Adapting the HOPE Online Support Intervention to Increase MAT Uptake Among OUD Patients

调整 HOPE 在线支持干预措施以提高 OUD 患者对 MAT 的吸收

• 批准号: 10076344
• 负责人: Sean Young
• 金额: $ 37.43万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-28 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10076344
• 关键词: Adapting; HOPE; Online; Support; Intervention

In a randomized controlled trial, with 3, 6-month and 1-year follow-up, this application seeks to assess the effectiveness of using an online peer support community intervention to increase MAT initiation and sustainment among participants with opioid use disorder (OUD) who are recruited online. On average, 130 people die in the United States each day from opioid overdoses, making the opioid crisis the country's top public health concern (1,2). Although effective FDA-approved medication-assisted therapy (MAT) is available for patients with opioid use disorder (OUD), including buprenorphine and injectable naltrexone, only a small fraction of those who would benefit from these medications use them. There are a number of reasons for low MAT use, including lack of insurance; knowledge, among both providers and patients; MAT-related stigma; and social norms (e.g., people would be more willing to use MAT if their peers were also using MAT). Innovative methods, especially those that address multiple levels (e.g., the individual, culture, and society/community) are needed to increase MAT use among individuals with OUD. Online peer-led support interventions might be particularly effective at increasing MAT uptake because they can leverage peers to widely and rapidly scale changes in social norms (e.g., interest in using MAT) throughout people's natural, real-world, virtual environments. For example, the Harnessing Online Peer Education (HOPE) intervention, an online peer support community intervention designed to reduce stigma and increase health behavior change, has been shown to be effective at changing health behaviors among stigmatized populations, such as for HIV. Specific to opioid-related issues, our team recently found the HOPE intervention to be a feasible and acceptable method of reducing risk for prescription opioid misuse among chronic pain patients on opioid therapy. However, no research has studied whether online support interventions, such as HOPE, might be effective in increasing MAT requests, uptake, and sustainment among OUD patients. It is therefore critical to evaluate these social normative/behavioral technology methods to reduce the increasing rate of opioid overdose. In this study, we seek to explore whether and how the HOPE online support intervention might be adapted to increase MAT initiation and sustainment among participants with OUD, assess the effectiveness of using the intervention to increase MAT use among OUD participants recruited online who are not using MAT, and using an implementation science approach (based on constructs from the Consolidated Framework for Implementation Research, CFIR, determine the relationship between social network dynamics (e.g., network size), topics discussed on the online community, and behavior change.

在一项随机对照试验中，有3、6个月和1年的随访，该申请旨在评估 使用在线同行支持社区干预以增加垫子的启动和 在网上招募的阿片类药物使用障碍（OUD）参与者之间的维持。 平均而言，每天有130人死于阿片类药物过量，使阿片类药物危机 该国最高的公共卫生问题（1,2）。虽然有效的FDA批准药物辅助治疗 （MAT）可用于阿片类药物使用障碍（OUD）的患者，包括丁丙诺啡和可注射 Naltrexone，只有一小部分会从这些药物中受益的人使用它们。有一个 垫子使用低的原因，包括缺乏保险；知识，在提供者和 患者;与MAT相关的污名；和社会规范（例如，如果他们的同龄人，人们会更愿意使用垫子 也使用垫子）。创新方法，尤其是那些解决多个层面的方法（例如，个人， 需要增加文化和社会/社区）来增加OUD个人的垫子使用。 以在线同行为主导的支持干预措施可能特别有效地增加了MAT吸收 他们可以利用同龄人广泛，快速扩大社会规范的变化（例如，对使用MAT的兴趣） 在人们的自然，现实世界中的虚拟环境中。例如，利用在线同行 教育（希望）干预，一种在线同伴支持社区干预措施，旨在减少污名和 增加健康行为改变，已被证明可以有效改变健康行为 污名化的人群，例如艾滋病毒。我们的团队最近发现了与阿片类药物有关的问题，最近发现了希望 干预是一种可行且可接受的方法，可减少处方阿片类药物滥用的风险 阿片类药物治疗的慢性疼痛患者。但是，尚无研究研究是否在线支持 诸如Hope之类的干预措施可能有效地增加了MAT请求，吸收和维持 Oud患者。因此，评估这些社会规范/行为技术方法至关重要 降低阿片类药物过量的增加速率。 在这项研究中，我们试图探讨如何以及如何适应希望在线支持干预措施 为了增加OUD参与者之间的MAT启动和维持，评估使用的有效性 干预措施以增加不使用MAT的在线招聘的Oud参与者中的垫子使用，并使用 一种实施科学方法（基于从合并框架的结构 实施研究，CFIR，确定社交网络动态之间的关系（例如，网络 大小），在线社区讨论的主题以及行为改变。