NorthStar Node of the Clinical Trials Network

项目摘要 自2019冠状病毒病大流行以来，美国印第安人和阿拉斯加原住民（AIAN）成年人现在经历的最高 美国的药物过量率比白色成年人高31%。 特别是由于慢性健康状况的风险增加而导致阿片类药物使用障碍（OUD）的高风险 非法使用类阿片主要受健康的社会决定因素以及历史创伤的影响。 与艾滋病毒、丙型肝炎相关的重大发病率和死亡率相关的重大公共卫生问题， 3 -5明尼苏达州的AIAN成年人死于阿片类药物过量的可能性是 白人，代表了AIAN和美国白人之间观察到的最大差距。 阿片类药物使用障碍（MOUD）是一种以证据为基础的方法，7-9和促进继续使用阿片类药物的战略。 药物治疗和支持OUD恢复很重要。10，11影响阿片类药物使用的性别特异性因素 与男性相比，在女性中更普遍的复发和恢复包括感觉到的压力，创伤， 和增强的生物应激反应;以及对禁欲的社会支持较少。12，13 AIAN性别- 目前还不存在针对开放式发展的具体干预措施。研究证明了社交网络的积极影响 145然而，了解如何最好地利用社会支持， 在NIDA CTN-0123（目标1）中，我们 通过开发社交数字（Facebook）干预措施来解决这些差距，以促进压力管理 以及社会网络对AIAN妇女阿片类药物戒断的支持。尤其是在新冠肺炎疫情下 在大流行期间，虚拟数字平台具有扩大覆盖面和规模的潜力。16，17与AIAN一致 文化价值的相互依存，社会媒体形成的团体，以防止阿片类药物复吸可能会导致更大的 通过鼓励几代AIAN妇女的合作努力， 利用社区复原力应对压力。18 -21总体研究目标是发展和 评估Facebook干预的可行性，以支持AIAN中阿片类药物使用的恢复 妇女该项目是与MN印第安妇女资源中心的社区合作伙伴共同设计的 （MIWRC）。社区咨询委员会（CAC）为Facebook的发展做出了贡献。 目标1的干预内容和研究方案（NIDA CTN 0123），并将继续指导所有研究 目标2试点RCT的活动。

Project Summary Since the COVID-19 pandemic, American Indian and Alaska Native (AIAN) adults now experience the highest rate of drug overdose in the United States, which is 31% higher than that of White adults.1 AI/AN adults are particularly at high risk for opioid use disorder (OUD) due to elevated risk of chronic health conditions influenced primarily by social determinants of health, as well as historical trauma.2 Illicit use of opioids is a major public health problem associated with significant morbidity and mortality related to HIV, hepatitis C, and overdose.3-5 AIAN adults in Minnesota are seven times more likely to die of an overdose involving opioids than whites, representing the greatest disparity observed between AIAN and whites in the US.6 Medication for opioid use disorder (MOUD) is an evidence-based approach,7-9 and strategies to promote the continuation of pharmacotherapy and support OUD recovery are important.10,11 Gender-specific factors affecting opioid use relapse and recovery that are more prevalent in women compared with men include perceived stress, trauma, and enhanced biological stress reactivity; as well as less social support for abstinence.12,13 AIAN gender- specific interventions for OUD do not exist. Research has documented the positive impact of social networks and social support on abstinence from substance use.145 However, understanding how best to leverage social support remains a key challenge for the addictions treatment field.15 In NIDA CTN-0123 (Aim 1) we are addressing these gaps by developing a social digital (Facebook) intervention to promote stress management and social network support for opioid abstinence among AIAN women. Especially with the COVID-19 pandemic, virtual digital platforms have potential for greater reach and scale.16,17 Consistent with the AIAN cultural value of interdependence, social media-formed groups to prevent opioid relapse could lead to greater adoption and sustainability by encouraging collaborative efforts across generations of AIAN women and leveraging community resilience for coping with stress.18-21 The overall research objective is to develop and evaluate the feasibility of a Facebook intervention for supporting recovery from opioid use among AIAN women. This project was designed with community partners at the MN Indian Women’s Resource Center (MIWRC). A community advisory committee (CAC) contributed to the development of the Facebook intervention content and study protocol for Aim 1 (NIDA CTN 0123) and will continue to guide all study activities for the Aim 2 pilot RCT proposed here.