Community-based, client-centered prevention homes to address the rural opioid epidemic

联系PD/PI：Westgaard，Ryan 项目总结 我们补充申请的范围与我们最初提交的一致。以下摘要如下 从我们最初提交的材料中。 受阿片类药物影响的农村社区对RFA-DA-17-014、艾滋病毒、丙型肝炎及相关合并症的反应 美国的注射毒品流行：建立预防、治疗和控制系统 (UG3/UH3)，我们提出了一项多阶段、混合方法的研究，旨在实施和评估一种新的 社区响应模式，我们将其命名为以社区为基础、以客户为中心的预防之家。 使用大型多站点注射器服务计划的组织基础设施，在地理上为 驱散威斯康星州北部农村社区的注射吸毒者，我们将建立 在当地建立响应系统，以促进为高风险客户提供循证预防服务。这个 以客户为中心的预防之家模式融合了预防病例管理和移动医疗 将信息技术纳入通过注射器服务方案提供的传统减少伤害服务，其中 我们假设将增加使用预防服务。在UG3阶段，我们将满足需求 与当地利益相关者合作，在威斯康星州6个农村县进行评估，并使用受访者驱动 抽样以进行横断面流行病学评估，以估计艾滋病毒、病毒的流行率 肝炎和性传播感染。视实现征聘和数据收集目标而定，#年 在项目的UH3阶段，我们将在第三阶段部署和评估以客户为中心的预防之家模式 表现出最易受阿片类药物注射流行病恶化影响的县。剩下的3个人 未被选中实施的县将在计划的量化评估中作为比较地点 第5年有效。威斯康星州农村地区阿片类药物注射问题日益严重 因为它体现了在全国范围内观察到的趋势，表明对日益恶化的流行病具有严重的脆弱性 农村社区艾滋病毒、丙型肝炎和阿片类药物过量死亡的证据严重不足- 以预防为主的干预措施。这项建议具有很高的创新性，因为它将是第一个使用 循证移动健康战略和正式执行科学方法，以加强协调 注射器服务项目中的预防服务。它有可能产生很大的影响，因为我们团队的状态- 广泛的覆盖面、广泛的风险接触范围和强大的基础设施，可进行严格的多站点 对我们提出的模型进行了评估。 项目摘要/摘要

Contact PD/PI: WESTERGAARD, RYAN PROJECT SUMMARY The scope of our supplemental application is consistent with our original submission. The below summary is from our original submission. In response to RFA-DA-17-014, HIV, HCV and Related Comorbidities in Rural Communities Affected by Opioid Injection Drug Epidemics in the United States: Building Systems for Prevention, Treatment and Control (UG3/UH3), we propose a multi-phase, mixed-methods study that aims to implement and evaluate a novel community response model, which we have named the Community-Based, Client-Centered Prevention Home. Using the organizational infrastructure of a large, multi-site syringe service program serving a geographically disperse population of people who inject drugs in rural communities across Northern Wisconsin, we will build locally responsive systems to facilitate uptake of evidence-based prevention services for high-risk clients. The Client-Centered Prevention Home model incorporates prevention case management and mobile health information technology into traditional harm-reduction services delivered at syringe service programs, which we hypothesize will increase use prevention services. During the UG3 phase, we will perform needs assessments in 6 rural Wisconsin counties in partnership with local stakeholders, and use respondent driven sampling to conduct a cross-sectional epidemiologic evaluation to estimate the prevalence of HIV, viral hepatitis and sexually transmitted infections. Contingent upon meeting recruitment and data collection goals, in the UH3 phase of the project we will deploy and evaluate the Client-Centered Prevention Home model in the 3 counties demonstrating highest vulnerability to worsening epidemics of opioid injection. The 3 remaining counties not selected for implementation will serve as comparison sites in a quantitative evaluation of program effectiveness during year 5. The growing problem of opioid injection in rural Wisconsin is highly significant because it exemplifies trends observed nationally indicating severe vulnerability to worsening epidemics of HIV, HCV, and opioid overdose deaths in rural communities that are substantially underserved by evidence- based prevention interventions. This proposal is highly innovative because it will be the first study to use an evidence-based mHealth strategy and a formal implementation science approach to enhance coordination of prevention services in syringe service programs. It has potential for high impact because of our team's state- wide reach, broad access to at-risk individuals, and robust infrastructure for conducting a rigorous, multi-site evaluation of our proposed model. Project Summary/Abstract