Adapting the HOPE Online Support Intervention to Increase MAT Uptake Among OUD Patients

调整 HOPE 在线支持干预措施以提高 OUD 患者对 MAT 的吸收

• 批准号: 10219462
• 负责人: Sean Young
• 金额: $ 291.27万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-28 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10219462
• 关键词: Address; Adoption; Affect; Behavioral; Buprenorphine; Clinic; Clinical; Communities; Country; Data; Education; Educational Intervention; FDA approved; Future; Goals; HIV; Health behavior change; Image; Incentives; Individual; Injectable; Insurance; Intervention; Interview; Knowledge; Lifestyle-related condition; Methods; Naltrexone; Opioid; Participant; Patient Recruitments; Patient Self-Report; Patients; Persons; Pharmaceutical Preparations; Population; Provider; Public Health; Randomized Controlled Trials; Relapse; Reporting; Research; Resources; Risk; Societies; Stigmatization; Surveys; Technology; Text; Time; United States; Use Effectiveness; addiction; base; behavior change; chronic pain; chronic pain patient; cohesion; community intervention; experience; follow-up; group intervention; implementation science; improved; innovation; insight; interest; online community; opioid epidemic; opioid overdose; opioid therapy; opioid use disorder; outreach; peer; peer support; prescription opioid; prescription opioid misuse; prevent; recruit; social; social media; social norm; social stigma; therapy design; treatment center; uptake; virtual environment; willingness

In a randomized controlled trial, with 3, 6-month and 1-year follow-up, this application seeks to assess the effectiveness of using an online peer support community intervention to increase MOUD initiation and sustainment among participants with opioid use disorder (OUD) who are recruited online. On average, 130 people die in the United States each day from opioid overdoses, making the opioid crisis the country’s top public health concern (1,2). Although effective FDA-approved medication for opioid use disorder (MOUD) is available for patients with opioid use disorder (OUD), including buprenorphine and injectable naltrexone, only a small fraction of those who would benefit from these medications use them. There are a number of reasons for low MOUD use, including lack of insurance; knowledge, among both providers and patients; MOUD-related stigma; and social norms (e.g., people would be more willing to use MOUD if their peers were also using MOUD). Innovative methods, especially those that address multiple levels (e.g., the individual, culture, and society/community) are needed to increase MOUD use among individuals with OUD. Online peer-led support interventions might be particularly effective at increasing MOUD uptake because they can leverage peers to widely and rapidly scale changes in social norms (e.g., interest in using MOUD) throughout people’s natural, real-world, virtual environments. For example, the Harnessing Online Peer Education (HOPE) intervention, an online peer support community intervention designed to reduce stigma and increase health behavior change, has been shown to be effective at changing health behaviors among stigmatized populations, such as for HIV. Specific to opioid-related issues, our team recently found the HOPE intervention to be a feasible and acceptable method of reducing risk for prescription opioid misuse among chronic pain patients on opioid therapy. However, no research has studied whether online support interventions, such as HOPE, might be effective in increasing MOUD requests, uptake, and sustainment among OUD patients. It is therefore critical to evaluate these social normative/behavioral technology methods to reduce the increasing rate of opioid overdose. In this study, we seek to explore whether and how the HOPE online support intervention might be adapted to increase MOUD initiation and sustainment among participants with OUD, assess the effectiveness of using the intervention to increase MOUD requests among OUD participants recruited online who are not using MOUD, and using an implementation science approach determine the relationship between online community data and behavior change.

在一项为期3、6个月和1年的随访的随机对照试验中，该申请旨在评估使用在线招募在线招聘阿片类药物使用障碍（OUD）参与者中使用在线同伴支持社区干预的有效性。 平均而言，每天有130人死于阿片类药物过量，使阿片类药物危机成为该国最高公共卫生的关注（1,2）。尽管有效的FDA批准药物用于阿片类药物使用障碍（MOUD），可用于阿片类药物使用障碍（OUD）的患者，包括丁丙诺啡和可注射的纳曲酮，但只有一小部分可以从这些药物中受益的人使用它们。低moud使用的原因有很多，包括缺乏保险；在提供者和患者中，知识；与穆德相关的污名；和社会规范（例如，如果他们的同龄人也在使用穆德，人们将更愿意使用穆德）。需要创新的方法，尤其是那些解决多个级别的方法（例如，个人，文化和社会/社区）来增加在患有OUD个人中的MOUD使用。 在线同行支持干预措施可能在增加MOUD吸收方面特别有效，因为它们可以在整个人的自然，现实世界中的虚拟环境中利用同龄人到社会规范的广泛而迅速扩展社会规范的变化（例如，对使用MOUD的兴趣）。例如，旨在减少污名和增加健康行为改变的在线同伴支持社区干预措施的利用在线同伴教育（HOPE）干预措施已被证明可以有效地改变受污名人群的健康行为，例如HIV。针对阿片类药物相关的问题，我们的团队最近发现，希望干预是一种可行且可接受的方法，可降低阿片类药物治疗中慢性疼痛患者处方阿片类药物滥用的风险。但是，尚未研究在线支持干预措施（例如Hope）是否可以有效地增加OUD患者的MOUD请求，吸收和维持。因此，评估这些社会规范/行为技术方法以降低阿片类药物过量速度的增加至关重要。 在这项研究中，我们试图探索希望在线支持干预措施是否以及如何适应OUD参与者之间的MOUD启动和维持，评估使用干预措施增加不使用MOUD的OUD参与者之间的MOUD请求的有效性，并使用使用MOUD的OUD参与者使用MOUD，并使用实施科学方法来确定在线社区数据之间的关系。