Identifying and Testing Post-Overdose Outreach Adaptations to Enhance Survivor Engagement During the COVID-19 Pandemic

项目概要/摘要 作为意外伤害死亡的主要原因，药物过量仍然是一个关键的公共卫生挑战， 于2019冠状病毒病大流行期间恶化。在OEND和MOUD中参与过量幸存者 这是减少随后致命过量的关键机会。为了应对阿片类药物过量的流行， 社区过量后外展计划，其中通常包括合作伙伴的公共卫生和公共安全 专业人士与过量幸存者亲自跟进，已经出现了参与过量幸存者， Oend和MOUD。随着COVID-19大流行的爆发，大多数过量用药后计划暂停或 最初，他们减少了与吸毒过量幸存者的接触，然后调整了他们的外展活动， 他们与高风险的吸毒过量幸存者的接触这些创新包括电话和短信联系， 向那些没有手机的人分发手机，分发OEND套件和口罩，以及远程医疗 低障碍MOUD启动的伙伴关系。识别、描述和测试这些创新对于 了解如何在COVID大流行期间及以后最好地吸引过量幸存者。在这 R21，我们提出了一个为期两年的计划，以确定和描述创新的过量后参与战略 在COVID-19大流行期间开发，并对最有前途的适应工具包进行试点测试。的 具体目标是通过全州范围内的 调查（目标1），描述促进或阻碍与COVID-19相关的成功的行动机制 通过对过量用药幸存者和过量用药后外联工作人员进行30次定性访谈进行调整（目标2）， 并在一次过量用药后的外联活动中对最有希望的COVID-19适应性策略工具包进行试点测试 计划增加过量幸存者接触的数量，提供纳洛酮急救包，并转介到 MOUD（目标3）。在PARiHS框架的指导下，我们的混合方法将为以下方面提供关键的见解： 什么促进或阻碍了COVID-19相关适应的成功，并使成功和 在COVID-19大流行期间及之后持续变化。我们的最终目标是建立一个有效的， 社区一级过量后外联干预工具包，通过以下方式减少阿片类药物过量死亡 让过量用药幸存者参与OEND和MOUD，以适应COVID-19大流行的社会和 经济挑战。

PROJECT SUMMARY / ABSTRACT As the leading cause of accidental injury death, overdose remains a critical public health challenge that has worsened in the midst of the COVID-19 pandemic. Engaging overdose survivors in OEND and MOUD presents a key opportunity to reduce subsequent fatal overdose. In response to the opioid overdose epidemic, community post-overdose outreach programs, which typically include partner public health and public safety professionals to follow-up with overdose survivors in-person, have emerged to engage overdose survivors in OEND and MOUD. With the onset of the COVID-19 pandemic, most post-overdose programs suspended or initially reduced their contact with overdose survivors and, then, adapted their outreach activities to continue their engagement with high-risk overdose survivors. These innovations included telephone and texting contact, distributing phones to those without, drop-off distribution of OEND kits and masks, and telemedicine partnerships for low barrier MOUD initiation. Identifying, describing, and testing these innovations is crucial to understand how to best engage overdose survivors in the midst of the COVID pandemic and beyond. In this R21, we propose a two-year plan to identify and describe innovative post-overdose engagement strategies developed during the COVID-19 pandemic, and to pilot test a toolkit of the most promising adaptations. The specific aims are to identify innovative adaptions in response to the COVID-19 pandemic through a statewide survey (Aim 1), describe mechanisms of action that promote or impede successful COVID-19 related adaptations through 30 qualitative interviews of overdose survivors and post-overdose outreach staff (Aim 2), and pilot test a toolkit of the most promising COVID-19 adaptive strategies within one post-overdose outreach program to increase the number of overdose survivor contacts, naloxone rescue kits provided, and referrals to MOUD (Aim 3). Guided by the PARiHS framework, our mixed-method approach will provide critical insight on what has promoted or impeded success of COVID-19 related adaptations and enable successful and sustained change during the COVID-19 pandemic and beyond. Our ultimate goal is to develop an effective, community-level post-overdose outreach intervention toolkit that reduces opioid overdose fatalities via engaging overdose survivors in OEND and MOUD that is resilient to the COVID-19 pandemic’s social and economic challenges.