Kentucky CAN HEAL (Communities and Networks Helping End Addiction Long-term)

肯塔基州可以治愈（社区和网络帮助长期消除成瘾）

• 批准号: 9917748
• 负责人: Sharon L. Walsh
• 金额: $ 2525万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-17 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9917748
• 关键词: Address; Affect; Age; Algorithms; Attitude; Awareness; Benzodiazepines; Buprenorphine; Caring; Cessation of life; Communities; Community Networks; County; Criminal Justice; Data; Death Rate; Development; Diagnosis; Education; Effectiveness; Emergency Situation; Ensure; Epidemiology; Evidence based intervention; Evidence based practice; Fentanyl; Funding; Government Agencies; Government Officials; Guidelines; Health Communication; Health Professional; Health Services Accessibility; Healthcare; Heroin; Individual; Intervention; Jail; Kentucky; Life Expectancy; Methadone; Modeling; Naloxone; Needle-Exchange Programs; Opioid; Opioid Antagonist; Outcome; Overdose; Pharmaceutical Preparations; Pharmacists; Phase; Policies; Prevention; Prevention approach; Professional Education; Provider; Public Health; Public Policy; Randomized; Recovery; Request for Proposals; Research; Resources; Rural; Services; Site; State Government; Structure; System; Testing; Training; Training Support; United States; Universities; Work; addiction; barrier to care; base; behavioral health; community center; community intervention; community organizations; cost; design; evidence base; experience; healing; health economics; high risk; illicit drug use; implementation science; implementation strategy; improved; metropolitan; mortality; opioid epidemic; opioid misuse; opioid mortality; opioid overdose; opioid use disorder; overdose death; overdose prevention; parole; prescription monitoring program; prescription opioid; probation; programs; response; screening; social stigma; stem; synthetic opioid; telehealth; theories; treatment program; waiver

ABSTRACT The Kentucky CAN (Communities and Networks) HEAL (Helping End Addiction Long-term) [KCH] study is a large-scale, community intervention project submitted in response to the HEALing Communities request for proposals to “test the immediate impact of implementing an integrated set of evidence-based interventions” with the aim of reducing opioid overdose deaths by 40% in three years. KCH represents a partnership between the University of Kentucky, Kentucky State government officials and numerous community organizations. This project will employ an incomplete stepped-wedge, cluster randomized design to deploy an integrated set of evidence-based practices in 17 highly affected counties in Kentucky in two waves of assignment. Highly affected counties were identified through an empirical algorithm that incorporated the requisite epidemiological criteria for opioid overdose and structural systems in place to support the deployment of evidence-based interventions (EBIs). Prior to randomization, a systematic implementation science-based approach will be used to assess barriers, attitudes and assets and to enhance implementation of EBIs. Primary intervention aims are to improve and expand treatment with medications for opioid use disorder (MOUD) by increasing capacity, entry and retention, expand overdose prevention approaches in the community and reduce opioid supply by decreasing high risk prescribing and increasing safe drug disposal. Community partners include those representing behavioral health, healthcare, public health, criminal justice and community coalitions. Interventions will include those focused on 1) development of a Care Navigation network in MOUD treatment programs (FQHC’s, OTPs and OBOT providers), syringe service programs, jails and parole and probation offices to increase the number of individuals screened, referred to, initiating evidence-based care, retained in treatment and receiving ancillary recovery support services; 2) enhancing and expanding the treatment workforce through increased DATA 2000 waiver trainings and weekly support through expert telehealth guidance using the ECHO model; 3) increasing overdose education and naloxone distribution in treatment settings, syringe services programs, jails, parole and probation; and the community; 4) increasing access to syringe services programs; 5) reducing risky opioid prescribing and dispensing; and 6) enhancing drug disposal. By targeting individuals who are at highest risk (e.g., out of treatment, reentering the community) and deploying a community-wide health communication strategy to increase awareness and demand for EBIs, we hypothesize that KCH will reduce overdose deaths by 40% in three years. KCH will leverage existing funding and resources to enhance its effectiveness, and the health economics of these interventions will be evaluated in order to have meaningful and translatable impact on public policy.

抽象的 肯塔基州罐头（社区和网络）治愈（长期帮助结束成瘾）[KCH]研究是一个 针对康复社区要求提交的大规模，社区间隔项目 提案“测试实施一组基于证据的干预措施的影响的直接影响” 目的是将阿片类药物过量死亡减少40％。 肯塔基州肯塔基州政府官员和众多社区组织 项目将雇用一个不完整的跨斜向，群集随机设计，以部署一组集成的集合 肯塔基州的17个高度影响县的循证实践高度高 通过经验算法确定了受影响的县，该算法纳入了必要的流行病学 阿片类药物过量和结构系统的标准，以支持基于证据的部署 干预措施（EBIS）。 评估障碍，态度和资产并增强EBIS的实施。 通过增加容量来改善和扩展使用阿片类药物使用障碍（MOUD）的药物治疗 进入和保留，扩大社区中预防过量的预防方法，并通过再见减少阿片类药物供应 降低高风险处方并增加安全药物的伴侣。 代表行为健康，医疗保健，公共卫生，刑事司法和社区联盟。 干预措施将包括专注于1）MOUD TRUSTMENT中的护理导航网络的开发 计划（FQHC，OTP和OBOT提供商），注射器服务计划，监狱和假释和缓刑 办公室增加了筛选，提及，启动循证护理的个人数量，保留在 治疗和接收辅助恢复支持服务； 2）增强和扩展治疗 通过增加数据2000豁免培训和每周支持远程医疗的劳动力 使用ECHO模型的指导； 3）增加过量教育和纳洛酮 设置，注射服务计划，监狱，假释和缓刑； 4 注射服务计划； 5）减少风险的阿片类药物处方； 处置。 部署范围内的保健沟通策略以提高对EBIS的认识和需求，我们 假设KCH将在三年内服药过量死亡40％。 增强的资源是有效性，这些干预措施的健康经济学将得到评估 为了对公共政策产生有意义的转换影响。