Project 2: Prevention of Opioid Overdose following Incarceration Leveraging Mobile Health Technology

项目 2：利用移动医疗技术预防监禁后阿片类药物过量

• 批准号: 9766335
• 负责人: Kasey R Claborn
• 金额: $ 25.73万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9766335
• 关键词: Adoption; Alcohol or Other Drugs use; Behavioral; Centers of Research Excellence; Collection; Communities; Criminal Justice; Data; Development; Devices; Drug usage; Educational Intervention; Feasibility Studies; Goals; Harm Reduction; Health Technology; Imprisonment; Individual; Intervention; Interview; Knowledge; Link; Location; Methods; Mobile Health Application; Modality; Modification; Naloxone; Naloxone Training; Opioid; Opioid user; Outcome; Overdose; Participant; Patient Self-Report; Pattern; Phase; Pilot Projects; Population; Populations at Risk; Prevention; Preventive Intervention; Process; Protocols documentation; Qualitative Methods; Randomized Controlled Trials; Recording of previous events; Research; Resources; Rhode Island; Risk; Risk Behaviors; Series; Services; Structure; System; Target Populations; Technology; Telephone; Testing; Text Messaging; Time; Training; Treatment Efficacy; Woman; Work; base; behavioral health; design; high risk; high risk population; implementation strategy; innovation; mHealth; men; mobile application; mobile computing; motivational enhancement therapy; opioid epidemic; opioid overdose; opioid use; opioid use disorder; overdose prevention; overdose risk; prevent; primary outcome; programs; prototype; recruit; relapse risk; skills; skills training; standard of care; therapy development; tool

Project Summary/Abstract Fatal opioid overdoses have increased dramatically over the past decade. Incarcerated men and women with a history of opioid use are at high-risk for overdose upon re-entry into the community. Effective methods of overdose prevention and linkage to community-based substance use treatment post-incarceration are needed. The criminal justice setting is an ideal location to implement opioid overdose prevention interventions due to the high rates of at-risk populations and the opportunities for education and intervention upon re-entry into the community. However, this setting poses significant structural barriers to implementing and sustaining interventions. The use of mobile technology offers an innovative approach to overcoming these barriers and preventing opioid overdose among at-risk men and women upon re-entry into the community post-incarceration. This study will be a Stage I pilot and feasibility study that will be the first to use mobile technology tools to prevent opioid overdose following incarceration. The proposed study seeks to develop and test two mobile platforms: (a) mobile health application intervention (MAI); and (b) text messaging intervention (SMS) and will compare them to standard of care (SOC). Both interventions will use motivational interviewing and harm reduction skills training prior to release from incarceration. The proposed method of opioid overdose prevention is expected to be an efficient and easily disseminable platform that will facilitate linkage to community-based resources, increase knowledge and behavioral skills regarding opioid overdose prevention, and prevent the occurrence of opioid overdose among a key population during a particularly vulnerable period of time. A three-phase, top-down research approach to adapt, refine, and pilot test the interventions will be conducted. Phase 1 will include individual interviews (IDIs) with the target population and key stakeholders in the criminal justice setting to inform intervention development and the implementation strategy. Phase 2 will include development of the mobile intervention technologies. We will conduct a beta test and a series of IDIs with the target population and key stakeholders to inform iterative revision of the interventions. During Phase 3, we will evaluate the feasibility, acceptability, and preliminary efficacy of the mobile technology tools among men and women at-risk for opioid overdose upon re-entry into the community post-incarceration via a 3-armed (MAI vs. SMS vs. SOC) randomized controlled trial with 90 participants. Data will be collected regarding recent drug use, overdose risk behaviors, and linkage to community-based substance use services at 1-, 3-, 6- and 12-month follow-ups. Through IDIs, we will explore: (1) the difference between individuals who demonstrate high usage patterns of the intervention technologies and those with low usage patterns; (2) barriers and facilitators related to implementation and sustainability within the criminal justice setting; and (3) the relationship between outcomes and usage of the intervention technologies. The project is significant in regards to its potential to prevent opioid overdose among criminal justice populations and gain greater understanding of the utility of two mhealth intervention modalities.

项目总结/摘要 过去十年来，致命的阿片类药物过量急剧增加。被监禁的男女 有阿片类药物使用史的人在重返社区后有服用过量的高风险。的有效方法 需要预防过量用药，并与监禁后基于社区的药物使用治疗联系起来。 刑事司法环境是实施阿片类药物过量预防干预措施的理想场所， 高风险人口比例以及重返社会后接受教育和干预的机会 社区然而，这种环境对实施和维持构成了重大的结构性障碍 干预措施。移动的技术的使用为克服这些障碍提供了一种创新的方法， 预防有风险的男女在监禁后重新进入社区时阿片类药物过量。 该研究将是第一阶段试点和可行性研究，将是第一个使用移动的技术工具来预防 阿片类药物过量拟议的研究旨在开发和测试两个移动的平台： 移动的健康应用干预（MAI）;和（B）短信干预（SMS），并将对它们进行比较 标准治疗（SOC）。这两种干预措施都将使用动机访谈和减少伤害技能培训 在从监禁中释放之前。建议的预防阿片类药物过量的方法预计将是一个 建立一个高效、易于传播的平台，促进与社区资源的联系， 关于阿片类药物过量预防的知识和行为技能，并预防阿片类药物的发生 在一个特别脆弱的时期，在一个关键人群中过量使用药物。一个三相自上而下的 将采用研究方法调整、完善和试点测试干预措施。第一阶段将包括 与目标人群和刑事司法环境中的主要利益攸关方进行个别访谈， 制定干预措施和实施战略。第二阶段将包括开发移动的 干预技术。我们将进行一个beta测试和一系列的IDI与目标人群和关键 利益攸关方为干预措施的反复修订提供信息。在第三阶段，我们将评估可行性， 移动的技术工具在有阿片类药物风险的男性和女性中的可接受性和初步疗效 通过3组（MAI vs. SMS vs. SOC）随机化，在监禁后重返社区时用药过量 90名参与者的对照试验。将收集有关近期药物使用、过量风险行为， 并在1个月、3个月、6个月和12个月随访时与社区药物使用服务联系起来。通过IDIs， 我们将探讨：（1）表现出高使用干预模式的个体之间的差异 技术和低使用模式的技术;（2）与实施有关的障碍和促进因素， 刑事司法环境中的可持续性;以及（3）结果与使用 干预技术。该项目在预防阿片类药物过量方面具有重要意义， 刑事司法人口，并获得两个mhealth干预模式的效用更好的理解。