma of how people are getting addicted to opioids, that surrounds the

opioid crisis. There are the existing and permanent threats involving law enforcement which

prevents illegal distribution of Naloxone, needles, and other pharmaceuticals without a permit.

● Competitors - App Regional Healthcare etc.

● Social stigma
● Law enforcement
● Surrounded by areas who are also afflicted by the crisis - greater access

CURRENT SITUATION

Current Position

There is one major step that AppHealthCare has taken in advancing their campaign and that

is the ownership of a dedicated website: https://savealifenc.com/ This website functions as an

educational resource for people looking to learn more about naloxone, getting help, and about

opioid harm reduction. If one were to scroll down further, there are several videos embedded in the

page showcasing a variety of messages regarding opiates. This is the biggest and most significant

push that AppHealthCare has taken in their campaign.

Despite their intention to use social media to support their campaign, AppHealthCare has

not effectively published much content to their Facebook. Their most recent post (as of February 5,

2019) was the following:

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 https://bit.ly/2TGTCOL

The post is plain as it features no

images, has a wordy caption, and

has no other branding signifiers

referring to their “Save a Life

Campaign” explicitly. There is an

absence of branding, consistency,

and overall appeal for casual Facebook users to make any meaning or be attracted to following this

kind of content on social media.

Direction

Apart from their social media efforts, AppHealthCare is taking the necessary steps to

become an operational distributor of medicine and other supplies. In an interview with a

representative, it was explained that the organization is in the process of obtaining a distribution

permit and has already purchased Naloxone among other drugs to become a pharmacy.

Furthermore, AppHealthCare has several stakeholders already committed to their vision of reducing

the opioid epidemic in the community. For example, it was shared that the police have committed

themselves to an amnesty program wherein if someone witnesses an overdose and called for

emergency assistance, they will not be pressed with charges related to illicit drug possession.

KATE sCan concluded that there is a need for people to be informed of Naloxone

accessibility, the amnesty program, community events, relevant press releases, and more if there

were social media pages devoted exclusively to the “SaveALifeNC” campaign. AppHealthCare must

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focus on hiring qualified personnel required to manage their campaign and online presence. An

intern would be ideal.

In order to have success without funding there needs to be someone with the necessary skills

for social management who is willing to devote their time to the task without pay. Partnering with

Appalachian State University (among other local universities and colleges) would supply

AppHealthCare with the personnel they need to run a successful campaign with the allure of

receiving college credit for their efforts. The intern could create separate social media pages or

develop alternate social media accounts and tailor messages to each of the platforms to maximize

interaction with the local community. Other activities online could extend to creating events on their

online calendars to share with the community and developing additional educational/informational

materials for public access.

Potential Obstacles

As previously mentioned, the largest obstacle for AppHealthCare is its lack of funding and

inability to devote resources to managing social media and updating the campaign. Apart from the

campaign, the overall management of Facebook is unorganized and ill-suited to the platform. The

current methods are disorganized and have garnered little attention from the public. We suggest that

the Facebook page be updated with the following steps: the profile picture needs to feature humans,

perhaps wearing the logo but not the logo exclusively; the cover photo should be more related to the

organization and less of a glamor shot; the “About” section should include a brief description of

what AppHealthCare is and what it does; and there needs to be an increase in posting frequency.

The lack of resources that AppHealthCare can devote to the maintenance of their social media is

one of the major hindrances to social media success and therefore requires an official position

devoted to the online management of those channels.

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 To create a new position will take resources as is, however, the benefits will come

immediately once such a program is established. Another prevalent obstacle exists with the legal

licensing of the organization as a distributor of medicine and medical equipment. Once the license is

received, AppHealthCare can begin to distribute Naloxone and make the most significant headway

on their campaign: making the overdose antidote accessible. The desired result is to help increase

public awareness of the “#SaveALifeNC” campaign and the opioid overdose antidote Naloxone via

social media.

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RESEARCH REPORT

INTRODUCTION

The following report contains research conducted by KATE sCan in order to understand

more about the public's perception of addiction and the opioid crisis as a whole. KATE sCan

conducted multiple interviews with residents from Watauga County both over the phone and in-

person. All of the research questions were based around the idea of addiction and how

AppHealthCare’s message could be strengthened with further knowledge of their public audience.

Our research will be used to construct a campaign plan for AppHealthCare to help further develop

their current ‘You can SAVE a Life’ campaign.

RESEARCH PLAN

The purpose of this research is to inform researchers’ perspectives about addiction and

addicted populations, to gain a better understanding of desirable approaches to addiction-related

messaging directly from another addicted population, and to gauge common knowledge regarding

Naloxone and opiate-related health services. KATE sCan’s findings will be able to give

AppHealthCare information to how they can more successfully reach their target audience within

their opioid campaign in the most efficient way possible.

The research was centered around three primary

questions. The first: What resources do addicted

populations consult when looking for ways to overcome

their substance addiction? The second: What messages

do addicted populations want/need to see? Third: How

informed are people on opioids and Naloxone?

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 KATE sCan’s plan was to interview 12 individuals, who were either associated with a local

Alcohol Anonymous/Narcotics Anonymous chapter, or who had knowledge in the subject of

opioid/addiction-related problems in Watauga County, North Carolina. Once interviews were

completed and transcribed, they would be coded and analyzed to determine desired relevant message

tones and preferred message platforms.

METHODOLOGY

Overview

KATE sCan conducted interviews over the phone and in-person with volunteers from a

Watauga County Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) group, along with

other participants who have knowledge with opioid/addiction related issues. Quantitative responses

gathered in a survey will reflect demographic information, and qualitative data will be collected

through interview questions. The qualitative data acquired will inform us about individual

experiences related to substance addiction, relevant messaging that supports the confrontation of

addiction, and to determine the level of awareness about opioids and Naloxone.

Population

KATE sCan determined that interviewing local residents from and near Watauga County

would provide the most valuable insight since AppHealthCare is a regional provider. A total of 12

participants were contacted and interviewed, From the local AA support group, based in Watauga

County, and others who have experience or knowledge surrounding the opioid crisis or with

addiction in general. Gathering 12 participants allowed for the collection of diverse perspectives that

ultimately informed the campaign plan. Choosing to collect data from an addiction-afflicted group

provides a unique insight into substance abuse and the types of people affected. Interviewing opiate

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abusers, however, or those who use other illicit drugs would provide an ethical dilemma; therefore,

conducting research on a similarly affected group will still provide relevant insight despite a lack of

direct association with opioid use.

