Community-based, client-centered prevention homes to address the rural opioid epidemic

以社区为基础、以客户为中心的预防之家，解决农村阿片类药物流行问题

• 批准号: 10241935
• 负责人: David W Seal
• 金额: $ 78.82万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-15 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10241935
• 关键词: Acquired Immunodeficiency Syndrome; Address; Affect; Antiviral Agents; Area; Case Management; Case Manager; Characteristics; Client; Clinical; Collaborations; Communicable Diseases; Communities; County; Data; Data Collection; Epidemic; Epidemiology; Evaluation; Geography; Goals; HIV; HIV/HCV; Harm Reduction; Health Information System; Health Service Area; Health Services; Hepatitis C virus; Heroin; Home; Individual; Infection; Infrastructure; Injecting drug user; Intervention; Legal; Medical; Methods; Mobile Health Application; Modeling; Names; Needle-Exchange Programs; Needs Assessment; Opiate Addiction; Opioid; Pharmaceutical Preparations; Phase; Population; Population Surveillance; Prevalence; Prevention; Program Effectiveness; Provider; Public Health; Quantitative Evaluations; Questionnaires; Research; Resources; Respondent; Risk; Rural; Rural Community; Rural Population; Sampling; Service delivery model; Services; Sexually Transmitted Diseases; Site; Source; Syringes; System; Testing; Time; Translating; United States; Viral hepatitis; Wisconsin; World Health Organization; base; comorbidity; ethnographic method; evidence base; experience; geographic inaccessibility; health information technology; high risk; implementation framework; implementation science; innovation; mHealth; marginalized population; medication-assisted treatment; meetings; novel; opioid abuse; opioid abuse prevention; opioid epidemic; opioid injection; opioid mortality; opioid use disorder; opioid user; person centered; prescription opioid abuse; prevent; prevention service; preventive intervention; public health relevance; recruit; response; rural counties; rural dwellers; rural residence; service coordination; service delivery; success; treatment services; trend; uptake

PROJECT SUMMARY In response to RFA-DA-17-014, HIV, HCV and Related Comorbidities in Rural Communities Affected by Opioid Injection Drug Epidemics in the United States: Building Systems for Prevention, Treatment and Control (UG3/UH3), we propose a multi-phase, mixed-methods study that aims to implement and evaluate a novel community response model, which we have named the Community-Based, Client-Centered Prevention Home. Using the organizational infrastructure of a large, multi-site syringe service program serving a geographically disperse population of people who inject drugs in rural communities across Northern Wisconsin, we will build locally responsive systems to facilitate uptake of evidence-based prevention services for high-risk clients. The Client-Centered Prevention Home model incorporates prevention case management and mobile health information technology into traditional harm-reduction services delivered at syringe service programs, which we hypothesize will increase use prevention services. During the UG3 phase, we will perform needs assessments in 6 rural Wisconsin counties in partnership with local stakeholders, and use respondent driven sampling to conduct a cross-sectional epidemiologic evaluation to estimate the prevalence of HIV, viral hepatitis and sexually transmitted infections. Contingent upon meeting recruitment and data collection goals, in the UH3 phase of the project we will deploy and evaluate the Client-Centered Prevention Home model in the 3 counties demonstrating highest vulnerability to worsening epidemics of opioid injection. The 3 remaining counties not selected for implementation will serve as comparison sites in a quantitative evaluation of program effectiveness during year 5. The growing problem of opioid injection in rural Wisconsin is highly significant because it exemplifies trends observed nationally indicating severe vulnerability to worsening epidemics of HIV, HCV, and opioid overdose deaths in rural communities that are substantially underserved by evidence-based prevention interventions. This proposal is highly innovative because it will be the first study to use an evidence-based mHealth strategy and a formal implementation science approach to enhance coordination of prevention services in syringe service programs. It has potential for high impact because of our team's state-wide reach, broad access to at-risk individuals, and robust infrastructure for conducting a rigorous, multi-site evaluation of our proposed model.

项目摘要 回复RFA-DA-17-014，受阿片类药物影响的农村社区的HIV、HCV和相关合并症 美国的注射毒品流行病：建立预防、治疗和控制系统 (UG3/UH 3），我们提出了一个多阶段，混合方法的研究，旨在实施和评估一种新的 社区反应模式，我们称之为以社区为基础，以客户为中心的预防之家。 使用一个大型的、多地点的注射器服务项目的组织基础设施， 分散人口的人谁注射毒品在农村社区整个北方威斯康星州，我们将建立 地方应对系统，以促进高风险客户接受循证预防服务。的 以客户为中心的预防之家模式结合了预防病例管理和移动的保健 信息技术融入传统的减少伤害服务，在注射器服务计划，我们 假设将增加使用预防服务。在UG 3阶段，我们将进行需求评估 在6个农村威斯康星州县与当地利益相关者合作，并使用受访者驱动的抽样， 进行横断面流行病学评估，以估计艾滋病毒、病毒性肝炎和 性传播感染取决于是否达到UH 3中的招募和数据收集目标 在项目的第一阶段，我们将在3个县部署和评估以客户为中心的预防之家模式 这表明最容易受到阿片类药物注射流行病恶化的影响。剩下的三个县没有 在对计划的有效性进行定量评估时， 在第五年。在威斯康星州农村，阿片类药物注射问题日益严重，这一点非常重要，因为它 证实了在全国范围内观察到的趋势，表明艾滋病毒、丙型肝炎病毒和 农村社区阿片类药物过量死亡，循证预防服务严重不足 干预措施。这一建议具有高度的创新性，因为它将是第一项使用循证医学的研究。 移动卫生战略和正式实施科学方法，以加强预防协调 注射器服务计划中的服务。它有很大的影响力，因为我们的团队的全州范围内， 广泛接触处于风险中的个人，以及进行严格的多地点评估的强大基础设施 我们提出的模型。

项目成果

Validation of Dried Blood Spots for Capturing Hepatitis C Virus Diversity for Genomic Surveillance.

验证干血斑捕获丙型肝炎病毒多样性以进行基因组监测。

• DOI: 10.1101/2023.07.06.23292160
• 发表时间: 2023
• 期刊: medRxiv : the preprint server for health sciences
• 作者: Tully,DamienC;Power,KarenA;Sarette,Jacklyn;Stopka,ThomasJ;Friedmann,PeterD;Korthuis,PTodd;Cooper,Hannah;Young,AprilM;Seal,DavidW;Westergaard,RyanP;Allen,ToddM
• 通讯作者: Allen,ToddM

Predictors of skin and soft tissue infections among sample of rural residents who inject drugs.

注入药物的农村居民样本中皮肤和软组织感染的预测因子。

• DOI: 10.1186/s12954-020-00447-3
• 发表时间: 2020-12-02
• 期刊: Harm reduction journal
• 影响因子: 4.4
• 作者: Baltes A;Akhtar W;Birstler J;Olson-Streed H;Eagen K;Seal D;Westergaard R;Brown R
• 通讯作者: Brown R