UnityPhilly Response App for Overdose Reversal: Assessing Citywide Effectiveness and Sustainability

UnityPhilly 逆转用药过量响应应用程序：评估全市范围的有效性和可持续性

• 批准号: 10585638
• 负责人: Stephen E Lankenau
• 金额: $ 97.99万
• 依托单位: DREXEL UNIVERSITY
• 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 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10585638
• 关键词: Acute; Address; Adoption; African American population; COVID-19 impact; COVID-19 pandemic; Cessation of life; Cities; Communities; Disease; Effectiveness; Emergency Situation; Enrollment; Ensure; Environment; Epidemic; Equity; Event; Family member; Feasibility Studies; Fentanyl; Goals; Government Agencies; Health; Heroin; Intervention; Latinx; Link; Local Government; Maintenance; Medical; Mission; Modeling; Naloxone; Neighborhoods; Outcome; Outcome Measure; Overdose; Overdose reduction; Overdose reversal; Participant; Pathway interactions; Pattern; Persons; Philadelphia; Population; Process; Psyche structure; Public Health; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recovery; Research; Signal Transduction; Speed; Subgroup; United States National Institutes of Health; behavioral study; community organizations; design; experience; improved; innovation; insight; manufacture; member; mortality; opioid epidemic; opioid misuse; opioid mortality; opioid overdose; opioid use; overdose death; overdose risk; pilot test; prescription opioid; public health intervention; public health priorities; response; scale up; smartphone application; synthetic opioid; uptake; urban setting; usability; volunteer; willingness

PROJECT SUMMARY/ABSTRACT Reducing overdose mortality immediately and long-term is a top public health priority as the overdose epidemic in the U.S. continues to worsen. The COVID-19 pandemic, which began hitting the U.S. in early 2020, has exacerbated the overdose crisis - particularly among African Americans and Latinxs. Opioid overdose deaths, which accounted for the most overdose deaths in 2020, continue to drive the epidemic. Overdose deaths linked to synthetic opioids, such as illicitly manufactured fentanyl, have increased significantly and comprised most of the opioid-related deaths in 2020. Despite increasing availability and acceptability of naloxone among laypersons, opioid overdose deaths remain catastrophically high in communities across the U.S. The UnityPhilly smartphone app was developed in 2018-19 alongside several community-based organizations as a public health intervention in response to the opioid overdose crisis in Philadelphia, which has the most acute overdose epidemic among large cities in the U.S. UnityPhilly automatically connects bystanders and victims of opioid overdose with nearby community members who can respond immediately with naloxone. The objective of this proposal, following a successful feasibility study (R34) and clear evidence of overdose reversal supported by UnityPhilly, is to create an easy-to-use, effective, sustainable, and scalable smartphone app to be deployed across the city of Philadelphia. This objective will be achieved by studying subgroups of people equipped with naloxone and UnityPhilly (n=450) and disseminating UnityPhilly to 3,000 citizen volunteers for everyday use to respond to opioid overdose emergencies. The long-term goal of this research is to create a scalable app that can be disseminated to communities across the U.S. experiencing high levels of opioid overdose death. The rationale for this study is that expanding the availability of the UnityPhilly app to laypersons citywide will increase the speed and delivery of naloxone to opioid overdose events across Philadelphia while laying the groundwork for scalability and broader national uptake. Our goals will be achieved with three specific aims: 1) Redevelop UnityPhilly to ensure ease of use; 2) Assess differences in the effectiveness of UnityPhilly across varied urban environments and participant profiles; and 3) Build and study a sustainable environment for UnityPhilly to expand city-wide. This 5-year study will have significant impact by providing actionable evidence regarding the effectiveness of an app-based naloxone intervention to scale up for nationwide use. The study will be conducted in partnership with long-standing community-based organizations to ensure usability and acceptability. This intervention is highly significant since it directly addresses one of the most significant public health problems in the U.S. – the opioid overdose epidemic – which is worsening due to the effects of COVID-19. This intervention is highly innovative as it improves upon a previous developed successful mobile phone app and expands its use to a broader population of users in a large city most impacted by the opioid crisis.

项目摘要/摘要 立即降低过量死亡率并长期降低过量的公共卫生优先事项，因为过量的流行病 在美国，仍然更糟。 1920年代初开始袭击美国的COVID-19-19 加剧了过量的危机 - 尤其是在非裔美国人和拉丁裔中。阿片类药物过量死亡， 造成2020年过量死亡的最多，继续推动流行病。过量死亡有关 合成阿片类药物（例如非法生产的芬太尼）已显着增加，并包括大多数 2020年与OIOID相关的死亡。尽管纳洛酮的可用性和可接受性增加 在美国的社区中，外行人，阿片类药物过量死亡仍然在灾难性上很高 智能手机应用程序是在2018 - 19年开发的，与几个基于社区的组织一起作为公共卫生 响应费城阿片类药物过量危机的干预措施，该危机的急性过量 美国大城市中的流行统一会自动将旁观者和受害者联系起来 与附近的社区成员过量服用，他们可以立即用纳洛酮做出反应。这个目的 提案，经过一项成功的可行性研究（R34）和明确的过量逆转证据。 Unityphilly是要创建一个易于使用，有效，可持续和可扩展的智能手机应用程序 在费城市。这一目标将通过研究配备的人的子组来实现 纳洛酮和统一（n = 450），并将Unityphilly传播给3,000名公民志愿者，每天使用 应对阿片类药物过量紧急情况。这项研究的长期目标是创建一个可扩展的应用程序 可以将阿片类药物过量死亡的高水平的美国社区传播到美国各地的社区。这 这项研究的理由是，将Unityphilly应用程序的可用性扩大到全市外行人将增加 纳洛酮向费城整个阿片类药物过量事件的速度和交付，同时奠定基础。 可伸缩性和更广泛的国家吸收。我们的目标将通过三个具体目标实现：1）重新开发 Unityphilly以确保易用性； 2）评估Unityphilly在各种城市的有效性的差异 环境和参与者概况； 3）建立和研究一个可持续的环境，以扩展Unityphilly 全市。这项为期5年的研究将通过提供有关 基于应用程序的纳洛酮干预措施的有效性以扩大全国使用。该研究将进行 与长期以来的社区组织合作，以确保可用性和可接受性。这 干预非常重要，因为它直接解决了最重要的公共卫生问题之一 美国 - 阿片类药物过量流行 - 由于Covid-19的影响而引起的。这种干预 具有高度创新性，因为它可以改善以前开发的成功手机应用程序并扩大其使用 在大城市中，受阿片类药物危机影响最大的广泛用户。