Sample(s) & Sampling Technique(s)

KATE sCan will sample from a population of 12 interviewees. The population will be a

convenience sample and is contingent on voluntary response. It is likely that recruiting participants

to personally speak with, either face-to-face or over the phone, will be most effective in reaching our

goal of 12 participants from Club 12 to interview for data collection.

Instrument

KATE sCan’s research will be based on data collection through in-person and over the

phone interviews. A hard copy demographic questionnaire will collect basic demographic data from

the participants. After collecting the questionnaire, KATE sCan will ask questions based on

addiction and knowledge of the opioid crisis. Responses will be recorded through note taking as well

as voice recording. The participants will remain anonymous throughout the process.

Data Collection Procedures

KATE sCan conducted interviews over the phone and in-person according to the

participant's request. There was a printed questionnaire with basic demographic questions where our

participants will record their responses as a survey. Interview questions were asked following the

demographic survey. The questions were asked verbally and recorded via voice recorder.

Interview Questions

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 1. What do you know about the opioid crisis?
2. What does the social stigma look like for addiction? How does it differ from opioid
addiction?
3. Have you heard about Naloxone? If so, what do you know? Do you know how to
administer it should it be needed? Do you believe people should carry it regularly?
4. What, if any, resources have you used to seek information about addiction? Have you
referenced AppHealthCare or Appalachian Regional Healthcare?
5. What kind of example/messages were beneficial to you?
6. Would you consider navigating a website or social media page to find information about
decreasing the likelihood of addiction?
7. Do you use or have access to social media on a regular basis? If so, then what platforms do
you prefer? (Facebook, Instagram, Twitter, etc.) Do you conduct research on those
platforms?

Data Analysis

Because the research is interview-based, KATE sCan transcribed and coded the responses to

analyze data after its collection. KATE sCan examined the experience of substance addiction,

personal testimony, and determined preferred messaging and platforms for relevant resource access

and general support. The replies will be analyzed around three central themes: perception of crisis,

Naloxone knowledge, resources preferences.

FINDINGS

KATE sCan had a total of 12 participants. All participants classified themselves as white.

Five identified as male, six identified as female, and one identified as nonbinary. Six of the

participants’ ages ranged from 23 to 29 while three others were between the ages of 18 to 22. The

other three were between the ages of 40 to 49, 50 to 59, or over the age of 60. There was a total of

six students, five currently employed, and one who is unemployed (as of March 2019). Most KATE

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sCan’s participants said that they brought in less than $10,000 a year or between $10,000 to $24,999

a year. Altogether, each participant had completed at least some college.

Perception of Crisis

According to KATE sCan’s interview results, most participants seem to know that the

opioid crisis is a major problem. Most participants felt that the opioid crisis had not necessarily been

discussed in detail even though it is described as a negative issue. KATE sCan’s participants said that

people generally think that those who are dealing with addiction live in poor communities. The

participants also believe that more and more people are being affected by addiction even though it

has a long history on both the local and national levels.

“I know that it’s a problem in America… I know that it’s mainly affecting the poor or
communities of color…” - Participant F

“All I know is that there seems to be an influx of opioid users in NC, I used to live in
Fayetteville, and it was heavily used there. Heroine is very popular from what I know.” -
Participant I

“I know that it’s apparently an epidemic, and I know a couple of people who have struggled
with it in significant ways. I know in this area it’s a big deal, and rurally is where it’s a bigger
problem.” - Participant J

Regarding the social stigma that surrounds addiction itself, KATE sCan found that there is a

lot of discrepancy between the responses given by each participant. Out of the 12 participants, five

said that there seems to be a bigger social stigma that surrounds people who are addicted to the use

of opioids. One participant even said that there is no “specific picture” of who an addict is or isn’t

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(Participant D, 2019). Other characteristics that categorize those addicted to opioids include socio-

economic status, unemployment, depression, homelessness, and even poor decision-making skills.

KATE sCan received these responses from their interviewees which best elaborate on the statement

above:

“I think people think addicts are all homeless, dirty, have no life plans, etc. People in our
society look down on people struggling with addictions.” - Participant B

“People with addiction are looked down upon. Society views it as you can’t bounce back, not
capable, “normal.” - Participant E

“I think that there are people who have never had an addiction and have not been affected
by it from family or friends. They don't understand why people get addicted. Or they're not
properly educated.” - Participant L

Naloxone Knowledge and Attitude

Three out of the 12 participants had never heard about Naloxone before. For those who had

heard of it, they said they either carry it on their person, had been around it at an access point, or

knew someone who knew how to use it and had access to it for work-related purposes. One

participant mentioned that Naloxone was readily available at a community peer support group they

worked at previously and that they were taught how to administer it through that job. The

participant also mentioned that they learned how to administer Naloxone prior to that job while

living in a sober living community (Participant A, 2019). Another participant stated that Club 12 has

Naloxone in their office (Participant D, 2019).

The participants offered mixed responses regarding the question of if ordinary people (non-

emergency or medical professionals) should carry Naloxone. Three participants said that people

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shouldn’t carry it unless it was necessary and another three said that yes, it should be accessible, and

that people should carry it. One person believes that Naloxone should be carried by health

professionals only mainly because it could be used as a fallback for those who are addicted. Here is

what Participant F had to say about Naloxone being a fallback option:

“I have a unique understanding of the opioid crisis because of my connection to it since my

brother and sister very much deal with these communities on a regular basis and a lot of
times what I hear from them is that there are people who want to carry Narcan to simply
shoot up and not die.” - Participant F

Resources

KATE sCan’s participants said that they mainly use Appalachian Regional Healthcare and

that they are not familiar with AppHealthCare’s services or opioid information. Out of the 12

participants, three said they had used Appalachian Regional Healthcare for basic medical treatment.

One interviewee commented on using Appalachian Regional Healthcare for a physical injury while a

second person used their services for mental health-related purposes. A third person used

Appalachian Regional Healthcare for addiction-related issues. Here is what one participant had to

say about the resources available from Appalachian Regional Healthcare:

“I’ve used mental health resources from App Regional, they’re absolutely amazing.” -
Participant J

When asked about the type of beneficial content for combating addiction, interviewees said

that videos, the Gospel (the Bible and religious concepts/ideas), meetings, publicly placed

advertisements, an Alcoholics Anonymous publication known as the Grapevine, news segments, and

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testimonials were the most helpful. They mentioned that information on how to contact

psychiatrists, as well as rehab centers, was important and that diversity within services and programs

would most definitely be beneficial. The participants also mentioned that facts about brain function

during addiction was beneficial to the overall knowledge everyone in terms of what one could be

going through when dealing with a personal addiction. Below you will find two responses from two

different participants of KATE sCan’s interview process.

