Kentucky CAN HEAL (Communities and Networks Helping End Addiction Long-term)

肯塔基州可以治愈（社区和网络帮助长期消除成瘾）

• 批准号: 10388180
• 负责人: Sharon L. Walsh
• 金额: $ 859万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-17 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10388180
• 关键词: Address; Affect; Age; Algorithms; Attitude; Awareness; Benzodiazepines; Buprenorphine; Caring; Cessation of life; Communities; Community Networks; County; Criminal Justice; Data; Death Rate; Development; Diagnosis; Education; Effectiveness; Emergency Situation; Ensure; Epidemiology; Evidence based intervention; Evidence based practice; Fentanyl; Funding; Government Agencies; Government Officials; Guidelines; Health Professional; Health Services Accessibility; Healthcare; Helping to End Addiction Long-term; Heroin; Individual; Intervention; Jail; Kentucky; Life Expectancy; Methadone; Modeling; Naloxone; Needle-Exchange Programs; Opioid; Opioid Antagonist; Outcome; Overdose; Overdose reduction; Overdose reversal; Pharmaceutical Preparations; Pharmacists; Phase; Policies; Prevention; Prevention approach; Professional Education; Provider; Public Health; Public Policy; Randomized; Recovery Support; Request for Proposals; Research; Resources; Rural; Services; Site; State Government; System; Testing; Training; Training Support; United States; Universities; Work; barrier to care; base; behavioral health; community based participatory research; community center; community intervention; community organizations; cost; design; evidence base; experience; healing; health communication; health economics; high risk; illicit drug use; implementation facilitators; implementation science; implementation strategy; improved; metropolitan; mortality; opioid disposal; opioid epidemic; opioid misuse; opioid mortality; opioid overdose; opioid use disorder; overdose death; overdose education; overdose prevention; parole; prescription monitoring program; prescription opioid; probation; programs; response; screening; social stigma; stem; synthetic opioid; telehealth; test strip; theories; treatment program; waiver

ABSTRACT The Kentucky CAN (Communities and Networks) HEAL (Helping End Addiction Long-term) [KCH] study is a large-scale, community intervention project submitted in response to the HEALing Communities request for proposals to “test the immediate impact of implementing an integrated set of evidence-based interventions” with the aim of reducing opioid overdose deaths by 40% in three years. KCH represents a partnership between the University of Kentucky, Kentucky State government officials and numerous community organizations. This project will employ an incomplete stepped-wedge, cluster randomized design to deploy an integrated set of evidence-based practices in 17 highly affected counties in Kentucky in two waves of assignment. Highly affected counties were identified through an empirical algorithm that incorporated the requisite epidemiological criteria for opioid overdose and structural systems in place to support the deployment of evidence-based interventions (EBIs). Prior to randomization, a systematic implementation science-based approach will be used to assess barriers, attitudes and assets and to enhance implementation of EBIs. Primary intervention aims are to improve and expand treatment with medications for opioid use disorder (MOUD) by increasing capacity, entry and retention, expand overdose prevention approaches in the community and reduce opioid supply by decreasing high risk prescribing and increasing safe drug disposal. Community partners include those representing behavioral health, healthcare, public health, criminal justice and community coalitions. Interventions will include those focused on 1) development of a Care Navigation network in MOUD treatment programs (FQHC’s, OTPs and OBOT providers), syringe service programs, jails and parole and probation offices to increase the number of individuals screened, referred to, initiating evidence-based care, retained in treatment and receiving ancillary recovery support services; 2) enhancing and expanding the treatment workforce through increased DATA 2000 waiver trainings and weekly support through expert telehealth guidance using the ECHO model; 3) increasing overdose education and naloxone distribution in treatment settings, syringe services programs, jails, parole and probation; and the community; 4) increasing access to syringe services programs; 5) reducing risky opioid prescribing and dispensing; and 6) enhancing drug disposal. By targeting individuals who are at highest risk (e.g., out of treatment, reentering the community) and deploying a community-wide health communication strategy to increase awareness and demand for EBIs, we hypothesize that KCH will reduce overdose deaths by 40% in three years. KCH will leverage existing funding and resources to enhance its effectiveness, and the health economics of these interventions will be evaluated in order to have meaningful and translatable impact on public policy.

