Kentucky Communities and Researchers Engaging to Halt the Opioid Epidemic (CARE2HOPE)

肯塔基州社区和研究人员致力于制止阿片类药物的流行 (CARE2HOPE)

• 批准号: 10644787
• 负责人: Hannah LF Cooper
• 金额: $ 14.82万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-15 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10644787
• 关键词: Address; Appalachian Region; Area; Cities; Coal; Collaborations; Communities; Country; County; Disease Outbreaks; Disease Outcome; Drug user; Effectiveness; Elements; Ensure; Environment; Epidemic; Epidemiology; HIV; HIV/HCV; Harm Reduction; Health; Health Services; Health behavior; Hepatitis C Therapy; Hepatitis C virus; Heroin; Infrastructure; Injecting drug user; Intervention; Justice; Kentucky; Knowledge; Laws; Medicaid; Medical; Methods; Modeling; Naloxone; Needle-Exchange Programs; Outcome; Overdose; Pathway Analysis; Pharmaceutical Preparations; Phylogenetic Analysis; Plant Roots; Policies; Prescription opioid overdose; Progress Reports; Provider; Public Health; Readiness; Research; Research Infrastructure; Research Personnel; Resources; Risk; Risk Assessment; Risk Behaviors; Rural; Rural Appalachia; Secure; Site; Unsafe Sex; Work; combat; community based research; cost; data exchange; design; evidence base; heroin use; improved; injection drug use; innovation; intervention mapping; member; opioid epidemic; opioid injection; opioid use disorder; prescription opioid; prescription opioid misuse; programs; randomized trial; response; rural area; rural counties; service utilization; social stigma; theories; treatment program; virtual

Abstract: The proposed project will build evidence-based, community-rooted public health responses to the epidemics of non-medical prescription opioid (NMPO) and heroin injecting, overdoses (ODs), and HCV, and to imminent HIV outbreaks, in 12 rural Appalachian Kentucky counties at the epicenter of these intertwined national crises. 10 of these 12 counties rank in the top 5% for HIV/HCV vulnerability. Rates of HCV, injection drug use (IDU), and ODs are high in these counties, and most are in coal country, an RFA priority. Unfortunately, these counties exemplify an extreme version of the “implementation chasm,” a chasm dividing scientific knowledge from action. Evidence-based public health responses to these epidemics exist (e.g., syringe service programs [SSPs]) and are often deployed in cities. In these 12 rural counties, though, scarcities of resources and of providers conspire with drug-related stigma to constrain public health responses. The counties’ public health infrastructures are weak, their harm reduction infrastructures virtually non-existent. This project will bridge the implementation chasm in these 12 counties, and recognizes that bridging this chasm requires more than simply importing SSPs and other evidence-based community response projects (EB-CRPs) from cities. Guided by harm reduction principles, the Risk Environment Model, and Community/ Academic Partnerships (CAPs), in the UG3 we will: (1) Assess and enhance each county’s readiness to improve the local risk environment. (2) Examine the strengths, resources, needs, and gaps of each county’s risk environment. We will conduct a multi-method Community Assessment of the Risk Environment that integrates innovative, rigorous epidemiology (e.g., modeling); policy assessment; and best practices in community-based research (e.g., CAPs). (3) Select an EB-CRP that responds to local needs and strengths, using elements of Intervention Mapping. Go/no go milestone: Each CAP will have created an EB-CRP package that (1) addresses targets common across all counties (e.g., opioid injection, OD, HCV, HIV), and (2) is tailored to local needs, resources, and readiness. In the UH3, we will: (4) Tailor selected EB-CRP to each county’s context using ADAPT-ITT. (5) Analyze the effectiveness and cost of each county’s EB-CRP package, using an innovative community randomized trial. We will use continuous quality improvement to enhance each EB-CRP’s fidelity, reach, immediate effects, and outcomes. To inform interventions, advanced network analyses will overlay risk networks with GHOST phylogenetic transmission data to show where HCV has been and predict where it is going. We draw strength from our collaborations. CAPs will meld residents’ local knowledge with researchers’ scientific expertise. Multi-PIs Young and Cooper have assembled an academic team with unsurpassed expertise in key substance, theories, and methods, and in multisite studies. The combination of a rigorous, innovative design, strong theories, and a stellar team with community roots will ensure high impact.

