Vending machine Naloxone Distribution for Your community (VENDY): Increasing reach and implementation of naloxone distribution

社区自动售货机纳洛酮配送 (VENDY)：扩大纳洛酮配送的覆盖范围和实施

• 批准号: 10664040
• 负责人: Nicole Marie Wagner
• 金额: $ 14.73万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 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 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10664040
• 关键词: Address; Adoption; Adverse event; Australia; Awareness; COVID-19 pandemic; Communities; Data; Development Plans; Disparity; Dissemination and Implementation; Effectiveness; Ensure; Epidemic; Equity; Europe; Evaluation; Event; Evidence based practice; Evidence based program; Funding; Future; Geography; Goals; Harm Reduction; Health system; Home; Individual; Intervention; Interview; Life; Location; Maintenance; Mentors; Modeling; Naloxone; National Institute of Drug Abuse; Needle-Exchange Programs; Opioid Antagonist; Outcome; Overdose reduction; Overdose reversal; Pharmaceutical Preparations; Physical environment; Policies; Population; Populations at Risk; Practical Robust Implementation and Sustainability Model; Privacy; Public Health; Qualitative Evaluations; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Research; Research Project Grants; Resource-limited setting; Risk; Rural; Rural Community; Safety; Secure; Services; Social Environment; Surveys; Target Populations; Testing; Training; Underserved Population; United States; Urban Community; Work; built environment; career; career development; cost; design; effective intervention; evidence base; experience; high risk; implementation barriers; implementation cost; implementation strategy; improved; innovation; interest; low socioeconomic status; member; opioid epidemic; opioid misuse; opioid mortality; opioid overdose; opioid use; opioid user; overdose death; pragmatic randomized trial; pragmatic trial; programs; skills; substance use; tool; underserved community; uptake; usability; user centered design; young adult

PROJECT SUMMARY/ABSTRACT There has been more than a 30% increase in opioid overdose deaths in the last year. Bystander access to naloxone medication effectively reverses opioid overdose deaths with limited adverse events. However, current naloxone distribution strategies are missing individuals at high risk of opioid overdose. Vending machines are an innovative strategy shown to increase reach of harm reduction services in Europe. Young adults who witnessed or experienced an opioid overdose expressed a desire for naloxone vending machines but identified features of the built environment (including safety and location) as perceived factors contributing to use. There is widespread interest in naloxone vending machines in the U.S. Yet, implementation challenges have slowed down or limited adoption including navigating stakeholder approvals and identifying appropriate locations for placement. The aim of this proposal is to study a community-initiated, stakeholder engaged adaptation of naloxone distribution, VEnding machine Naloxone Distribution for Your community (VENDY), to increase the reach of naloxone in underserved populations at-risk of opioid overdose. Study Aims include: Aim 1: To refine the VENDY program in 3 underserved communities (2 urban and 1 rural) using an iterative user centered design (UCD) implementation strategy and stakeholder engagement to increase reach, implementation, and sustainability. We will use iterative usability and message testing to refine the program with community members who misuse opioids. We will conduct surveys and qualitative interviews with stakeholder to refine the UCD implementation strategy for future use. Aim 2: Conduct a 6 month pilot assessment of the VENDY program in 2 urban and 1 rural community. The pilot includes a midcourse adaptation and evaluation of reach, effectiveness, adoption, implementation and maintenance (RE-AIM) outcomes. Aim 3: Identify factors in the social and built environment contributing to reach and implementation of the VENDY program using photovoice qualitative evaluations with organization implementers and community members currently using opioids. Photovoice evaluations will occur in potential locations in Aim 1 to inform VENDY placement and in the VENDY location in Aim 2 to inform stakeholder adaptations. Community-based approaches such as VENDY are particularly important to reach opioid users not currently engaged with health systems. To accomplish these aims, Dr. Wagner will pursue training in 1) user centered design, an innovative implementation strategy, 2) conduct of pragmatic trials in diverse settings, and 3) assessment of the built and social environment and its effect on reach and implementation. This mentored research project and career development plan are designed to prepare Dr. Wagner to become a leader in the adaptation of effective interventions addressing substance use to better reach underserved populations and to produce sustainable implementation models.

项目摘要/摘要 去年，阿片类药物过量死亡增加了30％以上。旁观者访问 纳洛酮药物有效地逆转了不良事件有限的阿片类药物过量死亡。但是，当前 纳洛酮的分布策略是缺失阿片类药物过量风险的个体。自动售货机是 一种创新的策略，该策略显示出欧洲减少伤害服务的影响力。年轻人 目击或经历了阿片类药物过量表达了对纳洛酮自动售货机的渴望，但被确定 建筑环境（包括安全性和位置）的特征是有助于使用的感知因素。那里 在美国，对纳洛酮自动售货机的普遍兴趣，实施挑战已放缓 下降或有限的采用率，包括浏览利益相关者批准并确定适当的位置 放置。该提案的目的是研究社区发起的，利益相关者的适应 纳洛酮分布，您的社区（Vendy）的自动售货机纳洛酮分布，以增加 在服务不足的人群中，阿片类药物过量的纳洛酮范围。研究目的包括： 目的1：使用一个服务的3个服务不足的社区（2个城市和1个农村）的vendy计划 迭代用户以用户为中心的设计（UCD）实施策略和利益相关者参与，以增加 覆盖，实施和可持续性。我们将使用迭代可用性和消息测试来完善 与滥用阿片类药物的社区成员进行计划。我们将进行调查和定性访谈 利益相关者可以完善UCD实施策略，以供将来使用。 目标2：对2个城市和1个农村社区的Vendy计划进行6个月的试点评估。 飞行员包括中期适应和评估覆盖范围，有效性，采用，实施 和维护（re-aim）结果。 目标3：确定社会和建筑环境中的因素，促进和实施 Vendy计划使用组织实施者和社区的Photovoice定性评估 成员当前使用阿片类药物。光盘评估将在AIM 1的潜在位置进行，以告知 Vendy安置和AIM 2的Vendy位置，以告知利益相关者的适应。 诸如Vendy之类的社区方法对于与当前尚未达到阿片类药物的用户尤为重要 参与卫生系统。为了实现这些目标，瓦格纳博士将在1）以用户为中心进行培训 设计，创新的实施策略，2）在不同环境中进行务实试验的行为，3） 评估建筑和社会环境及其对覆盖范围和实施的影响。这是指导的 研究项目和职业发展计划旨在为瓦格纳博士做好准备，成为成为领导者 适应有效干预措施，以解决药物使用，以更好地达到服务不足的人群和 生产可持续的实施模型。