“Knowing that you have a choice seemed like the most beneficial thing I learned. But for
those who are more fact-based, anywhere where you can get information on how your brain
works/doesn’t work during addiction is helpful, it was for me.” - Participant J

“I like the wide variety of types of meetings that were offered at Club 12. They had groups
for women or young people, or meditation or free-thinking. A lot of programs are based in
Christian organizations which can be kind of polarizing or less welcoming.” - Participant K

“I think it's horrible to see but you've probably seen it. Have you seen the video where the
parents were both passed out in the front seat? That's hard stuff to watch but I think that's
the most effective stuff because it's something that’s happening in real life and you're seeing
the effects. So sometimes I think that tough love approach is better than just a poster with
the opioid crisis. I think more of those real good visuals that make you think versus just
words on a poster.” - Participant L

From the volunteers, six of the 12 reported that they would consider navigating a website or

social media webpage to find information about decreasing the likelihood of addiction. The research

also indicated that two would use online web pages, depending on the situation, and three said they

would not use a website or social media page to find information about addiction because of privacy

concerns or just not being on social media in general. The data collected shows how participants do

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have access to social media on a regular basis even though two participants said that they aren’t

super active on their social media platform accounts. One person said that they weren’t on social

media at all but that they used to use Instagram and Facebook to keep in touch with other people or

to find events. Out of the various platforms that have been made available to the general public,

Facebook, Instagram, and Twitter were the preferred social media platforms for KATE sCan’s

participants.

INTERPRETATION

The data collected is indicative of current understandings of the opioid crisis. The lack of

understanding of the opioid crisis by the interviewees indicates a greater need for public information

or a delivery that is more easily understood. From the data gathered, there is a discrepancy

surrounding opioid use and addiction. Many of the interviewees expressed that they did not know

very much about the crisis. Participant B stated: “I know that it is a huge issue in our country;

however, I feel like the problem is sort of ‘hidden’ or pushed aside.” Participant C reflected: “I am

very aware of the opioid crisis, but I’m not informed about local statistics.” From either

perspective‒informed or uninformed‒there is a common theme of not quite understanding the

scope of the crisis with immediate relevance to the region or nation.

Misinformation can allow for stigmas to form, and the sample elaborated on their

perceptions of the stereotypes and assumptions of opiate-addicted communities. The overwhelming

impression of the stigma was best summarized by a statement from Participant F:

“Even though we do have programs for alcohol addiction and things like gambling
addictions, we still treat those in a very different manner--those are treated as ‘hey go get
help’ vs. opioids that are seen as very much a ‘suffer/die’ situation.”

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 Other descriptions included words such as: homeless, black, white, lower and middle class,

no social acceptance, no sympathy, illness, homeless, poor, and depressed. The overwhelming

negativity surrounding the stereotypes disallows any improvement, acceptance, or legitimate

acknowledgment of the addicted community as being “regular people” or deserving help or

healthcare. With a more informed public, the stigma can become less negative and less punishing for

addicted communities.

Greater understanding can come through online campaigns both on social media and

through a trusted website. Many responses from the participants indicated that when conducting

research, people tend to gravitate towards Google searches and referenced credible websites. Having

an updated website is essential for successful communication and education. Successful messages

were indicated by the volunteers as being videos, articles and journals, meeting times and places,

public ads or flyers, news segments, Alcohol’s Anonymous publications, and testimonials. The

content of those messages was suggested how to reach psychiatrists, information about rehab,

emphasizing an individual’s choice for getting clean/sober, facts and statistics about brain function

during addiction, and advertising a diversity of programming.

Limitations

There were limitations to our data particularly in determining our sample. Six of the 11

interviews were conducted as convenience samples where group members interviewed others they

knew personally. The other five were conducted from Club 12 members and are therefore limited as

they are not randomly selected and offered their interviews as volunteers.

Communication Program

● Appropriate target publics:

○ Watauga residents from all backgrounds; adult-focused

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● Communication channels:
○ Social media - Facebook, Instagram
○ Website - requires major reorganization or resources and web design for easier user
navigation
● Messages and themes:
○ Emphasizing individual’s choice to start getting clean
○ Diversity in program type (meetings for women, men, younger people, religious
support, etc.)
○ Welcoming, inviting, supportive (non-patronizing)
○ Naloxone accessibility
○ AppHealthCare as a resource/authority on the opioid crisis
● Goals:
○ To have a more active social media presence.
○ To be a credible online resource.
● Strategies:
○ Increase social media interactions
■ Monitor with Facebook/Instagram analytics for evaluation
○ Increase social media postings
○ Deliberate use/development of credible resources
■ Have a goal to create a new resource(s)‒especially videos‒with each grant
received related to the opioid crisis
○ Development of internship program to manage social media and create promotional
content
■ Measure success with social media analytics and event attendance
● Tactics:
○ Flyers in public spaces (restaurants, bars, community centers, bathrooms)
○ Facebook use to post events, credible article shares, statistics, videos, etc.
○ Use campaign hashtag (#SaveALifeNC) to promote savealifenc.com
○ Create a posting schedule for social media (bi-weekly posting)
○ Update website to be more comprehensive and easier to navigate

25
Campaign Plan

INTRODUCTION

The following contains KATE sCan’s campaign plan to bring awareness to Naloxone and

provide general information on what it is and how to administer it. Naloxone is a crucial part of the

“SaveALifeNC” campaign; therefore, it is the central theme of KATE sCan’s campaign plan.

Several tactics of the plan include: having an active social media presence on Facebook and

Instagram, posting up-to-date and relevant information, and encouraging the development of

educational materials to post on social media as well. Additionally, KATE sCan plans to help

establish AppHealthCare as a credible online resource. KATE sCan has created a budget for the

campaign as well as a calendar for social media postings to go by to improve and inform the public

more effectively.

TARGET PUBLIC

KATE sCan identifies the campaign’s target audience as anyone who wants to know more

about the problems and solutions surrounding opioid the opioid crisis. This public may include

those who may be friends, family members, or acquaintances with opioid users, or opioid users

themselves. Ultimately the goal is to focus on those who AppHealthCare caters to, which is Watauga

County and surrounding High Country areas. This group

of people would find it very useful to know more about

the topic, or how to administer Naloxone, since opioids

may be either directly or indirectly related to their lives.

26
 Education is the number one priority in the campaign. The more awareness and knowledge

AppHealthCare spreads, the better. Through social media, traditional media, and online website

efforts, three things that the general public is exposed to daily, KATE sCan plans to use visual and

statistical information to reach this audience in the most efficient way. With #SaveALifeNC, more

people will know about the risks, precautions, signs, and where to go if help is needed with anything

pertaining to the opioid crisis.

