CHASE: An Innovative County-Level Public Health Response to the Opioid Epidemic in New York State

CHASE：针对纽约州阿片类药物流行病的创新县级公共卫生应对措施

• 批准号: 10893819
• 负责人: Nabila El-Bassel
• 金额: $ 83.3万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10893819
• 关键词: Achievement; Acute; Address; Adoption; Age; Attention; Awareness; Black Populations; COVID-19 pandemic; Communities; Continuity of Patient Care; County; Data; Data Analyses; Data Sources; Death Rate; Decision Making; Discrimination; Disparity; Drug usage; Equity; Ethnic Origin; Frequencies; Gender; Geography; Goals; Grant; Health; Health Services Accessibility; Homelessness; Housing; Individual; Infrastructure; Infusion procedures; Intervention; Kentucky; Learning; Legal system; Manuscripts; Maps; Massachusetts; Measures; Modeling; Naloxone; Nature; New York; Not Hispanic or Latino; Ohio; Outcome; Outcome Study; Overdose; Overdose reduction; Parents; Participant; Pattern; Persons; Pharmaceutical Preparations; Phase; Policies; Population; Prevention education; Prevention strategy; Process; Protocols documentation; Public Health; Publications; Publishing; Race; Racial Equity; Randomized; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Readiness; Reporting; Research Personnel; Resources; Respondent; Rural; Site; Special Population; Surveys; Time; Training; Transportation; Underserved Population; Waiting Lists; Work; arm; black men; comparative effectiveness; contextual factors; demographics; design; disparity reduction; dynamic system; effectiveness evaluation; ethnic disparity; ethnic diversity; ethnic minority; ethnic minority population; healing; health care availability; health equity; implementation strategy; innovation; medication for opioid use disorder; meetings; member; minority communities; novel; opioid epidemic; opioid mortality; opioid overdose; opioid use disorder; overdose death; overdose prevention; peer influence; peer networks; racial disparity; racial minority; racial minority population; response; satisfaction; sex; shared decision making; social health determinants; social stigma; sociodemographics; tool; treatment as usual; trend

Project Summary/Abstract This supplement aims to explore the impact of the infusion of health equity principles on overdose prevention strategies during the implementation of the Communities That Heal (CTH) intervention as part of the HEALing Communities Study (HCS). The HCS is a multi-site, parallel arm, cluster randomized, wait-list controlled trial evaluating the impacts of the CTH intervention, compared with usual care in wait-list communities, on overdose deaths. The overall goal of the HCS is to reduce opioid overdose deaths by 40% in 67 HCS communities across four states. Communities form coalitions to make shared decisions about what overdose prevention strategies to implement and how best to implement them, particularly strategies that promote Overdose Prevention Education and Naloxone Distribution (OEND) and Medications for Opioid Use Disorder (MOUD). Even though minoritized communities (whether due to race, ethnicity, gender, or LGBTQIA+ status) have less and poorer access to treatment for Opioid Use Disorder (OUD) and associated disparities in outcomes at its outset, HCS did not explicitly aim to reduce disparities or measure the effect of centering equity on overdose prevention. This approach changed in 2020 with an acute awareness of the racial and ethnic disparities within the COVID epidemic and the racial awakening in response to the George Floyd killing. This supplement will leverage its parent study existing staff and infrastructure and study staff to analyze surveys and other qualitative data already collected. The primary data sources will include surveys of coalition members, completed at four-time points during the study period; the Opioid-Overdose Reduction Continuum of Care Approach Tracker (ORCCAT), completed monthly by study staff, that includes overdose prevention information by strategy, sector, venue, population served, coalition approval date, implementation plan developed, date started, number of partners/practices associated with strategy, and mode of delivery; and REACH data, completed by study staff monthly once each strategy is implemented that includes information on number of persons reached and demographics of those reached (e.g., race, ethnicity, sex, age). Data analysis will consist of qualitative analysis looking at associations between survey answers regarding health equity topics and incorporation of equity into strategies, and qualitative analysis examining how coalitions discussed and prioritized equity topics. The parent study’s PRISM/RE-AIM(S) conceptual framework will guide this study with a novel health equity lens to examine how diversifying coalitions and infusing opioid overdose prevention strategies with health equity principles may help reach minoritized communities and how these contextual factors and processes may interact to promote or impede health equity. Results from this study may be used to inform policies, strategies, and practices for incorporating health equity principles when implementing overdose prevention strategies.

项目概要/摘要 本增刊旨在探讨健康公平原则的注入对预防用药过量的影响 作为 HEALing 一部分的社区治愈 (CTH) 干预实施期间的策略 社区研究 (HCS) 是一项多中心、平行组、整群随机、等候名单对照试验。 与候补社区的常规护理相比，评估 CTH 干预对药物过量的影响 HCS 的总体目标是将 67 个 HCS 社区的阿片类药物过量死亡人数减少 40%。 四个州的社区组成联盟，就预防过量用药做出共同决定。 实施策略以及如何最好地实施它们，特别是促进过量用药的策略 预防教育和纳洛酮分配 (OEND) 以及阿片类药物使用障碍药物 (MOUD)。 尽管少数群体（无论是由于种族、民族、性别还是 LGBTQIA+ 身份）拥有较少的 阿片类药物使用障碍 (OUD) 的治疗机会较差，且治疗结果存在相关差异 一开始，HCS 并没有明确旨在减少差异或衡量以公平为中心对用药过量的影响 随着人们对种族和民族差异的敏锐认识，这种方法在 2020 年发生了变化。 本增刊将讨论新冠疫情和针对乔治·弗洛伊德之死的种族觉醒。 利用其母公司研究现有人员和基础设施，并研究人员来分析调查和其他 已收集的定性数据将包括对联盟成员的调查， 在研究期间的四个时间点完成阿片类药物过量减少连续护理； 方法跟踪器 (ORCCAT)，由研究人员每月完成，其中包括过量预防信息 按战略、部门、地点、服务人口、联盟批准日期、制定的实施计划、日期 已启动、与战略相关的合作伙伴/实践数量、交付方式以及 REACH 数据； 每项战略实施后，研究人员每月完成一次，其中包括有关数量的信息 所接触的人数和所接触的人口统计数据（例如种族、民族、性别、年龄）。 定性分析着眼于健康公平主题的调查答案与 将公平纳入战略，并进行定性分析，检查联盟如何讨论和 父研究的 PRISM/RE-AIM(S) 概念框架将指导本研究。 用新颖的健康公平视角来研究如何使联盟多样化并预防阿片类药物过量 具有健康公平原则的战略可能有助于覆盖少数群体社区，以及这些背景如何 因素和过程可能相互作用，促进或阻碍健康公平。本研究的结果可用于： 为政策、战略和实践提供信息，以在实施过量用药时纳入健康公平原则 预防策略。

项目成果

Economic Evaluation in Opioid Modeling: Systematic Review.

阿片类药物模型的经济评估：系统评价。

• 发表时间: 2021-02
• 作者: Beaulieu, Elizabeth;DiGennaro, Catherine;Stringfellow, Erin;Connolly, Ava;Hamilton, Ava;Hyder, Ayaz;Cerdá, Magdalena;Keyes, Katherine M;Jalali, Mohammad S
• 通讯作者: Jalali, Mohammad S

Addressing long overdue social and structural determinants of the opioid epidemic.

解决早该解决的阿片类药物流行的社会和结构性决定因素。

• 发表时间: 2021
• 影响因子: 4.2
• 作者: El;Shoptaw, Steven;Goodman;Ono, Hiromi
• 通讯作者: Ono, Hiromi