抽象的 肯塔基州 CAN（社区和网络）HEAL（帮助长期戒除成瘾）[KCH] 研究是一项 应 HEALing 社区要求而提交的大规模社区干预项目 “测试实施一套综合的循证干预措施的直接影响”的提案 目标是在三年内将阿片类药物过量死亡人数减少 40%。 KCH 代表了以下伙伴关系： 肯塔基大学、肯塔基州政府官员和众多社区组织。这 项目将采用不完整的阶梯楔形、集群随机设计来部署一套集成的 分两波任务在肯塔基州 17 个受影响严重的县开展了循证实践。高度 受影响的县是通过经验算法确定的，该算法结合了必要的流行病学知识 阿片类药物过量的标准和支持部署循证的结构系统 干预措施（EBI）。在随机化之前，将使用基于科学的系统实施方法 评估障碍、态度和资产并加强 EBI 的实施。主要干预目标是 通过提高能力来改善和扩大阿片类药物使用障碍 (MOUD) 的药物治疗， 进入和保留，扩大社区的过量预防方法，并减少阿片类药物的供应 减少高风险处方并增加安全药物处置。社区合作伙伴包括 代表行为健康、医疗保健、公共卫生、刑事司法和社区联盟。 干预措施将包括以下重点：1) 开发 MOUD 治疗中的护理导航网络 计划（FQHC、OTP 和 OBOT 提供商）、注射器服务计划、监狱以及假释和缓刑 办公室增加接受筛查、转介、启动循证护理、保留在 治疗和接受辅助康复支持服务； 2）加强和扩大治疗 通过增加 DATA 2000 豁免培训和通过专家远程医疗提供每周支持来培训员工 使用 ECHO 模型进行指导； 3) 增加药物过量教育和治疗中纳洛酮的分配 设置、注射器服务计划、监狱、假释和缓刑；和社区； 4) 增加访问 注射器服务计划； 5) 减少有风险的阿片类药物处方和配药； 6) 增强药物 处理。通过针对风险最高的个人（例如，停止治疗、重新进入社区）和 部署社区范围内的健康传播战略，以提高对 EBI 的认识和需求，我们 假设 KCH 将在三年内将过量死亡人数减少 40%。 KCH 将利用现有资金 和资源来提高其有效性，并将评估这些干预措施的卫生经济学 以便对公共政策产生有意义且可转化的影响。

项目成果

Women with schizophrenia and co-occurring substance use disorders: an increased risk for violent victimization and HIV.

患有精神分裂症和同时发生的物质使用障碍的女性：暴力受害和艾滋病毒的风险增加。

• DOI: 10.1023/a:1018778310859
• 发表时间: 1999
• 期刊: Community mental health journal
• 影响因子: 2.7
• 作者: Gearon,JS;Bellack,AS
• 通讯作者: Bellack,AS

Changing Trends in Drug Overdose Mortality in Kentucky: An Examination of Race and Ethnicity, Age, and Contributing Drugs, 2016-2020.

肯塔基州药物过量死亡率的变化趋势：种族和族裔、年龄和贡献药物的检查，2016-2020 年。

• DOI: 10.1177/00333549221074390
• 发表时间: 2023
• 期刊: Public health reports (Washington, D.C. : 1974)
• 作者: Slavova,Svetla;Freeman,PatriciaR;Rock,Peter;Brancato,Candace;Hargrove,Sarah;Liford,Madison;Quesinberry,Dana;Walsh,SharonL
• 通讯作者: Walsh,SharonL

Drug disposal deserts: An assessment of receptacle availability in Kentucky community pharmacies.

药物处置荒漠：对肯塔基州社区药房容器可用性的评估。

• DOI: 10.1111/jrh.12786
• 发表时间: 2024
• 期刊: The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association
• 作者: Miracle,DustinK;Smith,Noah;Slavova,Svetla;Stinson,LauraK;Roberts,MonicaF;Rock,Peter;Walsh,SharonL;Freeman,PatriciaR
• 通讯作者: Freeman,PatriciaR

Get It in Writing: How to Make Medications for Opioid Use Disorder Available During Incarceration.

以书面形式获取：如何在监禁期间提供治疗阿片类药物使用障碍的药物。

• DOI: 10.1089/jchc.23.08.0065
• 发表时间: 2024
• 期刊: Journal of correctional health care : the official journal of the National Commission on Correctional Health Care
• 作者: McGladrey,Margaret;Kelsch,Jordan;Lofwall,MichelleR;Fanucchi,LauraC;Walsh,SharonL;Oser,CarrieB
• 通讯作者: Oser,CarrieB

Embedding Big Qual and Team Science into Qualitative Research: Lessons from a Large-scale, Cross-site Research Study.

将大质量和团队科学嵌入定性研究：大规模跨站点研究的经验教训。

• DOI: 10.1177/16094069231165933
• 发表时间: 2023
• 期刊: International journal of qualitative methods
• 影响因子: 5.4
• 作者: McAlearney,AnnScheck;Walker,DanielM;Shiu-Yee,Karen;Crable,ErikaL;Auritt,Vanessa;Barkowski,Laura;Batty,EvanJ;Dasgupta,Anindita;Goddard-Eckrich,Dawn;Knudsen,HannahK;McCrimmon,Tara;Olvera,Ramona;Scalise,Ariel;Sieck,Cynthia;Wo
• 通讯作者: Wo