Adapting the HOPE Online Support Intervention to Increase MAT Uptake Among OUD Patients

调整 HOPE 在线支持干预措施以提高 OUD 患者对 MAT 的吸收

• 批准号: 10219462
• 负责人: Sean Young
• 金额: $ 291.27万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-28 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10219462
• 关键词: Address; Adoption; Affect; Behavioral; Buprenorphine; Clinic; Clinical; Communities; Country; Data; Education; Educational Intervention; FDA approved; Future; Goals; HIV; Health behavior change; Image; Incentives; Individual; Injectable; Insurance; Intervention; Interview; Knowledge; Lifestyle-related condition; Methods; Naltrexone; Opioid; Participant; Patient Recruitments; Patient Self-Report; Patients; Persons; Pharmaceutical Preparations; Population; Provider; Public Health; Randomized Controlled Trials; Relapse; Reporting; Research; Resources; Risk; Societies; Stigmatization; Surveys; Technology; Text; Time; United States; Use Effectiveness; addiction; base; behavior change; chronic pain; chronic pain patient; cohesion; community intervention; experience; follow-up; group intervention; implementation science; improved; innovation; insight; interest; online community; opioid epidemic; opioid overdose; opioid therapy; opioid use disorder; outreach; peer; peer support; prescription opioid; prescription opioid misuse; prevent; recruit; social; social media; social norm; social stigma; therapy design; treatment center; uptake; virtual environment; willingness

In a randomized controlled trial, with 3, 6-month and 1-year follow-up, this application seeks to assess the effectiveness of using an online peer support community intervention to increase MOUD initiation and sustainment among participants with opioid use disorder (OUD) who are recruited online. On average, 130 people die in the United States each day from opioid overdoses, making the opioid crisis the country’s top public health concern (1,2). Although effective FDA-approved medication for opioid use disorder (MOUD) is available for patients with opioid use disorder (OUD), including buprenorphine and injectable naltrexone, only a small fraction of those who would benefit from these medications use them. There are a number of reasons for low MOUD use, including lack of insurance; knowledge, among both providers and patients; MOUD-related stigma; and social norms (e.g., people would be more willing to use MOUD if their peers were also using MOUD). Innovative methods, especially those that address multiple levels (e.g., the individual, culture, and society/community) are needed to increase MOUD use among individuals with OUD. Online peer-led support interventions might be particularly effective at increasing MOUD uptake because they can leverage peers to widely and rapidly scale changes in social norms (e.g., interest in using MOUD) throughout people’s natural, real-world, virtual environments. For example, the Harnessing Online Peer Education (HOPE) intervention, an online peer support community intervention designed to reduce stigma and increase health behavior change, has been shown to be effective at changing health behaviors among stigmatized populations, such as for HIV. Specific to opioid-related issues, our team recently found the HOPE intervention to be a feasible and acceptable method of reducing risk for prescription opioid misuse among chronic pain patients on opioid therapy. However, no research has studied whether online support interventions, such as HOPE, might be effective in increasing MOUD requests, uptake, and sustainment among OUD patients. It is therefore critical to evaluate these social normative/behavioral technology methods to reduce the increasing rate of opioid overdose. In this study, we seek to explore whether and how the HOPE online support intervention might be adapted to increase MOUD initiation and sustainment among participants with OUD, assess the effectiveness of using the intervention to increase MOUD requests among OUD participants recruited online who are not using MOUD, and using an implementation science approach determine the relationship between online community data and behavior change.

在一项为期 3、6 个月和 1 年随访的随机对照试验中，该应用程序旨在评估使用在线同伴支持社区干预措施来提高在线招募的阿片类药物使用障碍 (OUD) 参与者的 MOUD 启动和维持的有效性。 在美国，平均每天有 130 人死于阿片类药物过量，这使得阿片类药物危机成为该国首要的公共卫生问题 (1,2)。尽管 FDA 批准的治疗阿片类药物使用障碍 (MOUD) 的有效药物可用于阿片类药物使用障碍 (OUD) 患者，包括丁丙诺啡和注射纳曲酮，但只有一小部分受益于这些药物的患者会使用这些药物。 MOUD 使用率低的原因有很多，包括缺乏保险；提供者和患者之间的知识； MOUD 相关的耻辱；和社会规范（例如，如果他们的同龄人也使用 MOUD，人们会更愿意使用 MOUD）。需要创新方法，特别是那些涉及多个层面（例如个人、文化和社会/社区）的方法来增加 OUD 患者对 MOUD 的使用。 在线同行主导的支持干预措施可能对提高 MOUD 的采用特别有效，因为它们可以利用同行在人们的自然、现实世界、虚拟环境中广泛、快速地改变社会规范（例如，对使用 MOUD 的兴趣）。例如，利用在线同伴教育（HOPE）干预措施是一种在线同伴支持社区干预措施，旨在减少耻辱并促进健康行为改变，已被证明可以有效改变被耻辱人群的健康行为，例如针对艾滋病毒的行为。针对阿片类药物相关问题，我们的团队最近发现 HOPE 干预是一种可行且可接受的方法，可降低接受阿片类药物治疗的慢性疼痛患者处方阿片类药物滥用的风险。然而，尚无研究研究在线支持干预措施（例如 HOPE）是否可能有效增加 OUD 患者的 MOUD 请求、接受和维持。因此，评估这些社会规范/行为技术方法以减少阿片类药物过量的增加率至关重要。 在本研究中，我们试图探索 HOPE 在线支持干预措施是否以及如何调整以增加 OUD 参与者中 MOUD 的发起和维持，评估使用干预措施来增加在线招募的未使用 MOUD 的 OUD 参与者中 MOUD 请求的有效性，并使用实施科学方法确定在线社区数据和行为改变之间的关系。