CHASE: An Innovative County-Level Public Health Response to the Opioid Epidemic in New York State

项目总结/摘要 本补充材料旨在探讨健康公平原则对预防吸毒过量的影响 在实施社区治疗（CTH）干预措施期间， 社区研究（HCS）。HCS是一项多中心、平行组、随机分组、等待列表对照试验 评估CTH干预的影响，与等待名单社区的常规护理相比，对过量的影响 死亡HCS的总体目标是在67个HCS社区将阿片类药物过量死亡减少40% 横跨四个州社区组成联盟，共同决定如何预防过量用药 实施战略以及如何最好地实施这些战略，特别是促进过量用药的战略 预防教育和纳洛酮分配（OEND）和阿片类药物使用障碍（MOUD）。 即使少数群体（无论是由于种族，民族，性别或LGBTQIA+状态） 阿片类药物使用障碍（OUD）的治疗机会较少， 起初，HCS并没有明确的目标是减少不平等或衡量以公平为中心对过量的影响 预防这种做法在2020年发生了变化，人们敏锐地意识到了内部的种族和民族差异。 新冠疫情和种族觉醒，以回应乔治弗洛伊德杀害。该补充将 利用其母公司研究现有员工和基础设施以及研究人员来分析调查和其他 已经收集的定性数据。主要数据来源将包括对联盟成员的调查， 在研究期间的四个时间点完成;阿片类药物过量减少连续护理 方法跟踪器（ORCCAT），由研究工作人员每月完成，包括药物过量预防信息 按战略、部门、地点、服务人口、联盟批准日期、制定的实施计划、日期 开始，与战略相关的合作伙伴/实践的数量，以及交付模式;以及REACH数据， 一旦实施每项策略，研究工作人员每月填写一次，其中包括 所到达的人和所到达的人的人口统计（例如，种族、民族、性别、年龄）。数据分析将包括 定性分析，研究有关健康公平主题的调查答案与 将公平纳入战略，并进行定性分析，审查联盟如何讨论和 优先考虑公平问题。母研究的PRISM/RE-AIM（S）概念框架将指导本研究 用一种新的健康公平透镜来研究如何使联盟多样化并注入阿片类药物过量预防 具有健康公平原则的战略可能有助于接触少数群体社区， 各种因素和过程可能相互作用，促进或阻碍卫生公平。本研究的结果可用于 为实施过量用药时纳入健康公平原则的政策、战略和实践提供信息 预防战略。

Project Summary/Abstract This supplement aims to explore the impact of the infusion of health equity principles on overdose prevention strategies during the implementation of the Communities That Heal (CTH) intervention as part of the HEALing Communities Study (HCS). The HCS is a multi-site, parallel arm, cluster randomized, wait-list controlled trial evaluating the impacts of the CTH intervention, compared with usual care in wait-list communities, on overdose deaths. The overall goal of the HCS is to reduce opioid overdose deaths by 40% in 67 HCS communities across four states. Communities form coalitions to make shared decisions about what overdose prevention strategies to implement and how best to implement them, particularly strategies that promote Overdose Prevention Education and Naloxone Distribution (OEND) and Medications for Opioid Use Disorder (MOUD). Even though minoritized communities (whether due to race, ethnicity, gender, or LGBTQIA+ status) have less and poorer access to treatment for Opioid Use Disorder (OUD) and associated disparities in outcomes at its outset, HCS did not explicitly aim to reduce disparities or measure the effect of centering equity on overdose prevention. This approach changed in 2020 with an acute awareness of the racial and ethnic disparities within the COVID epidemic and the racial awakening in response to the George Floyd killing. This supplement will leverage its parent study existing staff and infrastructure and study staff to analyze surveys and other qualitative data already collected. The primary data sources will include surveys of coalition members, completed at four-time points during the study period; the Opioid-Overdose Reduction Continuum of Care Approach Tracker (ORCCAT), completed monthly by study staff, that includes overdose prevention information by strategy, sector, venue, population served, coalition approval date, implementation plan developed, date started, number of partners/practices associated with strategy, and mode of delivery; and REACH data, completed by study staff monthly once each strategy is implemented that includes information on number of persons reached and demographics of those reached (e.g., race, ethnicity, sex, age). Data analysis will consist of qualitative analysis looking at associations between survey answers regarding health equity topics and incorporation of equity into strategies, and qualitative analysis examining how coalitions discussed and prioritized equity topics. The parent study’s PRISM/RE-AIM(S) conceptual framework will guide this study with a novel health equity lens to examine how diversifying coalitions and infusing opioid overdose prevention strategies with health equity principles may help reach minoritized communities and how these contextual factors and processes may interact to promote or impede health equity. Results from this study may be used to inform policies, strategies, and practices for incorporating health equity principles when implementing overdose prevention strategies.