Implementing a Community-Based Response to the Opioid Epidemic in Rural Ohio - Supplement

对俄亥俄州农村地区的阿片类药物流行病实施基于社区的应对措施 - 补充材料

基本信息

批准号：
10644578
负责人：
VIVIAN F. GO
金额：
$ 15.74万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-15 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10644578
关键词：
Abnormal coordination Acute Hepatitis C Address Adoption Advocacy Affect Behavior Caring Cessation of life Characteristics Collaborations Communities Consensus Cost Savings Country County Data Death Rate Decision Making Distal Drug Addiction Epidemic Epidemiology Evidence based intervention Funding Geography HIV Health Health Personnel Health Services Health Services Accessibility Healthcare Hepatitis C Hepatitis C virus Heroin Human Resources Human immunodeficiency virus test Injecting drug user Injections Intervention Interview Law Enforcement Laws Leadership Legal Maps Methods Modeling Monitor Morbidity - disease rate Naloxone Needle-Exchange Programs Needs Assessment Neonatal Abstinence Syndrome Ohio Opiate Addiction Opioid Outcome Overdose Parents Patterns of Care Penetration Persons Pharmaceutical Preparations Phase Pike fish Policies Politics Powder dose form Preparation Prevalence Process Provider Public Sector Regulation Resource-limited setting Resources Respondent Risk Behaviors Rural Rural Appalachia Sampling Service delivery model Service provision Services Sexually Transmitted Diseases Social Characteristics Social Network Surveys Tars Techniques Telemedicine Testing Time Training Work base comorbidity cost cost efficient data exploration data format design experience implementation outcomes implementation strategy improved infectious disease treatment injection drug use medication-assisted treatment opioid abuse opioid epidemic opioid injection opioid use overdose death pill prevent program costs programs public health relevance recruit response rural America rural Americans rural area rural counties scale up screening service coordination service delivery service gap service programs service providers social culture substance use substance use treatment surveillance data synthetic opioid tool trafficking

项目摘要

PROJECT SUMMARY/ABSTRACT Ohio is experiencing one of the worst opioid injection epidemics in the country. The epidemic has severely affected rural Appalachian counties in southern Ohio, leading to a surge in overdose fatalities. Ohio's heroin- related overdose rate is five times the national rate. In addition to overdose deaths, HCV has increased 400% between 2009-2013 and neonatal abstinence syndrome (NAS) has increased 9-fold between 2004-2014. Many evidence-based interventions (EBI), such as syringe service programs, medication-assisted treatment for substance use, naloxone provision for overdose treatment, and testing for HCV, HIV and sexually transmitted diseases (STD) are known to be effective in combating injection drug addiction and its consequences. Unfortunately, little is known about how to apply lessons learned in urban injection drug epidemics to sparsely- populated rural areas. In rural Ohio, as in much of the U.S., the delivery of EBI is limited or fragmented. A lack of coordination between key agencies to address overlap and gaps in services, especially in the context of severely constrained resources, has dire consequences for those struggling with opioid injection drug use. The proposed study will develop and implement a service delivery plan for EBI that can be scaled up in rural Ohio as well as other rural areas in the US experiencing opioid epidemics. In the UG3 phase, we will use a mixed methods approach to assess the socio-cultural and political context of the epidemic across multiple levels, including agencies, health care and service providers, and people who inject drugs (PWID) within three counties in rural Appalachia. We will use respondent-driven sampling (RDS) to assess injection behaviors and HCV, HIV, and STD prevalence. Building on this multi-level formative data, we will identify service gaps and work closely with key community stakeholders to build consensus around and prioritize the most relevant, feasible and acceptable implementation strategies to deliver EBI that may include coalition building, data synthesis across counties, crowdfunding models, and telemedicine. In the UH3 phase, we will implement, monitor and evaluate our service delivery plan for opioid injectors, using a regression point displacement design and repeat RDS surveys. Outcomes will include overdose deaths, NAS cases, HCV and HIV tests performed, and referral for HCV and HIV care. Implementation outcomes will include acceptability, adoption, feasibility, fidelity, penetration, sustainability, and cost. Scalability will be assessed by applying lessons learned in the UG3 phase in three additional counties during the UH3. Upon completion of the study, we will have enhanced EBI service delivery in multiple counties in Ohio and developed an exportable model of service needs assessment, community-engaged decision-making, and implementation. This model will be suitable for use throughout rural American in settings where opioid addiction has been identified and existing service delivery is limited or fragmented.