摘要：拟议项目将建立基于证据、植根于社区的公共卫生应对措施 非医疗处方阿片类药物 (NMPO) 和海洛因注射、过量 (OD) 和丙型肝炎的流行 肯塔基州阿巴拉契亚山脉 12 个农村县的艾滋病毒疫情即将爆发，这些县相互交织 国家危机。这 12 个县中有 10 个县的 HIV/HCV 脆弱性排名前 5%。 HCV 注射率 这些县的吸毒 (IDU) 和 OD 很高，而且大多数位于煤炭国家，这是 RFA 的优先事项。 不幸的是，这些县体现了“执行鸿沟”的极端版本 将科学知识与行动分开。针对这些流行病存在基于证据的公共卫生应对措施 （例如注射器服务计划 [SSP]）并且通常部署在城市中。然而，在这 12 个农村县中， 资源和提供者的稀缺与毒品相关的耻辱相结合，限制了公共卫生应对措施。 这些县的公共卫生基础设施薄弱，减少危害的基础设施几乎不存在。 该项目将弥合这 12 个县的实施鸿沟，并认识到弥合这一问题 鸿沟需要的不仅仅是导入 SSP 和其他基于证据的社区应对项目 (EB-CRP) 来自城市。以减少危害原则、风险环境模型和社区/ 学术合作伙伴关系 (CAP)，在 UG3 中，我们将： (1) 评估并加强每个县的准备情况 改善当地风险环境。 (2) 检查各县的优势、资源、需求和差距 风险环境。我们将对风险环境进行多方法社区评估 整合创新、严格的流行病学（例如建模）；政策评估；以及最佳实践 基于社区的研究（例如 CAP）。 (3) 选择能够满足当地需求和优势的 EB-CRP， 使用干预映射的元素。通过/不通过里程碑：每个 CAP 将创建一个 EB-CRP 一揽子计划 (1) 解决所有县的共同目标（例如阿片类药物注射、OD、HCV、HIV），以及 (2) 根据当地需求、资源和准备情况量身定制。在 UH3 中，我们将： (4) 为每个人量身定制选定的 EB-CRP 使用 ADAPT-ITT 分析县的情况。 (5) 分析每个县 EB-CRP 方案的有效性和成本， 使用创新的社区随机试验。我们将用持续的质量改进来提升每一个 EB-CRP 的保真度、覆盖范围、即时效果和结果。为干预措施提供信息，先进的网络 分析将用 GHOST 系统发育传播数据覆盖风险网络，以显示 HCV 的分布情况 并预测它要去哪里。我们从合作中汲取力量。 CAP 将融合居民当地的 知识与研究人员的科学专业知识。多位 PI Young 和 Cooper 组建了一个学术团队 团队在关键物质、理论和方法以及多地点研究方面拥有无与伦比的专业知识。这 严谨、创新的设计、强大的理论以及具有社区根基的一流团队的结合将 确保高影响力。

项目成果

"I'm not going to lay back and watch somebody die": a qualitative study of how people who use drugs' naloxone experiences are shaped by rural risk environment and overdose education/naloxone distribution intervention.

• DOI: 10.1186/s12954-023-00900-z
• 发表时间: 2023-11-10
• 期刊: HARM REDUCTION JOURNAL
• 影响因子: 4.4
• 作者: Kesich, Zora;Ibragimov, Umedjon;Komro, Kelli;Lane, Kenneth;Livingston, Melvin;Young, April;Cooper, Hannah L. F.
• 通讯作者: Cooper, Hannah L. F.

Emergence of wasp dope in rural Appalachian Kentucky.

• DOI: 10.1111/add.15291
• 发表时间: 2021-07
• 期刊: Addiction (Abingdon, England)
• 作者: Young AM;Livingston M;Vickers-Smith R;Cooper HLF
• 通讯作者: Cooper HLF

Capacity for sustainment of recently established syringe service programs in Appalachian Kentucky: The central role of staff champions.

阿巴拉契亚肯塔基州最近建立的注射器服务计划的维持能力：员工拥护者的核心作用。

• DOI: 10.1111/dar.13436
• 发表时间: 2022
• 期刊: Drug and alcohol review
• 影响因子: 3.8
• 作者: Cooper,HannahLF;Gross,Skylar;Klein,Emma;Fadanelli,Monica;Ballard,April;Lockard,Scott;Batty,Evan;Young,April;Ibragimov,Umed
• 通讯作者: Ibragimov,Umed

"I'm not going to lay back and watch somebody die": A qualitative study of how people who use drugs' naloxone experiences are shaped by rural risk environment and naloxone distribution/overdose education intervention.

“我不会袖手旁观，看着别人死去”：一项关于农村风险环境和纳洛酮分配/过量教育干预如何影响吸毒者纳洛酮经历的定性研究。

• DOI: 10.21203/rs.3.rs-3310319/v1
• 发表时间: 2023
• 期刊: Research square
• 作者: Kesich,Zora;Ibragimov,Umedjon;Komro,Kelli;Lane,Kenneth;Livingston,Melvin;Young,April;Cooper,Hannah
• 通讯作者: Cooper,Hannah

A qualitative study on pharmacy policies toward over-the-counter syringe sales in a rural epicenter of US drug-related epidemics.

• DOI: 10.1186/s12954-021-00569-2
• 发表时间: 2022-01-08
• 期刊: Harm reduction journal
• 影响因子: 4.4
• 作者: Fadanelli M;Cooper HLF;Freeman PR;Ballard AM;Ibragimov U;Young AM
• 通讯作者: Young AM