CAMPAIGN PLAN

Theme

“Knowloxone.” The main theme of this campaign is to bring awareness to Naloxone and

provide general information on what it is and how to administer it.

Key Messages

● Naloxone will be easily accessible once AppHealthCare receives its permit.

● Carrying Naloxone for family or friends could #SaveALife.
● Providing educational programming could make individuals more comfortable with
Naloxone and encourage them to learn more about it.
● Education is key in informing the public and changing their preconceived notions about the
opioid crisis.

GOALS, OBJECTIVES, STRATEGIES & TACTICS

Goal 1: To have a more active social media presence.

● Objective 1: Increase social media posting and activity

● Objective 2: Improve the overall quality and uniformity of posts to ensure a professional
look and voice for social media channels

27
 ● Strategy 1: Increase social media posts
● Strategy 2: Increase social media interactions (liking/following/tagging/responding)
○ Stewardship existing followers and partners with social media interactions (liking,
reposting, commenting)

● Tactic 1: Bi-weekly campaign posts to Facebook

● Tactic 2: Generate Instagram Business Account
● Tactic 3: Use of all social media to follow partners, support partners with re-posting and
tagging in relevant posts
● Tactic 4: Use of Facebook and Instagram posts and story functions to advertise events, post
videos, and share other visual content (pictures/videos)
● Tactic 5: Use of campaign hashtag #SaveALifeNC and other relevant hashtags
● Tactic 6: Generation of digital and printed flyers to educate on the opioid crisis, and include
additional information about savealifenc.com and AppHealthCare’s social media channels

● Objective 1 Evaluation: Short Term Evaluation (Weekly & Monthly)

○ Monitor weekly activity using Facebook and Instagram Analytics. All Facebook
pages have analytics, but Instagram has analytics only for “Business” accounts.
Analyze what posts bring in the most interactions from the follower base over the
month. Utilize that format most frequently in the future and continue with the
suggested pattern of posting in “Implementation” section.
○ Success will be determined if social media impressions increase.
○ Success will be determined with the inclusion of visual or video content in all social
media posts.

Goal 2: To be a credible online resource.

● Objective 1: Development of new materials, and making them publicly accessible

● Objective 2: Update savealifenc.com

28
 ● Strategy 1: Deliberate development of educational materials
● Strategy 2: Collaborate with existing partners to circulate new and existing materials
○ Stewards existing partners by sharing their hard work, celebrating/acknowledging,
and maintaining a relationship with online interaction and public, publicized, mutual
support

● Tactics
○ Update website to be more comprehensive, visually attractive, and easier to navigate
○ Use Facebook to post AppHealthCare resources, credible articles, statistics and
infographics, videos, and other educational content
○ Development of educational videos with subtitles (Recommended, once every grant
received.)
○ Contact partners on their existing material about relevant topics and redistribute
existing content
○ Contact partners about AppHealthCare’s existing and new content and encourage
additional circulation on partner platforms, websites, and circulations

● Objective 2 Evaluation: Short Term Evaluation (Weekly/Monthly)

○ Track the number of website “hits” in addition to Facebook and Instagram analytics.
Success will be determined by increased online activity in general on all online
AppHealthCare platforms.
○ Success will be determined by the incorporation of partner resources and interaction
with those resources on all platforms. Will also be determined in the other direction
with the inclusion of AppHealthCare resources on partner online platforms.

Rationale: Diffusion Innovation - Behavior Approach

KATE sCan based this plan on the diffusion innovation model with an emphasis on the

behavior approach. The model indicates that the transmitter of the message raises a need or

concern, packages the desired behavior as a credible solution, helps the receiver mentally rehearse

and adapt to the desired behavior, and provides a call to action. AppHealthCare will be able to

29
indicate a need for awareness about opioids, provide a solution for opioid overdoses with Naloxone,

and help concerned individuals understand how to administer Naloxone in the event of an

emergency overdose situation. AppHealthCare can also encourage that the recipients of the

messages are at least aware of where to access Naloxone or present itself as an organization with

information and expertise on the crisis.

The casual nature of social media platforms will make the information more approachable or

palatable to online users. As long as AppHealthCare presents the information in a manner that is

easy to receive and comprehend, and as long as AppHealthCare presents the need for Naloxone in a

convincing way, users may feel compelled to learn more or try to understand what Naloxone is and

the significance of it in their immediate, impacted community.

An example of the successful implementation of the diffusion innovation model revolving

around the opioid crisis happened in Wilkes County. The community was one of the most impacted

regions in the country with some of the highest heroin overdose rates. Wilkes County recognized

the need to support its addicted community and “made a community-based initiative to fight the

crisis using education for doctors and patients, support groups and other local projects, and with the

publicity and encouraging sentiment around” (Duong, 2018). The crisis indicated a need for change,

and with the help of the community, the county was able to catalyze change through their own shift

behavior and attitudes. The article reported that Wilkes County now has one of the lowest overdose

rates thanks to the united effort the county presented towards its own community.

IMPLEMENTATION

Timeline

In order to increase awareness about the opioid antidote, Naloxone, and expand individual

knowledge regarding the opioid crisis in general, KATE sCan suggests that AppHealthCare provide

30
relevant information about the issue on their social media platforms. With consistent updates

throughout the week on social media, there will be a significant surge in activity in addition to

information that will be readily accessible to interested publics. Awareness is contingent on

information accessibility; therefore, a social media information inundation is recommended

especially if the campaign website and hashtag, #SaveALifeNC, are included in the posts.

AppHealthCare should release these posts on Mondays, Tuesdays, and Thursdays to make sure all of

their followers, as well as others who come across their page, have access to information that will

educate them and in turn potentially help them save a life.

Facebook and Instagram were the most used social media platforms as indicated by KATE

sCan’s interview participants. KATE sCan believes that continuing the use of these platforms will

be beneficial in making sure people have access to information, know about the crisis itself, and

know what to do if they encounter someone who is overdosing on opioids. KATE sCan suggests

that AppHealthCare posts information about upcoming events as well as developments within the

organization on Mondays. Since AppHealthCare is actively working to obtain their pharmaceutical

distribution license, they should “celebrate” their incoming authorization with posts which highlight

their new status as well as the medications they will have on hand. Acknowledging the new service

will provide the opportunity for people to view AppHealthCare in a pharmaceutical service capacity

in addition to an educational and medical resource. This step is important in letting people know

that medications will be more readily available in the High Country and contribute to the credibility

of AppHealthCare as an organization.

