Culturally Response Integrated Harm Reduction Services for Black and Latinx People Who use Drugs

为黑人和拉丁裔吸毒者提供文化响应综合减害服务

基本信息

批准号：
10590442
负责人：
Ayana Jordan
金额：
$ 212.56万
依托单位：
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-30 至 2025-09-29
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10590442
关键词：
Address Adherence Affect Aftercare Belief Black Populations Black race Caring Cessation of life Cocaine Collaborations Communities Community Services Coupled Data Death Rate Drug usage Drug user Elements Environment Evidence based treatment Face Foundations Geography Goals Harm Reduction Health Health Services Health Services Accessibility Helping to End Addiction Long-term Housing Imprisonment Improve Access Individual Intervention Knowledge Latinx Latinx population Legal Link Mediator of activation protein Mental Health Methamphetamine Modeling Morbidity - disease rate National Institute of Drug Abuse New York City Opiate Addiction Opioid Outcome Overdose Participant Pathway interactions Persons Pharmaceutical Preparations Plant Roots Police Policies Population Public Health Quality of life Research Rights Risk Role Services Social Justice Social Work Social support Speed Stimulant Structural Racism System Trust United States National Institutes of Health addiction base effective therapy effectiveness evaluation effectiveness testing efficacy evaluation expectation experience flexibility follow-up health disparity improved mortality opioid misuse opioid overdose opioid user overdose death participant retention patient engagement racial and ethnic reduced substance use response satisfaction secondary outcome service intervention service programs services as usual social determinants social health determinants social movement substance misuse substance use substance use treatment treatment program

Address Adherence Affect Aftercare Belief Black Populations Black race Caring Cessation of life Cocaine Collaborations Communities Community Services Coupled Data Death Rate Drug usage Drug user Elements Environment Evidence based treatment Face Foundations Geography Goals Harm Reduction Health Health Services Health Services Accessibility Helping to End Addiction Long-term Housing Imprisonment Improve Access Individual Intervention Knowledge Latinx Latinx population Legal Link Mediator of activation protein Mental Health Methamphetamine Modeling Morbidity - disease rate National Institute of Drug Abuse New York City Opiate Addiction Opioid Outcome Overdose Participant Pathway interactions Persons Pharmaceutical Preparations Plant Roots Police Policies Population Public Health Quality of life Research Rights Risk Role Services Social Justice Social Work Social support Speed Stimulant Structural Racism System Trust United States National Institutes of Health addiction base effective therapy effectiveness evaluation effectiveness testing efficacy evaluation expectation experience flexibility follow-up health disparity improved mortality opioid misuse opioid overdose opioid user overdose death participant retention patient engagement racial and ethnic reduced substance use response satisfaction secondary outcome service intervention service programs services as usual social determinants social health determinants social movement substance misuse substance use substance use treatment treatment program

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项目摘要

This study is part of the NIH’s Helping to End Addiction Long-term (HEAL) initiative to speed scientific solutions to the national opioid public health crisis. The NIH HEAL Initiative bolsters research across NIH to improve treatment for opioid misuse and addiction. Over 100,000 people died from drug overdoses in 2021, underscoring the need for urgent action. While the rates of overdose deaths among White people have begun to plateau, there has been a drastic surge in deaths among racial/ethnic minoritized individuals. There are also stark disparities from other substance use, including stimulants among Black and Latinx people who use drugs (PWUD). While effective treatment exists for problematic substance use, along with harm reduction (HR) services that decrease substance-related harms, studies demonstrate that racial/ethnic minoritized people are less likely to have access to these services. They not only experience more negative consequences related to substance misuse but are also less likely to receive HR services or be retained in evidence-based treatment such as MAT. To tackle these unique problems, we created an integrated harm reduction intervention (IHRI) to be mobile and flexible to the needs of Black and Latinx PWUD. This culturally responsive IHRI will employ a HR care coordinator that can assess vulnerabilities in the social determinants of health (SDOH) and link people to needed services. Data from community partners who operate HR services and serve largely Black and Latinx PWUD suggests that participants who receive HR services have significant improvements in health and engagement. Yet, systemic barriers to additional social services NOT directly related to substance use persist, which often influence health outcomes and quality of life. Thus, offering a low barrier, geographically distributed, culturally informed HR intervention in historically excluded communities may prove a highly disseminable strategy, for improving access to HR services and MAT. We plan to evaluate the efficacy of this integrated HR intervention (by providing legal, housing and mental health treatment support, along with linkage to MAT) on participant retention and engagement of HR services among n=200 Black and Latinx PWUD compared to services as usual in two mobile Community Harm Reduction Organizations. The escalating overdose death rates among Black and Latinx PWUD is a serious public health. The focus on health disparities in addiction is of high priority to NIDA and may prove a useful model for decreasing harm and broadening MAT access for Black and Latinx PWUD, who have been historically excluded these services in traditional settings.

这项研究是NIH的一部分，有助于长期（HEL）倡议结束成瘾，以加快对国家阿片类药物公共卫生危机的科学解决方案。 NIH Heal Heal Initiative Bolsters跨NIH的研究，以改善阿片类药物滥用和成瘾的治疗方法。 2021年，超过100,000人因药物过量死亡，强调了紧急行动的需求。虽然白人过量死亡的发生率已经开始稳定，但其他使用药物的兴奋剂也存在明显的差异，包括使用毒品的黑人和拉丁裔人中的兴奋剂（PWUD）。尽管存在有效的物质使用的有效治疗，以及减少与物质有关的危害的危害（HR）服务，但研究表明，种族/族裔少数化的人不太可能获得这些服务。他们不仅遭受与滥用物质有关的更负面后果，而且不太可能接受人力资源服务或保留在基于证据的治疗中（例如MAT）。为了解决这些独特的问题，我们创建了一种综合的危害减少干预措施（IHRI），以使黑人和拉丁裔PWUD的需求灵活地进行移动和灵活。这种具有文化反应的IHRI将采用人力资源护理协调员，该协调员可以评估卫生社会决定者（SDOH）中的脆弱性，并将人们与所需服务联系起来。来自经营人力资源服务并为大型黑人和拉丁人提供服务的社区合作伙伴表明，接受人力资源服务的参与者在健康和参与方面有了显着改善。然而，与药物使用无直接关系的其他社会服务的系统性障碍持续存在，这通常会影响健康结果和生活质量。提供低障碍，地理分布，文化知情的人力资源对历史上排除的社区进行干预可能是一项高度可观的策略，用于改善获得人力资源服务和垫子的访问。我们计划评估这种集成的人力资源干预效率（通过提供法律，住房和心理健康治疗支持，以及与MAT的联系）在n = 200个黑人和拉丁裔PWUD之间的参与保留和参与度上的效率与在两个移动社区减少社区危害组织中的服务相比。黑人和拉丁人的过量死亡率不断升级是一种严重的公共卫生。对成瘾中健康差异的关注是NIDA的优先事项，并且可能是一种有用的模型从历史上看，在传统环境中被排除在外。