@article{THESIS,
      recid = {12915},
      author = {Claypool, Emily},
      title = {Social Service Laboratories: The Politics of Reform in an  Overdose Prevention Clinical Trial},
      publisher = {University of Chicago},
      school = {Ph.D.},
      address = {2024-08},
      number = {THESIS},
      abstract = {Researchers have made increasing efforts to consider the  contexts where evidence is implemented, and more  meaningfully include forms of public participation that  make science more accountable and responsive to the people  and places meant to take it up. The rise of implementation  science and hybrid clinical trials are both examples of  this contextualization. As the production of evidence moves  toward its contextualization and begins to more  meaningfully consider the role of the social environment in  knowledge making and uptake, novel partnerships and  political questions emerge. This dissertation is an  ethnographic study of a complex harm reduction and peer  recovery-based case management intervention (HaRP). Instead  of studying whether and how HaRP works, however, this  dissertation examines how researchers and various  implementation actors negotiate the tension between  conducting experimental science to produce a standardized,  scalable intervention, while also being attuned to the  “real world” of social service practice. Drawing on over  two years of ethnographic field work of a federally funded,  multi-sited clinical trial, I ask: how, and with what  social effects, do researchers negotiate the principles of  scientific inquiry with the exigencies of the “real world,”  and the diverse sets of institutional commitments that make  it up? Throughout this dissertation, I highlight how local  context and scale, objectivity and activism, and  standardization and tacit, embodied forms of care are  negotiated with experimental logics like standardization,  fidelity and objectivity. I argue that the imperatives of  the clinical trial, coupled with the institutional  obligations to which it is tethered, operate against the  ethical and political commitments of practitioners and  researchers themselves regarding the most effective  strategies for preventing overdose. I show how care is  refashioned (Chapter Three), and activism is deferred  (Chapter One). However, no one actor had an unwavering  commitment to the scientific integrity of the clinical  trial and this dissertation set out to reveal how  researchers themselves grapple with these tensions. Indeed,  Chapter two demonstrates how the imminent needs of study  participants led trial actors to compromise model stability  and feasibility (Chapter Two). Indeed, experimental  concepts like feasibility and fidelity were contested  throughout HaRP’s implementation, by PIs and practitioners  alike, and were actively redefined to meet the diverse, and  often competing nature of hybrid clinical trials. The  findings of my dissertation will help researchers, and  implementation actors negotiate locally embedded social and  professional values and growing activist commitments with  the obligations of scientific inquiry during  socio-behavioral clinical trials.},
      url = {http://knowledge.uchicago.edu/record/12915},
      doi = {https://doi.org/10.6082/uchicago.12915},
}