Research Examining Factors Associated with the Opioid Crisis among Underserved African Americans (REFOCUS)

摘要 非裔美国人中与阿片类药物相关的过量服药率呈指数级增长。考虑到非洲人 与其他种族/民族相比，美国阿片类药物使用者的治疗完成率最低 死亡和发病的风险增加。因此，迫切需要更好地理解这一点。 在这一历史上服务不足的群体中出现了致命的流行病。亚文化进化与毒品理论的运用 使用表明文化和世代影响与吸毒模式和风险有关 非裔美国人，研究与服务不足的阿片类药物危机相关的因素 非洲裔美国人(重新聚焦)项目将在非洲人中采用种族内、混合方法的设计 社区中的美国成年人。总体目标是更好地理解复杂的结构、社会、 以及不同文化因素对NMPOU、其他非医疗处方药的使用和治疗的影响 非裔美国人中的服务使用情况。最终，我们的目标是收集数据，为文化定制提供信息 采取干预措施，减少NMPOU，更好地促进治疗的开始和完成。重新聚焦 该项目有三个目标：1)了解与以下方面相关的文化和代际特征 NMPOU、其他NMPDU、非法药物使用和治疗服务使用。我们将深入采访 大约40名非洲裔美国人非医疗处方阿片类药物使用者按性别和年龄分层到 在生活体验的背景下，理解整个生命周期的NMPOU。使用主题分析、数据 将被聚集在一起，根据文化定制这项调查。2)评估结构、社会和文化模式 800人中的非法药物使用和治疗服务使用(400=男性和400= 女性)非裔美国人NMPO用户。我们将进行跨部门面对面的文化知识交流 调查(根据目标1中获得的信息进行修改)和使用定向招募和分层的药物测试 按年龄和性别抽样。3)预先测试根据初始调查结果生成的报文传送 针对非裔美国人非医疗处方阿片类药物使用者的有针对性的干预。我们会 进行深入、半结构化的访谈，并使用健康传播技术，我们将制定 与减少NMPOU和增加NMPOU相关的文化、性别和代际特定信息的库 治疗参与度和保留率。我们将测试将从目标1和AIM构建的这些消息 2大约40名非洲裔美国人非医疗处方阿片类药物使用者的数据，按性别和 年龄。这项预试任务将为我们进行全功率随机对照试验做好准备，作为我们研究的下一步。 这个代表不足的新调查员主导的项目直接与PAR和NIDA的优先重点保持一致 在“解决现实世界的复杂性”领域。因为这个高影响力的项目关注的是边缘群体 在阿片类药物使用研究中代表性不足，它有可能为文化定制提供见解 未来对非裔美国人的干预。

ABSTRACT Opioid-related overdose rates among African Americans have increased exponentially. Given African American opioid users have the lowest treatment completion rates when compared to other races/ethnicities there is increased risk for mortality and morbidity. As a result, there is a dire need to better understand this fatal epidemic among this historically underserved group. Using the theory of Subcultural Evolution and Drug Use which suggests cultural and generational influences are linked to drug use patterns and risks among African Americans, the Research Examining Factors Associated with the Opioid Crisis among Underserved African Americans (REFOCUS) project will employ a within-racial group, mixed-methods design among African American adults in the community. The overall objective is to better understand the complex structural, social, and cultural factors that differentially influence NMPOU, other nonmedical prescription drug use and treatment service use among African Americans. Ultimately, our goal is to gather data that will inform culturally-tailored interventions to reduce NMPOU and better facilitate initiation and completion of treatment. The REFOCUS project has three aims: 1) To understand cultural and generational characteristics associated with NMPOU, other NMPDU, illicit drug use and treatment service use. We will conduct in-depth interviews with approximately 40 African American nonmedical prescription opioid users stratified by gender and age to understand NMPOU across the lifespan within the context of lived experience. Using thematic analysis, data will be gathered to culturally-tailor the survey. 2) To assess structural, social and cultural patterns of NMPOU, other NMPDU, illicit drug use and treatment service use among 800 (400 = male and 400 = female) African American NMPO users. We will conduct cross-sectional face-to-face culturally-informed surveys (modified by information obtained in Aim 1) and drug testing using targeted recruitment and stratified sampling by age and gender. 3) To pretest messaging generated from initial findings that will inform targeted interventions specific to African American nonmedical prescription opioid users. We will conduct in-depth, semi-structured interviews and using health communication techniques, we will develop a library of cultural, gender, and generational specific messages related to decreasing NMPOU and increasing treatment engagement and retention. We will test these messages that will be constructed from Aim 1 and Aim 2 data with approximately 40 African American nonmedical prescription opioid users stratified by gender and age. This pretesting task will prepare us to conduct a fully powered RCT as the next step in our research. This underrepresented new investigator led project directly aligns with the PAR and NIDA’s priority focus area of “addressing real-world complexities”. As this high-impact project focuses on a marginalized group underrepresented in opioid use research and it has the potential to yield insights on ways to culturally-tailor future interventions for African Americans.