Community Wise: An innovative multi-level intervention to reduce alcohol and illegal drug use

社区智慧：减少酒精和非法药物使用的创新多层次干预措施

基本信息

批准号：
9129395
负责人：
Ellen Benoit
金额：
$ 53.75万
依托单位：
UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-05-16 至 2019-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9129395
关键词：
Address Affect African American Alcohols Attention Behavior Behavioral Cognitive Communities Complex Conscious Crime Data Development Distress Drug usage Employment Etiology Evidence based intervention Experimental Designs Feasibility Studies Frequencies Future General Population Goals HIV/HCV Health Services Accessibility Hepatitis C Homelessness Housing Imprisonment Indigenous Individual Inequality Intervention Knowledge Literature Manuals Modeling Outcome Participant Performance Plant Roots Population Poverty Preclinical Drug Evaluation Principal Investigator Process Protocols documentation Provider Public Health Publishing Quality of life Randomized Recommendation Recording of previous events Research Research Methodology Research Personnel Resources Rest Sampling Services Substance Use Disorder Testing United States Substance Abuse and Mental Health Services Administration community based participatory research community organizations cost effectiveness design effective therapy empowered health inequalities illicit drug use innovation member men public health relevance research study social social health determinants social stigma standard of care standardize measure success theories wasting

Address Affect African American Alcohols Attention Behavior Behavioral Cognitive Communities Complex Conscious Crime Data Development Distress Drug usage Employment Etiology Evidence based intervention Experimental Designs Feasibility Studies Frequencies Future General Population Goals HIV/HCV Health Services Accessibility Hepatitis C Homelessness Housing Imprisonment Indigenous Individual Inequality Intervention Knowledge Literature Manuals Modeling Outcome Participant Performance Plant Roots Population Poverty Preclinical Drug Evaluation Principal Investigator Process Protocols documentation Provider Public Health Publishing Quality of life Randomized Recommendation Recording of previous events Research Research Methodology Research Personnel Resources Rest Sampling Services Substance Use Disorder Testing United States Substance Abuse and Mental Health Services Administration community based participatory research community organizations cost effectiveness design effective therapy empowered health inequalities illicit drug use innovation member men public health relevance research study social social health determinants social stigma standard of care standardize measure success theories wasting

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项目摘要

DESCRIPTION (provided by applicant): Rates of alcohol and illicit drug use (AIDU) among residents of distressed communities with concentrations of African Americans (DCAA- i.e., localities with high rates of poverty and crime) are similar to the general population. Yet AIDU has significantly higher consequences for residents in DCAAs (e.g., higher incarceration and HIV/HCV infection rates), who also have considerably less access to effective treatment of substance use disorders. This project will continue to develop and test Community Wise, an innovative multi-level intervention created in partnership with service providers, residents of DCAAs and individuals with histories of substance use disorders and incarceration, to reduce health inequalities related to AIDU. We used community-based participatory research (CBPR) to develop and pilot test Community Wise, achieving 75% intervention completion rates, despite great participant challenges (such as homelessness, AIDU, and poverty). Note that substance use disorder intervention completion rates in the literature are much lower among populations with fewer challenges (often 30 to 40%). We believe that this success is due to the CBPR model used to develop an intervention that is relevant to participants' needs. Community Wise addresses social determinants of health (e.g., stigma, poverty, lack of treatment access, housing, and meaningful employment) and inequalities related to AIDU at the micro level (e.g., cognitive and behavioral processes), meso level (e.g., relationships with individuals and organizations) and macro level (e.g., political and cultural processes). Community Wise builds on critical consciousness theory, which empowers individuals, organizations, and communities to address social determinants of health while changing individual behaviors (e.g., reducing AIDU). We propose to apply the Multiphase Optimization Strategy (MOST) - an innovative and rigorous framework that employs factorial designs - to optimize Community Wise. Specifically, using MOST we will identify the most efficient, scalable, and sustainable components of Community Wise so that we can refine the intervention protocol by including only components that significantly reduce AIDU. The long-term goal of Community Wise is to reduce health inequalities related to AIDU between men with substance use disorders and a history of incarceration residing in DCAAs and the general population through an intervention that is congruent with DCAA world views and grounded in scientific and indigenous knowledge. Data from this study will culminate in an optimized Community Wise manual; enhanced methodological strategies to develop multi-component scalable interventions using MOST and CBPR; and a better understanding of the application of critical consciousness theory to the field of health inequalities related to AIDU.