项目概要/摘要俄亥俄州正在经历该国最严重的阿片类药物注射流行病之一。疫情已经严重影响了俄亥俄州南部阿巴拉契亚乡村县，导致服药过量死亡人数激增。俄亥俄州的海洛因—— 相关药物过量发生率是全国的五倍。除了服药过量死亡外，HCV 增加了 400% 2009-2013年间，新生儿戒断综合症（NAS）在2004-2014年间增加了9倍。许多基于证据的干预措施 (EBI)，例如注射器服务计划、药物辅助治疗物质使用、纳洛酮过量治疗以及 HCV、HIV 和性传播疾病检测众所周知，疾病（STD）可以有效对抗注射吸毒成瘾及其后果。不幸的是，人们对如何将城市注射毒品流行中的经验教训应用到稀疏的地方知之甚少。人口稠密的农村地区。在俄亥俄州农村地区，与美国大部分地区一样，EBI 的提供有限或分散。缺乏关键机构之间的协调，以解决服务重叠和差距问题，特别是在资源严重受限，给那些与阿片类注射毒品斗争的人们带来了可怕的后果。拟议的研究将制定并实施一项 EBI 服务提供计划，该计划可以在俄亥俄州农村地区以及美国其他农村地区正在经历阿片类药物流行病。在UG3阶段，我们将使用采用混合方法评估流行病的社会文化和政治背景级别，包括机构、医疗保健和服务提供者以及注射吸毒者 (PWID) 三年内阿巴拉契亚农村地区的县。我们将使用受访者驱动抽样 (RDS) 来评估注射行为和 HCV、HIV 和 STD 患病率。基于这些多层次的形成性数据，我们将确定服务差距并与主要社区利益相关者密切合作，围绕最相关的问题建立共识并优先考虑提供 EBI 的可行且可接受的实施策略，可能包括联盟建设、数据跨县综合、众筹模式和远程医疗。在UH3阶段，我们将实施，使用回归点位移来监控和评估我们的阿片类药物注射器服务交付计划设计并重复 RDS 调查。结果将包括用药过量死亡、NAS 病例、HCV 和 HIV 检测进行，并转介接受 HCV 和 HIV 护理。实施结果将包括可接受性、采用、可行性、保真度、渗透力、可持续性和成本。将通过应用经验教训来评估可扩展性 UH3 期间另外三个县也处于 UG3 阶段。研究完成后，我们将加强俄亥俄州多个县的 EBI 服务交付开发了服务需求评估、社区参与决策的可输出模型，以及执行。该模型将适合在美国农村地区使用阿片类药物的地区使用已发现成瘾现象，现有的服务提供有限或支离破碎。

项目成果

期刊论文数量（16）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The impact of fentanyl on state- and county-level psychostimulant and cocaine overdose death rates by race in Ohio from 2010 to 2020: a time series and spatiotemporal analysis.

DOI：
10.1186/s12954-024-00936-9
发表时间：
2024-01-17
期刊：
HARM REDUCTION JOURNAL
影响因子：
4.4
作者：
Estadt, Angela T.;White, Brian N.;Ricks, JaNelle M.;Lancaster, Kathryn E.;Hepler, Staci;Miller, William C.;Kline, David
通讯作者：
Kline, David

"You are not clean until you're not on anything": Perceptions of medication-assisted treatment in rural Appalachia.

DOI：
10.1016/j.drugpo.2020.102704
发表时间：
2020-11
期刊：
The International journal on drug policy
影响因子：
0
作者：
Richard EL;Schalkoff CA;Piscalko HM;Brook DL;Sibley AL;Lancaster KE;Miller WC;Go VF
通讯作者：
Go VF

"I Was Raised in Addiction": Constructions of the Self and the Other in Discourses of Addiction and Recovery.

DOI：
10.1177/1049732320948829
发表时间：
2020-12
期刊：
Qualitative health research
影响因子：
3.2
作者：
Sibley AL;Schalkoff CA;Richard EL;Piscalko HM;Brook DL;Lancaster KE;Miller WC;Go VF
通讯作者：
Go VF

Challenges Facing a Rural Opioid Epidemic: Treatment and Prevention of HIV and Hepatitis C.

DOI：
10.1007/s11904-018-0393-0
发表时间：
2018-06
期刊：
Current HIV/AIDS reports
影响因子：
4.6
作者：
Schranz AJ;Barrett J;Hurt CB;Malvestutto C;Miller WC
通讯作者：
Miller WC

Houselessness and syringe service program utilization among people who inject drugs in eight rural areas across the USA: a cross-sectional analysis.

DOI：
10.1186/s12954-023-00892-w
发表时间：
2023-10-26
期刊：
HARM REDUCTION JOURNAL
影响因子：
4.4
作者：
Ballard, April M.;Falk, Dylan;Greenwood, Harris;Gugerty, Paige;Feinberg, Judith;Friedmann, Peter D.;Go, Vivian F.;Jenkins, Wiley D.;Korthuis, P. Todd;Miller, William C.;Pho, Mai T.;Seal, David W.;Smith, Gordon S.;Stopka, Thomas J.;Westergaard, Ryan P.;Zule, William A.;Young, April M.;Cooper, Hannah L. F.
通讯作者：
Cooper, Hannah L. F.