Rumbo: An Integrated Mobile and Web-Based Application to Overcome Barriers to Receive Substance Use Disorder (SUD) Treatment and Improve Outcomes for Spanish-Speaking, Hispanic and Latinx Individuals

Rumbo：一款基于移动和网络的集成应用程序，用于克服接受药物滥用障碍 (SUD) 治疗的障碍并改善西班牙语、西班牙裔和拉丁裔个人的治疗结果

• 批准号: 10601173
• 负责人: William P Campbell
• 金额: $ 27.57万
• 依托单位: VOLVER HEALTH LLC
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10601173
• 关键词: Acculturation; Address; Adoption; Alcohols; Area; Censuses; Clinic; Clinical; Clinical Trials; Collaborations; Communities; Complex; Country; County; Data; Databases; Development; Directories; Ethnic Population; Feedback; Focus Groups; Health; Health Insurance; Health Services Accessibility; Healthcare; Healthcare Systems; Heroin; Hispanic; Hispanic Populations; Individual; Insurance Coverage; Latinx; Latinx population; Massachusetts; Measurement; Mediating; Middle Class Populations; Minority Groups; New Mexico; Overdose; Ownership; Participant; Patient Recruitments; Patients; Persons; Pharmacotherapy; Phase; Population; Process; Race; Research; Resources; Self Efficacy; Services; Site; Software Framework; Substance Use Disorder; System; Target Populations; Technology; Testing; Treatment outcome; United States; access disparities; barrier to care; bilingualism; care seeking; design; eHealth; ethnic minority population; experience; feasibility testing; health care availability; hispanic community; implementation study; improved outcome; information seeking behavior; innovation; interoperability; iterative design; literacy; marginalization; marginalized population; medication-assisted treatment; mobile application; mortality; opioid overdose; outreach; overdose death; patient portal; prototype; racial minority; racial population; recruit; secondary analysis; social disparities; social stigma; substance use; substance use treatment; success; tool; treatment services; uptake; usability; user centered design; web app

PROJECT SUMMARY/ABSTRACT Substance use is a significant problem among Latinx and Hispanics due to the disproportionate number of physical harms and negative consequences associated with substance use relative to other racial/ethnic groups. However, Hispanics are less likely than other racial/ethnic groups to seek treatment for substance use, regardless of the substance(s) they use, and only 75% as likely to complete treatment for heroin as White individuals. Treatment navigators, like patient portals, were originally intended to offset disparities in access to treatment and health care. Unfortunately, initial uptake of these patient-facing eHealth tools was found among white, educated, middle-class individuals already actively engaged in their own health care and not by socially disadvantaged and marginalized minority populations, as though the structural barriers to care that exist in the treatment system were carried forward in the solution meant to overcome them. Nonetheless, there are still many who believe that eHealth has the potential to help marginalized people seeking care to surmount these barriers. Research over the last decade has revealed that adoption of eHealth among marginalized populations is influenced by factors such as health information-seeking behaviors, level of eHealth literacy, and technology acceptance, so we have designed a treatment navigator for Hispanics that is informed by these findings. “Rumbo” is an easily shared bi-lingual integrated web and mobile application that helps both Spanish-speaking and non-Spanish- speaking Hispanic individuals with substance use challenges find and access treatment services and related supportive resources. The proposed innovation stands out from other eHealth tools by leveraging the collective efficacy of the Hispanic community to overcome barriers and support individuals’ self-efficacy for engaging the treatment system. Rumbo’s simple, user-centered design provides less-acculturated Hispanic individuals with a culturally appropriate tool to understand their needs within the complex US treatment system. In this Phase I project we will develop the app’s content and functions with a community-based, user-centered, iterative design process that will inform the content and functions of the app. We will gather key stakeholders in the Bernalillo County treatment system (the most populous area in New Mexico and 50% Hispanic) to develop a database of available, culturally appropriate resources, and to support both project recruitment and dissemination of the initial version of the app. Once completed, we will evaluate Rumbo’s acceptability and capability as a treatment navigator in a naturalistic implementation study, as well as how it is shared among users, and whether the individuals who use Rumbo subsequently have increased confidence in accessing services.

项目摘要/摘要 由于拉丁裔和西班牙裔中的吸毒是一个重大问题 与之相关的身体危害和负面后果数量不成比例 相对于其他种族/族裔群体的物质使用。但是，西班牙裔的可能性较小 比其他种族/族裔群体寻求用于吸毒的治疗 他们使用的物质，只有75％的海洛因治疗可能与白色一样 个人。治疗导航器（例如患者门户）最初是为了抵消 获得治疗和医疗保健方面的差异。不幸的是，最初的吸收 面向患者的eHealth工具是在白人，受过教育的中产阶级的人中发现的 已经积极从事自己的医疗保健，而不是受到社会打扰和 边缘化的少数族裔人口，好像存在的结构性障碍 治疗系统是在旨在克服它们的解决方案中进行的。 尽管如此，仍然有许多人认为eHealth有潜力 边缘化的人寻求照顾以克服这些障碍。对最后的研究 十年透露，在边缘化人群中采用eHealth是 受健康信息行为，eHealth水平等因素的影响 识字和技术接受，因此我们为 这些发现所告知的西班牙裔。 “ Rumbo”是一个容易共享的双语 集成的Web和移动应用程序，可帮助讲西班牙语和非西班牙语 - 用毒品使用挑战说西班牙裔人发现和进入治疗 服务和相关的支持资源。拟议的创新与其他人脱颖而出 通过利用西班牙裔社区的集体效率来克服eHealth工具 障碍和支持个人参与治疗系统的自我效能。 Rumbo的 简单，以用户为中心的设计提供了较较少的西班牙裔人 在复杂的美国治疗中了解其需求的文化上适当的工具 系统。在这个阶段I项目中，我们将使用A开发应用程序的内容和功能 基于社区的，以用户为中心的迭代设计过程，将告知内容和 应用的功能。我们将在Bernalillo县的待遇中收集主要利益相关者 系统（新墨西哥州人口最多的地区和50％的西班牙裔地区）开发一个数据库 可用，文化上适当的资源，并支持项目招聘和 传播该应用程序的初始版本。完成后，我们将评估Rumbo的 自然主义实施中的可接受性和能力作为治疗导航器 研究以及用户之间的共享方式以及使用 Rumbo随后对访问服务的信心增加了。