On Tuesdays, AppHealthCare should only post updates to Facebook regarding relevant

articles and resources along with local partner updates and news. Even though events will be

discussed on Mondays, AppHealthCare will host classes on Naloxone in order to educate those

interested in knowing what it is and how to administer should it be needed in a crisis. These in-

31
person classes at AppHealthCare’s facility will be every second and fourth week of the month on

Wednesdays if the monthly timeline permits. On Thursdays, AppHealthCare should post updates on

Instagram that promote events other than the class on Naloxone. The posts on Instagram should

also include links to relevant information for the post that is being shared. The calendar below lays

out the suggestions made by KATE sCan.

May 2019

Week Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Types of 1 2 3 4 5
Posts for Instagram:
Facebook flyers &
and photos
regarding
Instagram
events, links
to more
information

6 7 8 9 10 11 12
Facebook Facebook: In-person Instagram:
and relevant class on flyers &
Instagram: articles and Naloxone photos
event resources, regarding
information local partner events, links
& updates & to more
developm- news information
ents within
AHC

13 14 15 16 17 18 19
Facebook Facebook: Instagram:
and relevant flyers &
Instagram: articles and photos
event resources, regarding
information local partner events, links
& updates & to more
developm- news information
ents within
AHC

20 21 22 23 24 25 26
Facebook Facebook: In-person Instagram:
and relevant class on flyers &
Instagram: articles and Naloxone photos
event resources & regarding
information local partner events, links
& updates & to more

32
 developmen news information
ts within
AHC

27 28 29 30 31
Facebook Facebook: Instagram:
and relevant flyers &
Instagram: articles and photos
event resources & regarding
information local partner events, links
& updates & to more
developmen news information
ts within
AHC

Budget

Although AppHealthCare has been given a $20,000 grant, KATE sCan has no proposed

budget distributing materials that promote what the campaign is; however, if AppHealthCare wanted

to develop materials to distribute to it key publics, KATE sCan suggests allocating $200 to printing

promotional materials. Additionally, KATE sCan suggests that AppHealthCare create videos based

around the content they wish to highlight during the execution of their campaign. KATE sCan has

determined that a total of $2,000 be designated towards the creation of video productions that will

promote new information and further explain what AppHealthCare has going on within their

organization. In accordance with KATE sCan’s research findings, the interviews, the continuance of

producing educational videos will further enhance the knowledge of those who struggle with or

know someone who currently deals with addiction.

In order to spread the word about the “You can SAVE a LIFE” campaign, KATE sCan

asserts that paying for advertisement on both Facebook and Instagram will aid in raising awareness

about the use of opioids and Naloxone. According to Blue Corona, advertising on Facebook costs

$7.19 per thousand impressions. With the remaining budget of $17,800, this would be very

manageable and AppHealthCare could initially pay for more if desired.

33
 For Instagram, cost per click ranges from $0.50 to $1.00 (Instagram Ads, 2019), and

depending on how many people AppHealthCare reaches through their Instagram account, the

overall price of advertising on this platform could also be easily managed. In the end, after creating a

budget for the multiple promotional content types, AppHealthCare still has around $17,000 to use if

monetary assistance is needed elsewhere.

CONCLUSION

The lack of financial backing for AppHealthCare’s anti-opioid operation “SaveALife”

campaign is lacking in online presence and activity. The lack of publicity hinders the progress of the

campaign and contributes to the growing opioid crisis throughout Watauga County. With the lack of

funding, AppHealthCare is unable to educate the public about the dangers of opioid addiction.

KATE sCan’s research was centered around three primary concerns: the resources addicted

populations consult when looking to research addiction and medical information, the messages local

populations prefer to see, and how informed people are about opioids and Naloxone in general.

Overall, KATE sCan had a total of 12 participants and according to the interview results, a majority

of the participants were aware that the opioid crisis is a major problem. Many participants felt that

the opioid crisis has not been discussed in detail even though it has been described as a negative

issue. Three out of the 12 participants had never heard about Naloxone before. The lack of

understanding surrounding the opioid crisis by the interviewees indicates a greater need for public

information and how it is delivered so it can be easily understood.

With the goals laid out in detail in the above sections, KATE sCan will achieve its goal of

spreading awareness about Naloxone through social media as well as become a more reliable online

resource. In order to increase AppHealthCare’s social media presence, KATE sCan’s propositions

include using several different strategies. Some of these tactics include posting multiple times a week

34
to Facebook, using Facebook and Instagram posts and story functions to advertise events, using

more visual and auditory content, as well as using hashtag promotion. In order to become a more

credible online source, KATE sCan suggests that AppHealthCare update their website to be more

visually attractive and easier to navigate. In addition, KATE sCan suggests that AppHealthCare link

their social media pages to their official website so viewers can be led to a place where they are able

to read credible articles, view statistics, find infographics and other informative content.

35
II. TACTICS / COLLATERAL
MATERIAL

36
Implementation Materials

DIGITAL/SOCIAL MEDIA – FACEBOOK AND INSTAGRAM

Below are examples of paid advertisements through Facebook and Instagram that

AppHealthCare could create along with their regular scheduled postings. While many social media

advertisements have a goal of getting more sales/money for a company, the objective this time is to

spread awareness and information, while also promoting services that AppHealthCare offers

pertaining to opioid-related issues, such as Naloxone administration/instruction demos. Through

this goal, KATE sCan suggests using eye-catching images/graphics, using one to three hashtags, and

a very short caption with a call to action to AppHealthCare’s social media pages or website. The

campaign theme, “Knowloxone” is presented in these examples, as well as attention-grabbing

content like statistics and images of pills.

Facebook Advertisements (Sidebar + Feed)

37
 Instagram Advertisements (Feed + Story)

*Note: “Swipe up” story feature for an external link is only available after obtaining 10,000
followers on Instagram, another option could be linking a feed post to a story post)

38
 Additionally, KATE sCan suggests doing maintenance on AppHealthCare’s social media

pages. Updating the online pages can strategically promote the campaign in the visual composition

of the pages. For example, below is AppHealthCare’s Facebook home page, where the profile

picture and cover photo can be seen. First and foremost, the current profile picture does not fit with

Facebook’s circle-shaped format. Removing the text in the photo and simply having the logo looks

more professional and well-kept. Second, for viewers to initially see the Knowloxone campaign

theme when they first click on AppHealthCare’s name, a cover photo emphasizing it and the

SaveALife hashtag would be beneficial.

39
TRADITIONAL MEDIA

While social media promotion for the campaign will reach a wider audience, traditional

media such as flyers and brochures are great for a local community, such as those in Watauga

County, to see a message. Below are examples of flyers that can be put up to promote

AppHealthCare events, such as demos of how to administer Naloxone. Linking social media at the

bottom of these flyers is another key factor for viewers to find out more information.

