Strengthening Addiction Care Continuum through Community Consortium in Vietnam

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Abstract The current opioid epidemic calls for global attention. Opioid use disorder is a chronical condition that requires long-term comprehensive health services, from assessment, treatment, continuous monitoring, to extended care. Medication-assisted therapy, although available as an effective strategy to treat opioid addiction, has been significantly underutilized due to the hard-to-reach nature of people who use opioids (PWUO) and the shortage of addiction specialist. An impetus for expanding and enhancing addiction treatment is to mobilize community-based healthcare agencies and family members of PWUO. The study will take advantage of the existing community health care infrastructure and family support systems in Vietnam to develop and test an intervention to strengthen a continuum of addiction services. The intervention, entitled “Community Care Consortium (CCC),” features community health workers’ joint effort with family members to provide patient-centered, individualized addiction care and support. The intervention will be developed and tested through three phases in three regions of Vietnam (Ninh Binh, Da Nang, and Can Tho). In Phase 1, we will conduct formative studies with community health workers, community representatives, PWUO, and their family members to identify barriers to addiction service utilization and discuss potential strategies to establish a continuum of addiction services. Based on the formative study findings, the CCC intervention and its implementation plans will be developed through workgroup meetings with researchers, community members, and target users. In Phase 2, the CCC Intervention will be piloted in three communes and revised based on acceptability/feasibility data, process evaluation, and feedback from field staff and participants. In Phase 3, a randomized controlled trial of the CCC Intervention will be conducted in 60 communes, which will be randomized to either an intervention condition or a control condition (30 in each condition). A total of 720 PWUO, 720 of their family members, and 180 commune health workers (CHW) will participate in the study. The intervention outcomes on PWUO, CHW, and family members will be assessed with the data collected at baseline, 3-, 6-, 9- and 12-month follow-ups.