Optimizing HEALing in Ohio Communities (OHiO)

优化俄亥俄州社区的治疗 (OHiO)

基本信息

批准号：
9917751
负责人：
REBECCA D JACKSON
金额：
$ 2077.93万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
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/9917751
关键词：
Achievement Acute Hepatitis C Address Adopted Adoption Affect Age Americas Birth Caring Characteristics Clinical Trials Clinical Trials Network Clinical and Translational Science Awards Collaborations Communities Community Health County County Government Criminal Justice Data Data Analytics Death Rate Decision Making Effectiveness Evidence based intervention Family Fostering Funding Goals Health Healthcare Infrastructure Intervention Investments Justice Learning Maintenance Medical Modeling Morbidity - disease rate Naloxone National Institute of Drug Abuse Neonatal Abstinence Syndrome Ohio Opioid Outcome Overdose Parents Patients Penetration Persons Policies Preparation Prevention Public Health Randomized Recovery Reporting Reproducibility Research Personnel Resources Rural Rural Community Service delivery model Services Site State Government Structure System Testing Time Training Translating Universities Virus Diseases Work base behavioral health community center community setting cost effectiveness design effectiveness evaluation evidence base healing health assessment healthcare community incremental cost-effectiveness mortality opioid epidemic opioid misuse opioid mortality opioid overdose opioid use disorder overdose death payment prescription opioid prevent programs rural counties secondary outcome service coordination success teacher urban area

项目摘要

PROJECT SUMMARY The opioid epidemic has become entrenched in Ohio, with an age-adjusted opioid-related overdose death rate of 32.9/100,000 people (2017), ranking second nationally. Neither rural nor urban areas have been spared, with 38 of Ohio’s 88 counties (43%) reporting opioid-related deaths exceeding 25/100,000 people. Since 2012, Ohio has mounted an unprecedented effort to reduce opioid use disorder (OUD) morbidity and mortality through policies and investments in prevention, treatment, and recovery efforts. However, challenges inherent in integrating and deploying evidence-based interventions (EBI) across sectors has limited their impact in affected communities. The goal of Optimizing Healing in Ohio Communities (OHiO) is to systematically plan, implement, and evaluate data-driven approaches that integrate multi-pronged EBI within healthcare, behavioral health, justice systems, and communities to reduce opioid overdose deaths in 19 highly affected counties by 40% in 3 years. OHiO is anchored by three NCATS-funded CTSAs and the NIDA-funded Ohio Valley Node of the Clinical Trials Network and leverages extensive existing collaborations with community coalitions, state and county governments, and healthcare, behavioral health and criminal justice sectors. OHiO’s approach is based upon and aligned with the state-mandated Community Health Assessments and Community Health Improvement Plans, leveraging state and federally funded programs already in place. The overarching goal will be met through completion of three aims. Aim 1) Plan: We will assess current policies/programs regarding OUD, opioid misuse, and opioid-related fatalities; using the Exploration, Adoption/Preparation, Implementation and Sustainment model, work with communities to select EBI to reduce OUD and overdose deaths; and identify gaps in services/service coordination that are amenable to intervention. Aim 2) Implement: Through a pragmatic community-based clinical trial, we will deliver EBI packages using a cluster stepped-wedge design in which collaborating communities are randomized by the timing of which selected interventions are received. Aim 3) Evaluate: We will continuously collect and analyze data using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) model to assess the impact of the integrated interventions and implementation outcomes including acceptability, adoption (including fidelity to the intervention), feasibility, penetration, and incremental cost and cost-effectiveness of the multipronged approach. We will also establish Learning Health Communities to provide community stakeholders access to real-time, actionable information. Ultimately, OHiO will provide rigorous and reproducible evidence of the effectiveness of integrated prevention, treatment, and recovery programs in the community context; an exportable and scalable model of service assessment, community-engaged decision-making; and integrated, data-driven EBI that can be implemented by affected communities in Ohio, the region, and across the US.

项目概要阿片类药物流行病在俄亥俄州已根深蒂固，与年龄调整的阿片类药物相关的过量死亡率 32.9/10万人（2017年），全国排名第二，农村和城市都未能幸免。俄亥俄州 88 个县中有 38 个县 (43%) 报告与阿片类药物相关的死亡人数超过 25/100,000 人。自 2012 年以来，俄亥俄州采取了前所未有的努力来减少阿片类药物使用障碍 (OUD) 的发病率和通过预防、治疗和恢复工作的政策和投资来降低死亡率然而，挑战也存在。跨部门整合和部署循证干预措施 (EBI) 所固有的限制了其对受影响社区的影响。优化俄亥俄州社区康复 (OHiO) 的目标是系统地规划、实施和评估数据驱动的方法，将多管齐下的 EBI 整合到医疗保健、行为健康、司法系统、 OHiO 计划在 3 年内将 19 个受影响严重的县的阿片类药物过量死亡人数减少 40%。由三个 NCATS 资助的 CTSA 和 NIDA 资助的俄亥俄谷临床试验节点支持建立网络并利用与社区联盟、州和县的广泛现有合作 OHiO 的方法基于政府、医疗保健、行为健康和刑事司法部门。并与国家规定的社区健康评估和社区健康改善保持一致利用州和联邦资助的计划，已经到位的总体目标将得到实现。通过完成三个目标 1) 计划：我们将评估有关 OUD 的现行政策/计划，阿片类药物滥用以及与阿片类药物相关的死亡；使用探索、采用/准备、实施和维持模式，与社区合作选择 EBI 来减少 OUD 和过量死亡；需要干预的服务/服务协调方面的差距目标 2) 实施：通过基于务实的社区临床试验，我们将使用集群阶梯楔形设计提供 EBI 包哪些合作社区是根据收到选定干预措施的时间随机分配的。目标 3) 评估：我们将使用覆盖率、功效、采用率、实施和维护（RE-AIM）模型，用于评估综合干预措施的影响和实施结果包括可接受性、采用（包括对干预措施的忠诚度）、可行性、我们还将建立多管齐下的渗透率、增量成本和成本效益。学习健康社区为社区利益相关者提供实时、可操作的信息。最终，OHiO 将提供严格且可重复的证据来证明综合预防的有效性，社区背景下的治疗和康复计划；可输出且可扩展的服务模式；评估、社区参与决策；以及可实施的综合、数据驱动的 EBI 俄亥俄州、该地区以及美国各地受影响的社区。