40
41
42
III. Appendices
Research Instruments

SURVEY INSTRUMENT

Demographic Questionnaire

1. What age group describes you?

a. 18-22
b. 23- 29
c. 30-39
d. 40-49
e. 50-59
f. 60+

2. What is your gender identity?

a. Male
b. Female
c. Nonbinary
d. Other

3. What is your occupation? (self-reported answer)

4. What is your annual income?

a. Less than $10,000
b. $10,000 to $24,999
c. $25,000 to $49,999
d. $50,000 to $74,999
e. $75,000 to $99,999
f. $100,000 to 149,999
g. $150,000 and greater

5. Which of these describes you?

a. Black or African American
b. American Indian and Alaska Native
c. Asian
d. Latin
e. Native Hawaiian or Pacific Islander

43
 f. White

6. What is your level of education?

a. Completed some high school
b. High school graduate
c. Completed some college
d. Associate degree
e. Bachelor's degree
f. Completed some postgraduate
g. Master's degree
h. Ph.D., law or medical degree
i. Other advanced degree beyond a master’s degree

INTERVIEW QUESTIONS

1. What do you know about the opioid crisis?

2. What does the social stigma look like for addiction? How does it differ from opioid
addiction?

3. Have you heard about Naloxone? If so, what do you know? Do you know how to
administer it should it be needed? Do you believe people should carry it regularly?

4. What, if any, online resources have you used to seek information about addiction? Have you
referenced AppHealthCare or Appalachian Regional Healthcare?

5. What kind of example/messages were beneficial to you?

6. Would you consider navigating a website or social media page to find information about
decreasing the likelihood of addiction?

7. Do you use or have access to social media on a regular basis? If so, then what platforms do
you prefer? (Facebook, Instagram, Twitter, etc.) Do you conduct research on those
platforms?

44
DEMOGRAPHIC QUESTIONNAIRE

1. What age group describes you?

a. 23-29
b. 18-22
c. 40-49
d. 50-59
e. 18-22
f. 23-29
g. 60+
h. 18-22
i. 23-29
j. 23-29
k. 23-29
l. 23-29

2. What is your gender identity?

a. Female
b. Female
c. Male
d. Female
e. Female
f. Male
g. Male
h. Male
i. Male
j. Nonbinary
k. Female
l. Female

3. What is your occupation?

a. Student, but used to work for community peer support group
b. Student
c. Currently unemployed but teaches guitar, background in retail, looking into school
(medical coding/ accounting)
d. Manages the office at Club 12
e. Student
f. Graduate student - graduate assistant
g. Self-employed woodworker.
h. Student
i. Retail

45
 j. Housekeeper
k. Graduate student
l. Athletic trainer

4. What is your annual income?

a. No income
b. Less than $10,000
c. Less than $10,000 alone but with spouse $50,000-$74,999
d. $10,000 to $24,999
e. Less than $10,000
f. Less than $10,000
g. $50,000 to $74,999
h. No income
i. $10,000-$24,000
j. $10,000-$24,000
k. $10,000-$24,000
l. $25,000-$49,999

5. What is your race/ethnicity? (aka which of these describes you?

a. White
b. White
c. White
d. White
e. White
f. White
g. White
h. White
i. White
j. White
k. White
l. White

6. What is your level of education?

a. Completed some college
b. Completed some college
c. Associate Degree
d. Master’s Degree
e. Bachelor’s Degree
f. Master’s degree
g. Completed some college
h. Completed some college

46
i. Associates Degree
j. Completed some college
k. Completed some postgraduate
l. Master’s degree

47
Transcripts

The information below is a complete collection of all the data KATE sCan acquired. In

order to better understand which answer belongs to who, KATE sCan has listed each participant’s

response under an ascribed letter. For instance, the letter A for each question will always be the

same person’s response to each question (letter A will always represent person A).

1. What do you know about the opioid crisis?

a. Knows the opioid crisis is really bad and intense. People are losing their life and the
crisis is controversial in terms of regulation and how pharmacists and doctors are
pushing it.
b. “I know that it is a huge issue in our country; however, I feel like the problem is sort
of ‘hidden’ or pushed aside.”
c. “ I am very aware about the opioid crisis, but I’m not informed about local
statistics.”
d. The opioid crisis is intense. A lot of people are addicted. My addiction was a while
back.
e. Hasn’t been super educated on it, doesn’t know many statistics or data.
f. “I know that it’s a problem in America… I know that it’s mainly affecting poor or
communities of color, and it also affects other communities, but they generally can
get access to ‘better’ opioids--like higher grade or whatever is the appropriate word
to use there. And I know it’s very prevalent in the communities that it’s in. Beyond
that, I’m not exactly sure.”
g. “I know that it began with the Civil War, after prescribing morphine. Pharmacies are
an aid in creating a situation where people have become and make it easier to
become addicted.”
h. “I know that this is an issue that people really do not pay much attention to.
Especially how addictive Opioids can be.”

48
 i. “All I know, is that there seems to be an influx of opioid users in NC, I used to live
in Fayetteville, and it was heavily used there. Heroine is very popular from what I
know.”
j. “I know that it’s apparently an epidemic, and I know a couple of people who have
struggled from it in significant ways. I know in this area it’s a big deal, and rurally is
where it’s a bigger problem. “Proper” Boone where it’s a bit more educated it’s okay,
but once you get to the outskirts, like towards Jefferson, maybe 20 minutes away,
that’s where it’s bad.”
k. “I’m actually in a master’s program that talks about opioids, so I have a bit of an
academic standpoints. When I got involved in recovery my perspective changed a lot
though. My experience is unrelated to opioids, but a lot of people in AA have
struggled with opioids. I heard that it’s hard to find recovery and that it’s really a big
problem. People with opioid addiction tend to gravitate to AA and I know several
people who struggle with that addiction. I know that AA is bigger than Narcotics
Anonymous which is why there are so many in AA.”
l. It's definitely an issue. So. I've seen it. Through you know with all the knee surgeries
that I've had. You're warned about it. From day one. And then working here. We
have to warn our patients about it. And also working as an EMT. You're trained in
how to fix it. Basically, or try to fix it. Oh really. Yes, of Narcan our kids the big
thing these days.

2. What does the social stigma look like for addiction? How does it differ from opioid
addiction?
a. Nuanced, a lot of factors (race, socio-economic status), majority is white people in
the middle-class, it’s important for lives to be valued, there’s more stigma toward
opioids which is scary
b. “I think people think addicts are all homeless, dirty, have no life plans, etc. People in
our society look down on people struggling with addictions. When I think of people
addicted to opioids, I see them as people with good life goals but are dealing with
their unresolved issues or traumatic events that led them to become addicts.”

