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 大规模的社区干预项目是针对治疗社区要求的 建议“测试实施一组基于证据的干预措施的立即影响” 目的是将阿片类药物过量死亡减少40％。 KCH代表 肯塔基大学，肯塔基州政府官员和众多社区组织。这 项目将采用不完整的阶梯式，群集随机设计来部署一组集成的集合 肯塔基州17个受影响的17个受到分配浪潮的循证实践。高度 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）。在随机化之前，将使用系统实施的基于科学的方法 评估障碍，吸引和资产并增强EBIS的实施。主要干预目的是 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 降低高风险处方并增加安全药物处置。社区合作伙伴包括 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）在MOUD治疗中开发护理导航网络的干预措施 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，提及的个人数量，启动循证护理，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的劳动力通过专家远程医疗 使用Echo模型的指导； 3）治疗中的过量教育和纳洛酮分布增加 设置，注射器服务计划，监狱，假释和调查；和社区； 4）增加获得 注射器服务计划； 5）减少有风险的阿片类药物处方和分配； 6）增强药物 处理。通过针对有风险最高的个人（例如，不接受治疗，重新进入社区）和 部署社区范围内的健康传播策略以提高对EBIS的认识和需求，我们 假设KCH将在三年内将过量死亡人数减少40％。 KCH将利用现有资金 以及提高其有效性的资源，并将评估这些干预措施的健康经济学 为了对公共政策产生有意义的转换影响。