Reviewer’s report
Title: 
Women’s multiple uses of an overdose prevention technology to mitigate
risks and harms within a supportive housing environment: A qualitative study
Version: 
0 
Date: 
14 Jan 2021
Reviewer's report:
This is a useful analysis of an overdose prevention tool and its uptake by women
who use drugs in a supportive housing environment. The topic is very relevant to
the journal's mandate. The writing is clear and concise, and the research design is
well-justified. The article's utility for practitioners is very clear.
The article is a solid manuscript but I would suggest that the authors could take a
cue from participants in strengthening the holistic dimensions of their analysis.
One of the striking dimensions of the article is how participants understand and
experience issues of safety and risk much more broadly and as more
interconnectedness than the developers of particular tools which may be focused
on much more specific dimensions of a particular issue. The authors' focus on
the very specific overdose prevention tool is very clear and justified and the
multiple uses of technology are explained very well, but I would argue that there
is an opportunity to extend this analysis of multiple uses a bit further which may
also help strengthen the practical utility of the article as well. 
For example, a bit more contextual information on how this particular tool
compares with other prevention technologies would be relevant and useful. The
authors do discuss other prevention tools in the introduction but it would also be
useful to return to this discussion after the findings have been presented and
discuss what the specific findings contribute to the larger discussion on overdose
prevention technologies more broadly. 
The manuscript clearly discusses the importance of housing in women's
experiences of safety and risk, but the authors analyses of the interactions
between housing and overdose prevention technologies could be made perhaps a
bit more assertively. For instance, does the success of this particular technology
depend on a supportive housing environment? Are there are other 'pre-existing'
conditions that need to be present before this tool is introduced successfully into
an environment? 
Considering the initial specificity of the tool and the other multiple uses that
women derived from it, how is or how should this be factored into the
evaluation, 'marketing' or introduction of related tools or interventions? Would
these other adaptations and uses be considered part of the technology's success?
The article reveals an interesting gap between how developers focus on a very
specific intention and the additional versatility that users derive from it. Do users'
experiences have anything to suggest to other developers in how to
conceptualize interventions that speak to the interconnectedness of people's
experiences? 
The authors specify how structural vulnerability will be defined in this article -
however, there could be a few references to the structural vulnerability literature
at the start of the discussion to provide cues on which scholarship the authors are
positioning themselves with.
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