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Democratizing innovation through grass-roots entrepreneurship: lessons from efforts to address the opioid epidemic in the United States
  1. Shriya Srinivasan1,
  2. Khalil B. Ramadi1,
  3. Andrea Ippolito2,
  4. Rifat Atun3
  1. 1Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
  2. 2Engineering Management Program, Cornell University, Ithaca, New York, USA
  3. 3School of Public Health, Harvard University, Boston, Massachusetts, USA
  1. Correspondence to Shriya Srinivasan; shriyas{at}


The nationwide opioid epidemic has substantially impacted economically-depressed regions in the USA. Eastern Appalachia has some of the lowest socioeconomic indicators in the USA and has suffered the highest rate of opioid-related fatality in 2016. Despite devoting considerable federal and state resources towards public health initiatives, the region continued to experience one of the highest death rates and sought alternative approaches to address the opioid crisis. Here, we describe a community-based co-creation initiative that convened diverse sectors and utilised design thinking principles to generate sustainable public health ventures towards addressing the opioid crisis. Participants of diverse backgrounds came together to attack key challenges and developed and implemented solutions, including a mobile application for naloxone delivery and exercise programs for high schools to promote healthy habits. Grassroots innovation efforts catalysed by the event strengthened community engagement and facilitated a sense of agency among participants. Through specific examples of initiatives that were launched, we provide evidence to encourage and highlight the value of healthcare innovation efforts in low-resource settings.

  • public health
  • health education and promotion
  • health economics

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  • Handling editor Soumitra S Bhuyan

  • Twitter @RifatAtun

  • Contributors SS: conducted this hackathon in 2016 and performed the analysis and writing of the manuscript. KR, AI and RA: contributed to writing and editing the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.