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有关的过量使用率呈指数级增长。鉴于非洲 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 死亡率和发病率的风险增加。因此，迫切需要更好地理解这一点 在这个历史上得不到充分服务的群体中发生致命的流行病。利用亚文化进化论和药物 使用表明文化和代际影响与吸毒模式和风险有关， 非裔美国人，研究检查与服务不足的阿片类药物危机相关的因素 非裔美国人（REFOCUS）项目将采用种族内的群体，非洲人之间的混合方法设计 美国成年人在社区总体目标是更好地了解复杂的结构，社会， 和文化因素，差异影响非医疗处方药的使用和治疗， 非裔美国人的服务使用。最终，我们的目标是收集数据， 干预措施，以减少非霍奇金淋巴瘤和更好地促进开始和完成治疗。重聚焦 该项目有三个目标：1）了解文化和代际特征与 NMPDU、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， 在生活经验的背景下，理解NMPs在整个生命周期中的作用。使用主题分析、数据 将聚集在一起，根据文化定制调查。2)评估人口的结构、社会和文化模式， 在800人（400人=男性，400人=男性）中，NMPDU、其他NMPDU、非法药物使用和治疗服务使用情况 非裔美国人NMPO用户。我们将进行跨部门的面对面的文化了解， 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 按年龄和性别抽样。3)为了预先测试根据初步发现生成的消息， 针对非裔美国人非医疗处方阿片类药物使用者的针对性干预措施。我们将 进行深入的，半结构化的访谈，并使用健康沟通技术，我们将制定一个 一个关于NMPG减少和NMPG增加的文化、性别和世代特定信息库 治疗参与和保留。我们将测试这些将从Aim 1和Aim构造的消息 2项数据，约40名非裔美国人非医疗处方阿片类药物使用者按性别分层， 年龄这项预测试任务将为我们进行全面的RCT做好准备，作为我们研究的下一步。 这个代表性不足的新研究者领导的项目直接符合PAR和NIDA的优先重点 “解决现实世界的复杂性”。由于这个高影响力的项目关注的是一个边缘化的群体 在阿片类药物使用研究中代表性不足，它有可能产生关于文化定制方法的见解 对非裔美国人的未来干预。

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.