49
c. Summary: “People who made bad decisions and no longer feel worthy of societal
acceptance, in jail, two-sided. People have sympathy because addiction came out of
an illness or you must be an addict because you had it coming.”
d. “I don’t think it’s obvious whose an addict and who is not. I don’t think there’s a
specific picture. I feel that opioid addiction has more stigma as in the “junkie on the
street, opiates create more pain the longer you take it, Catch 22, and it’s now more
potent. I probably wouldn’t have made it back then if it were like it is today.”
e. People with addiction are looked down upon. Society views it as you can’t bounce
back, not capable, “normal”. In terms of opioid specifically, unsure.
f. “Social stigmas around addiction, I think, can really vary. Whenever you look at
communities that have addictions to cigarettes or to alcohol, I think that they’re
usually seen as more appropriate addictions than something like opioids. Even
though we do have programs for alcohol addiction and things like gambling
addictions, we still treat those in a very different manner--those are treated as ‘hey go
get help’ vs. opioids that are seen as very much a ‘suffer/die’ situation, and that’s not
great. I think that’s the biggest difference that we see is that certain addictions are
seen as more appropriate than others in terms of health and social activities and
things like that.”
g. “Addiction across the board carries a different stigma. At this point, it has a large
stigma. Government is creating a social addiction and this on a scale would be about
a 1-9”
h. “I personally do not know much about the social stigma dealing with opioids. I
assume that they carry a pretty large one though and the people that have an
addiction are look at as being bad”
i. “I think addiction is addiction no matter what you’re addicted to. There’s always a
social stigma for any addiction, maybe they’re depressed, poor, uneducated, weak
willed.
j. “Personally, having experience within these communities, I would say that we come
from all sorts of backgrounds. You know, now that I’m in it, I don’t necessarily
judge like that anymore. But maybe before, I would have said accents, property, state
of living situation, not taking care of yourself, and unreliability would be your
indicators, in my experience.”

50
 k. “People who are not affected think it’s only low-income people or think that people
who use are homeless or can’t hold don’t a job--they don’t think that it can affect
anyone or any demographic. In my academic class, people who have no relation have
a terrible idea of addiction and think that it’s their fault that they’re addicted or that
they have no willpower to stop on their own. I’m glad that Narcan is legal and I wish
that more people had it, but there have been things said in my class like that people
that that if people have Narcan then they’ll use more. The academic conversation
and stigma are more problematic because they don’t know how close addiction is to
them or how prevalent it is an any demographic.”
l. “Yeah. I mean unfortunate I think that there is that. People. Who have never had an
addiction are not been affected by it either from family or friends that they don't
understand why people get addicted? Or they're not properly educated. So therefore,
I think that there's a negative. Stigma. Yeah. Well.” “It's sad really. Yeah. For sure
and you're right it's. That. And now they've made a law in North Carolina that you
can. It's like if you have surgery, they only give you a seven-day supply of. Opioids.
And trying. To help with the crisis. Says used to be before that you could basically
get as many as you wanted and now, they only give you a seven-day supply and then
you have to try to get more kind of thing.” “You had to have like a prescription from
a nurse.”

3. Have you heard about Naloxone? If so, what do you know? Do you know how to
administer it should it be needed? Do you believe people should carry it regularly?
a. Yes, there was Naloxone at the peer center, knows how to use and learned how to
use it at two different places (Sober Living Community and Community Peer
Support Group)
b. No
c. “Yes, I carry the nasal spray myself.”
d. Yes, Club 12 has it in the office. People should carry it if they personally feel it’s
necessary, but they should use good judgment before actually administering it.
e. “ No. No. Yes, if it is important.”
f. "Yes, I have, I think? Narcan? Yeah! My brother and sister are firefighters so …” ...
“I think it’s a shot or a nasal spray or something.”... “I think health professionals

51
 should. I have a unique understanding of the opioid crisis because of my connection
to it since my brother and sister very much deal with these communities on a regular
basis and a lot of times what I hear from them is that there are people who want to
carry Narcan to simply shoot up and not die. Because they also hold very different
values than I do‒I think it is a situation that, kind of like teachers carrying guns,
deserves a lot more attention and a lot more study on what’s appropriate, what’s not
appropriate and things like that. Because you will have people‒even if it’s not their
intent‒they’ll use it as a fallback subconsciously. They’ll say like ‘Oh, I have Narcan,
I’ll be fine’. And that’s not the idea we should go into any addiction with. It should
be ‘I have a fallback so I won’t die’ but I think that those people with those kinds of
opioid addictions should be seeking help in some way because there’s a reason that
it’s called an addiction‒it’s not healthy for you, and you need to address that issue
before it comes to the point that you’ll be needing Narcan.”
g. “Yes, substitute for those that are addicted it is a way to have those who are
addicted use this when an overdose is happening. No, I would not know how to
administer Naloxone. No, I do not believe that people should carry it. That would be
like people carrying around a heart palpitation machine.”
h. “Yes, I have. It is a way that you can stop an overdose. No, I would not know how
to administer it. If it were something necessary to have on you at all times, then yes I
would.”
i. “I have no idea what it is.”
j. “No, I don’t know what that is, but now that I do, I don’t think it’d be necessary to
carry that with you at all times.”
k. “Yeah, I know about Narcan. I don’t know how to use it, but at past work places
there have been workshops on how to administer it.” ... “Before recovery, I thought
that I wouldn’t encounter opioid addiction, but in the past year I’ve learned how
addiction can affect everyone. A lot of people think that they won’t encounter it. I
don’t think that Narcan should be restricted because people don’t know who are
affected. Opioid addiction shouldn’t be a secret topic and it shouldn't be removed
from conversation, some people are just so objective and cold about it and say, like,
‘those people’ but really Narcan should be accessible everywhere because you really
just don’t know who is addicted or who can overdose.”

52
 l. “I do. That's a tough question. There's a documentary on Netflix. It's called hero.
And it's about the Oprah addresses. You watch it. But basically, it talks about. People
how they are basically handing out. The. Narcan. And I think. It's almost becoming
like a scapegoat. For the people who are. Like they know that they have it in their
pocket. They could just pull it out. So, on the fence about it I haven't decided if I'm
one way or another. Because it's. I guess until you're in that situation it would be
hard to make a decision. But just being in the medical field I don't think I fully
support it.

