An Integrated Geospatial and Community-based Model to Prevent Opioid Overdose among Black Americans

防止美国黑人阿片类药物过量使用的综合地理空间和社区模型

基本信息

批准号：
10643343
负责人：
Devin Banks
金额：
$ 16.68万
依托单位：
UNIVERSITY OF MISSOURI-ST. LOUIS
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-04-01 至 2023-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10643343
关键词：
Address Area Black American Black Populations Black race Characteristics Cities Clinical Investigator Communities Community Health Community Health Aides Community based prevention Coroner Country Data Death Rate Decision Analysis Deterioration Development Development Plans Disparity Ensure Environment Environmental Impact Ethnic Population Evidence based treatment Face Feedback Fentanyl Focus Groups Future Geographic Information Systems Geography Goals Growth Harm Reduction Health Health Personnel Health Services Accessibility Income Individual Inequality Inequity Institution Intervention Maps Methods Missouri Modeling Morbidity - disease rate Neighborhoods Opioid Outcome Overdose Overdose reversal Policies Policy Maker Prevention Racial Equity Recovery Research Research Personnel Resource-limited setting Risk Structural Racism Structure Substance Use Disorder Technology Therapeutic Training Trust Underserved Population United States Universities access disparities addiction career career development caucasian American community based participatory research community engagement density deprivation design digital digital health digital tool effectiveness testing experience health equity high risk implementation science improved indexing mHealth manufacture member mortality opioid epidemic opioid mortality opioid overdose opioid use opioid use disorder opioid user outreach overdose death peer prevent programs psychoeducation psychoeducational racial disparity racial minority population response social social health determinants social interventions software systems structural health determinants substance use substance use treatment technology platform tool training opportunity treatment and outcome

项目摘要

PROJECT SUMMARY Opioid overdose death (OOD) rates in the among Black individuals in the U.S. have increased unabated since 2015, outpacing those of White individuals at a rate of two to one. Racial disparities in the growth rate of OOD have been documented in at least 23 states, including Missouri, which has second highest rate of OOD among Black individuals: 44 per 100,000 (relative to 16 per 100,000 nationally). There is a critical need to identify and mitigate social determinants of health (SDOH) that drive increasing racial inequities in OOD and opioid use disorder treatment utilization. One strategy that addresses SDOH—such as low geographic access to treatment and high neighborhood deprivation—is community-based outreach, which dispatches peers and community health workers to provide harm reduction tools and linkages to evidence-based treatment. Although outreach efforts improve psychoeducation and access to treatment for Black people who use opioids, existing efforts are limited by a lack of data-driven targets. Thus, there is an urgent need to identify and disseminate geographic and structural drivers of OOD among Black individuals to improve the efficacy of existing outreach interventions and in turn, improve treatment access. The current K08 proposal addresses this need by integrating geospatial information systems (GIS) technology and community based participatory research to create a digital tool designed to 1) identify current SDOH that underlie OOD among Black individuals and 2) provide data-driven targets to improve the efficacy of community-based outreach interventions. The project aims and career development plan will concurrently support Dr. Banks’ transition to an independent clinical investigator focused on the integration of technology and community engagement to improve substance use treatment among minoritized racial/ethnic groups. Specific aims of the project are to 1) develop and evaluate the predictive validity of a GIS-enabled index (the “Overdose Racial Equity Index”) to model risk for OOD among Black individuals based on SDOH identified and rated by community experts and 2) demonstrate initial acceptability and utility of the Overdose Racial Equity Index to guide outreach interventions for Black OOD via focus groups with peers and community health workers. Aims and related training opportunities facilitated by the rich intellectual environment of the University of Missouri—St. Louis and the two other research institutions in St. Louis will support Dr. Banks’ training goals to gain expertise in digital/mobile health therapeutics, opioid use disorder treatment, and implementation science. Outcomes include the identification of SDOH that underlie OOD among Black Americans and a research and replicable implementation model for other regions to identify policy and intervention targets that reduce the disproportionate burden of OOD among Black Americans. The research will provide the training and data necessary for an R01 application that tests the effectiveness of a mobile version of the Overdose Racial Equity Index to improve community-based prevention outcomes.

项目概要自此以来，美国黑人中阿片类药物过量死亡率 (OOD) 的比例有增无减 2015 年，OOD 增长率的种族差异超过了白人。至少有 23 个州有记录，其中包括密苏里州，该州的 OOD 发生率在美国排名第二。黑人：每 100,000 人中有 44 人（相对于全国每 100,000 人有 16 人）迫切需要识别和识别。缓解导致 OOD 和阿片类药物使用方面种族不平等加剧的健康社会决定因素 (SDOH) 一种解决 SDOH 问题的策略，例如获取地理信息的机会较少。治疗和高度邻里剥夺——是以社区为基础的外展活动，派遣同伴和社区卫生工作者提供减少危害的工具以及与循证治疗的联系。外展活动改善使用阿片类药物、现有药物的黑人的心理教育和获得治疗的努力由于缺乏数据工作驱动的目标而受到限制，因此迫切需要确定和传播。黑人群体中 OOD 的地理和结构驱动因素，以提高现有外展活动的效率当前的 K08 提案通过以下方式解决了这一需求。整合地理空间信息系统（GIS）技术和基于社区的参与性研究创建一个数字工具，旨在 1) 识别当前构成黑人 OOD 基础的 SDOH，以及 2) 提供数据驱动的目标，以提高基于社区的外展干预措施的有效性。目标和职业发展计划将同时支持班克斯博士向独立临床的过渡研究人员专注于将技术与社区参与相结合以改善物质使用该项目的具体目标是 1) 制定和评估。支持 GIS 的指数（“过量种族公平指数”）对 OOD 风险建模的预测有效性根据社区专家识别和评级的 SDOH 在黑人个体中进行评估，并且 2) 展示初步的过度种族公平指数的可接受性和实用性，用于指导黑人 OOD 的外展干预措施由同行和社区卫生工作者组成的焦点小组。密苏里大学圣路易斯分校和另外两所研究机构丰富的智力环境圣路易斯将支持班克斯博士的培训目标，以获得数字/移动健康疗法、阿片类药物方面的专业知识使用障碍治疗和科学实施包括识别 SDOH 的基础。美国黑人中的 OOD 以及可供其他地区识别的研究和可复制实施模型减少美国黑人过度的 OOD 负担的政策和干预目标。研究将为 R01 应用程序提供必要的培训和数据，以测试 R01 应用程序的有效性过量种族公平指数的移动版本，以改善基于社区的预防结果。