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.

项目总结/文摘