The Impact of Community Infrastructure Reinvestment Programs on Opioid Misuse and Opioid Overdose

社区基础设施再投资计划对阿片类药物滥用和阿片类药物过量的影响

• 批准号: 10771803
• 负责人: Elizabeth Nesoff
• 金额: $ 73.33万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10771803
• 关键词: Address; Affect; Behavioral Risk Factor Surveillance System; Black Populations; Black race; Cities; Communities; Crime; Data; Data Collection; Deterioration; Development; Diagnosis; Disease; Disparity; Distal; Drug usage; Drug user; Economics; Emergency Situation; Emergency department visit; Epidemic; Ethnic Origin; Fentanyl; Government; Grant; Green space; Harm Reduction; Health Status; Heroin; Home; Hospitals; Housing; Infrastructure; Intervention; Investments; Low income; Measures; Medical Examiners; Mental Depression; Mental Health; Methods; Minority; Modeling; Monitor; Naloxone; Neighborhoods; Not Hispanic or Latino; Opioid; Outcome; Overdose; Pharmaceutical Preparations; Philadelphia; Policies; Poverty; Prevalence; Process; Property; Public Health; Race; Racial Segregation; Randomized, Controlled Trials; Reporting; Research; Research Proposals; Resources; Risk; Stress; Structure; Syringes; System; Time; Tourniquets; Translations; Work; community partnership; cost effective; design; fentanyl use; gun violence; heroin use; improved; injection drug use; innovation; opioid misuse; opioid overdose; opioid use; opioid use disorder; overdose death; overdose prevention; overdose risk; prevent; programs; public health intervention; remediation; repaired; social; social capital; social cohesion; social determinants; social observations; synthetic opioid; violent crime; wound care

PROJECT SUMMARY/ABSTRACT Discriminatory housing and zoning policies that cause residential racial segregation, concentrated poverty, and lack of economic opportunity often result in neighborhood disinvestment and increased neighborhood disorder. Neighborhood disorder—deterioration of the urban landscape, also known as blight—significantly impacts opioid misuse, including opioid initiation, injection drug use, opioid use disorder development and duration, and risk of opioid-involved overdose. Interventions to improve disorder have shown significant positive impacts on neighborhood crime, gun violence, and mental health. No studies have yet investigated the degree to which neighborhood disorder interventions influence opioid misuse or associated overdose risk. The broad objective of this study is to investigate the impact of community infrastructure reinvestment programs on opioid misuse and opioid overdose. In Philadelphia, government, community, and academic partnerships have resulted in structural interventions (PHS Philadelphia LandCare and Basic Systems Repair Program) to remediate vacant lots, abandoned buildings, and dilapidated homes. These programs are designed to improve neighborhood disorder in resource-deprived, minority-majority neighborhoods with little to no green space and may have distal effects on opioid misuse and associated overdose risk. Previous Philadelphia studies have shown significant reductions in crime and improved stress and depression for residents on blocks with blight remediation. This study will use spatial analysis methods and systematic social observation to address HEAL's RFA DA-23-051 Preventing Opioid Misuse and Co-Occurring Conditions by Intervening on Social Determinants. Specific aims are: (1) Investigate whether street block-level indicators of opioid misuse differ on blocks with blight remediation activities using systematic social observation methods for primary data collection of litter from opioid misuse (e.g., syringes, tourniquets) and harm reduction paraphernalia (e.g., wound care, naloxone); (2) Examine if fatal and nonfatal opioid overdose rates improved with remediation activities using a longitudinal spatial panel approach with fatal overdose data from Philadelphia's medical examiner and nonfatal overdose data from hospital emergency care visits; (3) Explore mechanisms by which remediation activities improve neighborhood indicators of opioid misuse and fatal and nonfatal overdose rates, including improved community mental health (measured by BRFSS data) and improved community social capital and social cohesion (measured by primary data collection of neighborhood structures related to these concepts), using systematic social observation and spatial analysis methods. This study will examine the impact of highly innovative place-based public health interventions on opioid misuse and fatal and nonfatal opioid overdose. Findings will provide support for expanding neighborhood disorder remediation projects in Philadelphia and promote similar public health-based policy and community-level health interventions for opioid misuse and overdose prevention in other cities.

项目摘要/摘要 歧视性住房和分区政策，导致居民种族隔离，集中贫困和 缺乏经济机会通常会导致邻里投资和邻里障碍增加。 邻里障碍 - 城市景观的延伸，也称为蓝色 - 显着影响阿片类药物 滥用，包括阿片类药物倡议，注射药物使用，阿片类药物使用障碍的发展和持续时间以及有风险 阿片类药物涉及的过量。改善障碍的干预措施已显示出对 邻里犯罪，枪支暴力和心理健康。尚未研究 邻里障碍干预措施会影响Ooid滥用或相关的过量风险。广泛的目标 这项研究的是调查社区基础设施再投资计划对OOID MISSUSE的影响 和阿片类药物过量。在费城，政府，社区和学术伙伴关系已导致 结构性干预措施（PHS费城土地保健和基本系统维修计划）可补救空置 很多，废弃的建筑物和破旧的房屋。这些程序旨在改善社区 资源不足，少数族裔多数社区的障碍几乎没有绿色空间，可能有不同 对阿片类药物的影响和相关的过量风险的影响。以前的费城研究表明 减少犯罪和抑郁症的压力和抑郁症的减少。这 研究将使用空间分析方法和系统的社会观察来解决Heal的RFA DA-23-051 通过介入社会决定因素来防止阿片类药物滥用和同时发生条件。具体目标 是：（1）调查在具有蓝色修复的街区中，阿片类药物的街道块级指标是否有所不同 使用系统的社会观察方法的活动，从阿片类MISSUSE收集垃圾的主要数据 （例如，注射器，止血带）和损害减少用具（例如伤口护理，纳洛酮）； （2）检查是否致命 使用纵向空间面板，通过补救活动提高了非致命阿片类药物过量率 来自费城体检医师的致命过量数据和非致命过量数据的方法 医院急诊就诊； （3）探索修复活动改善社区的机制 阿片类药物的指标，致命的和非致命的过量率，包括改善社区心理健康 （通过BRFSS数据衡量）并改善了社区的社会资本和社会凝聚力（由主要衡量 使用系统的社会观察和 空间分析方法。这项研究将研究高度创新的基于地方的公共卫生的影响 阿片类药物的干预措施以及致命的和非致命的阿片类药物过量。调查结果将为 扩大费城的邻里障碍补救项目，并促进类似的公共卫生 在其他城市，针对阿片类药物遗产和预防过量的政策和社区级健康干预措施。