"Bupe by the Book:" Developing and Testing a Tele-Buprenorphine Intervention in Public Libraries with Unstably Housed Persons with Opioid Use Disorder

“Bupe by the Book：”针对居住不稳定且患有阿片类药物使用障碍的公共图书馆开发和测试远程丁丙诺啡干预措施

• 批准号: 10665787
• 负责人: Lianne A Urada
• 金额: $ 19.08万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-15 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10665787
• 关键词: 2 arm randomized control trial; Address; Adherence; Attitude; Books; Buprenorphine; Businesses; Caring; Child; Cities; Client satisfaction; Clinic; Clinical; Collaborations; Computers; Control Groups; County; Daughter; Dose; Drug Prescriptions; Drug Screening; Emergency Medicine; Environment; Evidence based treatment; Fathers; Focus Groups; Foundations; Health; Health Personnel; Homeless persons; Homelessness; Individual; Intention; Internet; Intervention; Intervention Trial; Interview; Libraries; Location; Measures; Medical; Mental Health; Methodology; Methods; Modeling; Naloxone; National Institute of Drug Abuse; Nurses; Overdose; Parents; Participant; Patient Self-Report; Patients; Perception; Persons; Pharmaceutical Preparations; Pharmacy facility; Population; Privacy; Privatization; Provider; Randomized; Randomized, Controlled Trials; Reproducibility; Research; Resources; Security; Series; Site; Social Workers; Strategic Planning; Structure; Substance Use Disorder; Techniques; Technology; Telemedicine; Testing; Training; Transportation; Treatment Efficacy; Work; arm; design; efficacy evaluation; eligible participant; experience; housing instability; implementation barriers; improved; individualized medicine; innovation; insight; intervention mapping; opioid mortality; opioid overdose; opioid use disorder; outreach; overdose death; peer; prevent; programs; recruit; relapse prevention; telehealth; treatment planning; uptake; urinary

Bupe by the Book: Developing and Testing a Tele-buprenorphine Intervention in Public Libraries with Unstably Housed Persons with Opioid Use Disorder Abstract Public libraries nationwide are experiencing an on-premise opioid overdose crisis. Buprenorphine “bupe” is a highly effective medical treatment for OUD, but many unstably housed persons at libraries lack access to bupe due to structural barriers. “Bupe by the Book” (BBB), in collaboration with our established local partners, San Diego Public Libraries and Father Joe's Village Health Center (FJV), would innovatively adapt FJV's already successful same-day, free low barrier tele-bupe treatment to library settings. By testing tele-bupe uptake and retention in libraries, this study will inform how individuals can receive bupe care in innovative low-barrier ways, potentially changing the landscape radically for implementing bupe. Our three aims are: 1) Develop and refine “Bupe by the Book” (BBB) within the Technology Acceptance Model (TAM): Through focus groups and intervention mapping techniques, we will: a) assess the perceptions of stakeholders such as local residents with children who use the library, library staff, tele-bupe providers, and persons with OUD about BBB's potential, b) develop a plan with stakeholder input, and c) identify modifiable barriers to implementation. 2) Determine the feasibility of BBB and measure treatment uptake and adherence: We will conduct a 12-week pilot 2-arm randomized controlled trial (RCT) (n=40). Study staff will recruit library patrons and randomize them to weekly tele-bupe at the library or in-person clinic control arms. A health provider will then screen participants for eligibility for same-day bupe induction. BBB's effects on bupe induction and adherence to prescribed doses will be based on self-reported measures at 1-,2-,4-,8-,12- week follow-ups with study staff, and weekly urinary drug screenings and prescription pickups. We hypothesize that tele-bupe in the library vs. the control group will have higher uptake and longer adherence to treatment. This pilot will provide estimates of uptake and adherence for the design of a larger trial of the intervention's efficacy. 3) Evaluate the acceptability of BBB and identify program components that could be improved to enhance adherence and patient satisfaction. We will conduct structured interviews with BBB patients, health providers, and library staff to gain insight into the patients' experiences with BBB compared to in-person clinic-based bupe treatment. By utilizing multiple library sites, we will render tele-bupe reproducible for other libraries nationwide facing opioid overdoses and pave the foundation for a larger RCT in a subsequent R01 to evaluate the efficacy of utilizing public settings to treat substance use disorders and reduce opioid-related deaths.

Bupe by the Book：开发和测试公共场所的远程丁丙诺啡干预措施 拥有阿片类药物使用障碍且居住不稳定的人员的图书馆 抽象的 全国范围内的公共图书馆正在经历一场阿片类药物过量危机。丁丙诺啡 “bupe”对于 OUD 来说是一种非常有效的医疗方法，但许多居住不稳定的人 由于结构性障碍，图书馆无法获得 bupe。 “Bupe by the Book”（BBB），与 我们已建立的当地合作伙伴，圣地亚哥公共图书馆和乔神父乡村健康中心 (FJV)， 将创新性地采用 FJV 已经成功的当天免费低屏障远程布佩治疗 库设置。通过测试图书馆对 tele-bupe 的吸收和保留，本研究将告诉您如何 个人可以以创新的低门槛方式接受 bupe 护理，这可能会改变现状 从根本上来说是为了实施bupe。我们的三个目标是： 1) 在技术接受模型中开发和完善“Bupe by the Book”(BBB) (TAM)：通过焦点小组和干预绘图技术，我们将：a) 评估看法 利益相关者，例如使用图书馆的当地有孩子的居民、图书馆工作人员、tele-bupe 提供商和 OUD 人员了解 BBB 的潜力，b) 根据利益相关者的意见制定计划，以及 c) 确定可改变的实施障碍。 2) 确定 BBB 的可行性并衡量治疗的采用率和依从性：我们将 进行为期 12 周的试点 2 组随机对照试验 (RCT) (n=40)。研究人员将招募图书馆 顾客，并随机将他们每周安排在图书馆或现场诊所控制中心接受远程教育。一个健康 然后，提供者将筛选参与者是否有资格进行当天的 bupe 诱导。 BBB对bupe的影响 诱导和遵守规定剂量将基于 1-,2-,4-,8-,12- 的自我报告措施 研究人员进行每周随访，每周进行泌尿药物筛查和处方领取。我们 假设图书馆中的 tele-bupe 与对照组相比会有更高的吸收率和更长的时间 坚持治疗。该试点项目将提供对设计的采用率和依从性的估计。 干预效果的更大规模试验。 3) 评估 BBB 的可接受性并确定可以改进的项目组件 以提高依从性和患者满意度。我们将与BBB进行结构化面试 患者、医疗服务提供者和图书馆工作人员深入了解患者的 BBB 体验 与面对面的临床 Bupe 治疗相比。 通过利用多个图书馆网站，我们将使全国其他图书馆可以复制 tele-bupe 面对阿片类药物过量，并为后续 R01 中更大的 RCT 评估奠定基础 利用公共场所治疗药物滥用障碍和减少阿片类药物相关死亡的功效。