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.

项目概要/摘要 由于药物过量流行，立即和长期降低药物过量死亡率是公共卫生的首要任务 2020 年初开始袭击美国的 COVID-19 疫情继续恶化。 加剧了用药过量危机——尤其是非裔美国人和拉丁裔因服用阿片类药物过量而死亡。 2020 年服药过量死亡人数最多，继续推动与服药过量死亡相关的流行。 合成阿片类药物，例如非法制造的芬太尼，已显着增加，并占大部分 2020 年与阿片类药物相关的死亡人数。尽管纳洛酮的可用性和接受度不断提高 外行人士，美国各地社区的阿片类药物过量死亡人数仍然居高不下 智能手机应用程序是在 2018-19 年与几个社区组织一起开发的，作为公共卫生 费城是阿片类药物过量危机最严重的地区，为应对阿片类药物过量危机而进行的干预 美国大城市的流行病 UnityPhilly 自动将阿片类药物的旁观者和受害者联系起来 附近社区成员服用过量，他们可以立即用纳洛酮做出反应 这样做的目的。 提案，在成功的可行性研究（R34）和过量逆转的明确证据支持后 UnityPhilly，旨在创建一个易于使用、有效、可持续且可扩展的智能手机应用程序进行部署 这一目标将通过研究配备有设备的人群来实现。 纳洛酮和 UnityPhilly (n=450) 并向 3,000 名公民志愿者传播 UnityPhilly 以供日常使用 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。 可以传播到美国各地阿片类药物过量死亡比例较高的社区。 这项研究的理由是，将 UnityPhilly 应用程序扩大到全市非专业人士的可用性将会增加 纳洛酮在费城各地处理阿片类药物过量事件的速度和交付，同时奠定了基础 我们的目标将通过三个具体目标来实现：1) 重新开发。 UnityPhilly 确保易用性；2) 评估 UnityPhilly 在不同城市的有效性差异 环境和参与者概况；以及 3) 建立和研究 UnityPhilly 扩展的可持续环境 这项为期 5 年的研究将通过提供有关该问题的可行证据来产生重大影响。 基于应用程序的纳洛酮干预措施在全国范围内推广的有效性将进行该研究。 与长期存在的社区组织合作，以确保可用性和可接受性。 干预措施非常重要，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，这种情况正在恶化。 具有高度创新性，因为它改进了之前开发的成功手机应用程序并扩展了其用途 面向受阿片类药物危机影响最严重的大城市中更广泛的用户群体。