Feasibility of Leveraging the National PulsePoint CPR Responder Network to Facilitate Overdose Education and Naloxone Distribution
利用国家 PulsePoint CPR 应答器网络促进药物过量教育和纳洛酮分发的可行性
基本信息
- 批准号:10811314
- 负责人:
- 金额:$ 19.81万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-09-15 至 2026-08-31
- 项目状态:未结题
- 来源:
- 关键词:AddressAgreementAmericanArticulationAwarenessBindingCaringCenters for Disease Control and Prevention (U.S.)Cessation of lifeCommunitiesDoseEducationEmergency responseEpidemicFatality rateFocus GroupsFosteringGoalsIncentivesIncidenceIndividualInfrastructureInterviewInvestmentsKnowledgeLaw EnforcementLifeLiteratureMedicalMisinformationNaloxoneNotificationOpioidOpioid AntagonistOutcomeOverdoseOverdose reversalPersonsPharmaceutical PreparationsPositioning AttributePrevalencePreventionProceduresRadialRandomizedRandomized, Controlled TrialsRecoveryReportingResourcesRestRisk FactorsSamplingSystemTestingTimeTrainingUnconscious StateUnited Statesarmcostdesigneffectiveness evaluationexperiencefeasibility testingfeasibility trialfirst responderfollow-upillicit opioidinformantmatriculationmobile applicationmultimodalityopioid overdoseoverdose deathoverdose educationpreventprogramsrecruitresponsesocial stigmatooltrial designuptakewillingness
项目摘要
Project Summary
For the 12 months ending in September 2022, more than 100,500 Americans died from an overdose,
the majority of which involved opioids. Substantial national, state, and local resources have been invested in
reducing the prevalence of overdose deaths in the United States. But rather than substantively declining, the
annual overdose death count has remained over 100,000 for year-over-year reports since June 2021. There is
no obvious, single solution to the overdose epidemic, which is a ‘wicked problem’ requiring a multifaceted
prevention, treatment, and recovery system addressing a wide variety of risk factors. However, it is
unequivocally clear that naloxone, an opioid antagonist that can reverse overdose, is a highly effective, rapid
response tool that can save lives.
What is perhaps less well understood is that naloxone is remarkably underutilized; in 2019, fewer
than one quarter of fatal opioid-involved overdoses in the US had any evidence of naloxone administration
prior to death. For naloxone to be an effective solution, it must be present at the scene (e.g., a dose must be
within a radius of an overdose where it can be used) and someone within that radius also needs to be trained
and willing to administer it. Overdose education and naloxone distribution (OEND) programming for laypersons
(e.g., bystanders; other citizens who are not first responders or medical professionals) has been shown to be
feasible and effective in reducing fatal overdose rates but does not presently have sufficient reach. As a
solution, we propose a strategy to leverage the PulsePoint Respond app and network to facilitate OEND
programming. The PulsePoint network is an existing, national network of more than 4,400 community first
responder agencies who coordinate with 894,744 layperson CPR responders who already have indicated
willingness to respond to unconscious and unresponsive persons in public. These layperson responders are
notified through the app when a community first response agency deploys an emergency response team to an
unconscious or unresponsive person in public who is within a certain radius of the layperson. This means that
the infrastructure to deploy individuals to potential opioid overdoses already exists and is active, but the citizen
responders have not necessarily been trained (overdose education and naloxone use) or carry naloxone.
We will test the feasibility of recruiting PulsePoint agencies and layperson responders for OEND using
a 3-arm, multi-stage randomized controlled trial that will assess (1) recruitment of community first responder
agencies and (2) layperson engagement with OEND programming across (a) a standard recruitment condition,
(b) an overdose/naloxone misinformation debunking condition, and (c) a control condition. We will also conduct
qualitative follow-up analyses. Successful completion of this project will directly inform procedures for a follow-
up R01 application to test this approach with an outcomes-focused randomized, controlled trial across a much
larger (1,000+) community sample with a goal of meaningfully reducing community fatal overdose rates.
项目摘要
在截至2022年9月的12个月中,超过100,500名美国人死于过量,
其中大多数涉及阿片类药物。国家、州和地方投入了大量资源,
减少美国过量死亡的发生率。但是,与其大幅下降,
自2021年6月以来,每年的过量死亡人数一直保持在10万人以上。有
没有明显的,单一的解决过量流行病,这是一个“邪恶的问题”,需要多方面的
预防、治疗和康复系统,解决各种各样的风险因素。但据
毫不含糊地清楚,纳洛酮,一种阿片类拮抗剂,可以逆转过量,是一种高效,快速,
可以拯救生命的应急工具。
也许不太清楚的是,纳洛酮的利用率明显不足;在2019年,
在美国,超过四分之一的致命阿片类药物过量有任何纳洛酮给药的证据
在死亡之前。对于纳洛酮是一种有效的解决方案,它必须存在于现场(例如,剂量必须
在过量的半径范围内可以使用它),并且在该半径范围内的人也需要接受培训
并愿意管理它。过量教育和纳洛酮分布(OEND)的外行编程
(e.g.,旁观者;不是第一反应者或医疗专业人员的其他公民)已被证明是
在减少致命过量率方面是可行和有效的,但目前还没有足够的覆盖面。作为
解决方案,我们提出了一个战略,利用PulsePoint响应应用程序和网络,以促进OEND
编程. PulsePoint网络是一个现有的全国性网络,拥有4,400多个社区
响应机构与894,744名已经表示
愿意在公共场合对无意识和无反应的人作出反应。这些非专业人员响应者是
当社区第一反应机构部署紧急反应小组到
在公众场合,在外行人一定范围内的无意识或无反应的人。这意味着
部署个人潜在阿片类药物过量的基础设施已经存在,并且正在活跃,但公民
应答者不一定接受过培训(过量教育和纳洛酮使用)或携带纳洛酮。
我们将测试招募PulsePoint机构和非专业人员响应OEND的可行性,
一项3组、多阶段随机对照试验,将评估(1)招募社区第一反应者
机构和(2)外行参与OEND编程(a)标准招聘条件,
(b)过量/纳洛酮错误信息揭穿条件,和(c)对照条件。我们还将进行
后续定性分析。这个项目的成功完成将直接通知程序如下-
R 01应用程序,以测试这种方法与结果为重点的随机对照试验,在多个
更大的(1,000+)社区样本,目标是有意义地降低社区致命过量率。
项目成果
期刊论文数量(0)
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会议论文数量(0)
专利数量(0)
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