4. What, if any, resources have you used to seek information about addiction? Have you
referenced AppHealthCare or Appalachian Regional Healthcare?
a. Has not used AppHealthCare or Appalachian Regional Healthcare to find resources
with information about addiction, can’t think of any resources used specifically
b. None
c. I’ve never used either, but I try to look for accredited/ verifiable information online
because there’s more information out there now than there used to be for our area. I
get most of my information from other addicts because I don’t read as much as I
should about it.”
d. “I have not referenced either. Most of my knowledge came from Club 12.”
e. No. Has never referenced anything of the sort.
f. “Not really. Because it’s something I’ve never really struggled with, so I’ve never
really felt the need to research” … “I’ve used App Regional Healthcare, but it was
for a physical injury.”
g. “ AA websites, Area 51 website, the North Carolina chapter. No, I have never visited
AppHealthCare or Appalachian Regional in relation to addiction.”
h. “No, I have not.”
i. “Because I’m not addicted, I haven’t done any research myself, but I just know
common knowledge from word of mouth and common sense. I don’t go seeking for
the information because it’s not relevant to my life, but I have friends that probably
do.”
j. “Podcasts are awesome, I have a manual labor job, so I tend to put on those and
sometimes they’re on those topics. AA websites are good too, and also just general

53
 research, any sort of database, personal reading, academic learning. Not anything
with AppHealthCare, but I’ve used mental health resources from App Regional,
they’re absolutely amazing.”
k. “Yeah, before recovery I looked up ‘how to get sober without a program’. Then I
googled ‘Boone AA’ and Club 12 came up which was so awesome. Another good
way to get resources is just traveling and showing up places for yourself to really get
to know what they have. Honestly, you’re not gonna google something unless you’re
trying to get clean or sober, so you really just have to search it and you’ll find
resources.”... “Oh, yeah I’ve used App Regional Healthcare before to see what they
had on alcohol addiction.”
l. “I don’t really need to look up that stuff, since I’m in the medical field and I’m
always educated on this subject

5. What kind of example/messages were beneficial to you?

a. Videos are great
b. The Gospel (Bible) is pretty helpful.
c. “ I personally look at news-outlet-based articles, specifically New England Journal. I
don’t watch too many videos about it.”
d. “I personally like 12 Step meetings because my recovery took a long time. People
who push you in the direction of doing something about your addiction is also very
helpful.”
e. Remembers seeing ads about healthcare and personal issues posted places, uses
example of back of bathroom stall.
f. “Not that I really know of. I was there for a sprained ankle, so it wasn’t so much of
a ‘resources’ thing.”
g. “AA’s website has a publication called The Grapevine, you can reference this and
read different stories.”
h. “Seeing things on the news and hearing people's stories would be beneficial”
i. “Messages about how to reach out to rehab or psychiatrists would be helpful.”
j. “Knowing that you have a choice seemed like the most beneficial thing I learned.
But for those who are more fact based, anywhere where you can get information on
how your brain works/doesn’t work during addiction is helpful, it was for me.”

54
 k. “I like the wide variety of types of meetings that were offered at Club 12. They had
groups for women or young people, or meditation or free-thinking. A lot of
programs are based in Christian organizations which can be kind of polarizing or less
welcoming. We’re lucky in Boone because there’s more diversity so it’s easier to feel
like you’ll be accepted somewhere, but in more rural areas I don’t think there’s that
much diversity even just in the types of programs.”
l. I think it's horrible to say but you've probably seen it. Have you seen the video where
the parents were both passed out in the front seat? Yeah. Yes. I mean yes. That's
hard stuff to watch but I think that's the most effective stuff because it's if you're
wanted something in real life it's happening and you're seeing the effects. So
sometimes I think that tough love approach. Is better than just. A poster with.
Opioid crisis. Yeah. I think more of those real. Good visual that makes you think.
Versus just words on a poster where it's on a poster.

6. Would you consider navigating a website or social media page to find information about
decreasing the likelihood of addiction?
a. Would maybe peruse because individual addiction is currently under control and is
aware of personal schedule
b. Yes
c. Sure
d. Yes
e. Yes.
f. “Probably not. I don’t tend to trust social media in terms of actual information. If it’s
someone sharing an actual article then sure, but I don’t go to Facebook to look up
the news or something… If I wanted to do research, I’d look for a website.”
g. Yes.
h. Yes.
i. “No, if I was trying to decrease an addiction of mine, I would go to a doctor or
professional person.”
j. “It depends on what stage of recovery you’re in honestly. But for me personally,
probably not.”

55
 k. “I’m not on Facebook, and I know that there are a lot of recovery group pages that
are, like, secret or hidden or whatever. I would worry about that because of privacy,
so I’ll stick to the meetings, but I think social media is a great way to connect and
find a little more support. I’m not it and I wouldn’t use it personally, though.”
l. Yes

7. Do you use or have access to social media on a regular basis? If so, then what platforms do
you prefer? (Facebook, Instagram, Twitter, etc.) Do you conduct research on those
platforms?
a. Not super active but uses Facebook the most, has an Instagram but doesn’t use it
often, no research conducted
b. I prefer Instagram and Facebook, but I do not conduct research on them.
c. I am pretty much limited to Facebook. I can’t remember the last time I checked my
Twitter account and I’m not on Snapchat or Instagram. I don’t conduct a lot of
research on Facebook but I’m open to the idea of it.”
d. Yes, Facebook mostly and Twitter occasionally but I have not done research on
them.
e. Yes. Prefers Instagram and snapchat. Has not done research on them.
f. Yes: Facebook, Twitter, Instagram, YouTube, Tumblr, Snapchat, Reddit (“first place
to go for new information”) - “I will say, Reddit is a great place to be finding out
about some upcoming social topics because it’s a different area that you can look
into and find information on a bunch of stuff.”
g. Yes, Facebook. No research conducted on these platforms.
h. “Yes, I prefer using Twitter. However, I do check all of the other platforms.
Instagram, Facebook occasionally.”
i. “Yes, Facebook & Instagram, but I don’t use it for research. I’m not trying to get
my facts from a Facebook page, too much fake news.”
j. “I use Facebook when I feel like it, but not for research. I really like Reddit though;
I always go on there. I have friends who use Instagram to post sort of reminders of
how well they’re doing, like how long they’ve been sober or something.”
k. “I have no social media, but I used to use Instagram and Facebook. I liked
Facebook just as a way to keep in touch with people from home or to find events.”

56
l. “Yep. I have Facebook. Discouraged. I use it when I get off the clock. Come on off
the clock. You know use it while you drive. You know. OK. So that's pretty much it

57
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AppHealthCare (2019, January 28). AppHealthCare Client Visit. Lecture presented at

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AppHealthCare (2019, February 5). Overdose Response in Watauga County [Web log post].
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Duong, Y. (2018, June 12). These 4 Nc Counties, Including One Near the Triangle, Saw
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costs

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