Digital, Community-Led, Social Action Initiative to Reduce Opioid Vulnerability and HIV/HCV in Rural Areas of the Midwest and Appalachia

数字化、社区主导的社会行动倡议，旨在减少中西部和阿巴拉契亚农村地区的阿片类药物脆弱性和艾滋病毒/丙肝病毒

• 批准号: 10455814
• 负责人: DOLORES ALBARRACIN
• 金额: $ 81.25万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10455814
• 关键词: Adverse event; Age; Appalachian Region; Area; Big Data Methods; Communication; Communities; Complex; County; Disease Outbreaks; Ensure; Facebook; HIV; HIV/HCV; Health; Indiana; Internet; Kansas; Kentucky; Measures; Medical; Michigan; Midwestern United States; Missouri; Naloxone; National Institute of Drug Abuse; Needle-Exchange Programs; Ohio; Opiate Addiction; Opioid; Outcome; Overdose; Participant; Pharmaceutical Preparations; Population; Populations at Risk; Principal Investigator; Public Health; Public Policy; Randomized Controlled Trials; Research; Research Personnel; Risk; Rural; Sampling; Social support; Spottings; Testing; United States; Universities; Virginia; Vision; West Virginia; behavior change; community consultation; condoms; cost effective; digital; high risk; innovation; meetings; member; middle age; news; non-opioid analgesic; novel; opioid epidemic; opioid use; opioid user; pre-exposure prophylaxis; prevent; programs; response; rural area; rural drug use; sex; social; social health determinants; social stigma; substance abuse treatment; virtual

PROJECT SUMMARY This project will develop, implement, and evaluate a transformative virtual initiative, high-impact initiative for protecting rural drug-using populations at risk from HIV/HCV outbreaks in the midst of the opioid epidemic in the United States. Most counties at high risk for HIV/HCV outbreaks are clustered in Appalachia and the Midwest. Although the origins of the opioid crisis are complex, social determinants of health, misconceptions about opioids, and a culture of isolation and despair are among the most critical causes. However, Internet use is common among opioid users in these areas (e.g., Facebook, Google) and may support scalable programs to supplement medical and public health responses to the crisis in difficult to reach regions. This project will involve two innovative platform modules: Social Action (virtual meeting and networking, contact with health officials, community consultation, and strategic news releases); and Communication (messages debunking misconceptions; messages promoting HIV/HCV testing, syringe exchange, and HIV pre-exposure prophylaxis (PrEP); on-the-spot responses to questions posed via live chat). The digital platform will incorporate Big Data methods to identify efficacious messages, misconceptions, and debunking messages. The project will target rural millennials (ages 18-35), a population that is sufficiently young to be malleable, to prevent opioid addiction and negative health outcomes in middle age. Thus, this project aligns with the NIDA agenda of generating rapid, scalable, and socially supported responses to the opioid epidemic. To evaluate the initiative, the Principal Investigator (PI) and colleagues will conduct a cluster randomized controlled trial with opioid using participants (n = 1,200) and non-opioid-using community members (n = 1,200). Assessments will occur every four months over a year. Trial outcomes will include HIV/HCV testing, syringe exchange participation, condom use, exchanging sex for money or drugs, initiation of PrEP, medication-assisted substance abuse treatment, and measures to avoid drug-related adverse events (e.g., carrying Naloxone kits for reversing overdoses), in addition to isolation and stigma measures. The Annenberg Public Policy Center has committed to hosting and maintaining the platform in parallel with www.FactCheck.org, ensuring sustainability. Given the lack of a similar social action platform in any domain and the urgent need for innovative and cost-effective approaches for the largely rural, white, poor, and anti-syringe-exchange counties at risk for HIV/HCV outbreaks, this project exemplifies the vision of the Avant-Garde Program. The PI has a distinguished record of novel, complex, theoretically-informed, and successful research on behavior change, HIV, and digital communication. The institutional support for this project is outstanding and includes www.thegrov.org, a coalition to reduce opioid vulnerability co-directed by the PI. The project brings together stellar and committed investigators at eleven elite universities and an impressive network of state health departments.

项目摘要 该项目将开发，实施和评估一项变革性的虚拟倡议，高影响力倡议，以保护美国阿片类药物流行病中的艾滋病毒/HCV暴发风险的农村毒品人群。大多数艾滋病毒/HCV暴发风险高的县都聚集在阿巴拉契亚和中西部。尽管阿片类药物危机的起源很复杂，但对健康的社会决定因素，对阿片类药物的误解以及孤立和绝望的文化是最关键的原因之一。但是，在这些领域（例如Facebook，Google）的阿片类药物用户中，互联网使用很常见，并且可能支持可扩展的计划，以补充难以到达地区的危机的医疗和公共卫生反应。该项目将涉及两个创新的平台模块：社会行动（虚拟会议和网络，与卫生官员联系，社区咨询和战略新闻发布）；和沟通（消息揭穿误解；促进HIV/HCV测试，注射器交换和HIV暴露前预防的消息（PREP）；对通过实时聊天提出的问题的现场回答）。数字平台将结合大数据方法，以识别有效的消息，误解和揭穿消息。该项目将针对农村千禧一代（18-35岁），这个人口足够年轻，可以延展，以防止阿片类药物成瘾和中年的负面健康结果。因此，该项目与NIDA的议程一致，即产生对阿片类药物流行的快速，可扩展性和社会支持的反应。为了评估该倡议，首席研究员（PI）和同事将使用参与者（n = 1,200）和非阿片类药物的社区成员（n = 1,200）对阿片类药物进行聚类随机对照试验。评估将在一年中每四个月进行一次。试验结果将包括HIV/HCV测试，注射器交换参与，使用避孕套，交换性别或药物，开始启动PREP，药物辅助药物滥用治疗以及避免与药物相关的不良事件的措施（例如，将Naloxone套件携带Naloxone套件除了隔离和污名措施外，过量服用过量）。安嫩伯格公共政策中心已致力于与www.factcheck.org并行托管和维护平台，以确保可持续性。鉴于任何领域中缺乏类似的社会行动平台，并且迫切需要为乡村，白人，穷人和反对偏见的县遇到艾滋病毒/HCV爆发风险的创新和成本效益的方法，因此这个项目典范前卫计划的愿景。 PI在行为变化，艾滋病毒和数字通信方面具有新颖，复杂，理论上的新颖，理论上和成功研究的杰出记录。对该项目的机构支持非常出色，包括www.thegrov.org，这是一个减少PI共同指导的阿片类药物脆弱性的联盟。该项目汇集了恒星，并在11所精英大学和一个令人印象深刻的州卫生部门网络中聘用了调查人员。