An mHealth Approach to Decreasing Opioid Abuse and Other Diseases of Despair in Rural Populations

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Project Summary/Abstract Rural Americans face numerous health disparities compared to their urban counterparts and are more likely to die from chronic health conditions, including substance abuse. Indeed, opioid-related mortality is highest in certain rural areas of the U.S., including Appalachia, New England, and the mountain west. A number of studies looking at morbidity and mortality provide insight into the health problems afflicting less educated, rural populations.6-9,14-15 Lack of high school diploma, mental illness, alcohol use, and illicit drug use were all substantially higher in the population of decedents, and individuals suffering from these problems are at heightened risk for opioid misuse.22-29 The purpose of this project is to develop a mobile-based opioid prevention program for rural-based blue-collar workers that provides robust preventive interventions aimed at reduction in alcohol consumption, management of negative mood states including anxiety and depression, and non-pharmacologic approaches to managing pain. The program aims to fill an important gap in service provision to rural adults at risk for opioid misuse. The program will capitalize on technologies available in rural communities – namely mobile health – and will be media rich, including a program ‘coach’ and videos of individuals that users can relate to describing their experiences dealing with pain, substance use difficulties, stress and mood issues - and the impact of these issues on their lives. Similar to other health promotion and substance abuse prevention programs developed by our group, the program will be highly individualized - tailored by user characteristics and experiences, directing users to management of difficult moods, techniques in the self-management of pain, and avoidance of abusing alcohol and other substances, including opioids. In Phase I, with crucial input from two focus groups and our expert consultants, ISA staff will develop and pilot test a mobile opioid misuse prevention program embedded within a larger health promotion program. Pre-development focus groups will be conducted with individuals who will be recruited to help shape the structure and content of the program. ISA staff and the Redmon Group will develop the prototype program, fully developing the Introduction, and extensive sections of My Health Profile, Understanding and Managing Moods, and Taking Care of Yourself – Never Give Up! for Phase I. Following development and expert review of the prototype program, 20 end users will be asked to pilot test the program, including a usability test, quantitative rating of the program, and interview about their experience using the program. To advance to Phase II, there must be an 80% error-free rate and quantitative ratings must be 4 or higher for all items.