UnityPhilly Response App for Overdose Reversal: Assessing Citywide Effectiveness and Sustainability

UnityPhilly 逆转用药过量响应应用程序：评估全市范围的有效性和可持续性

• 批准号: 10585638
• 负责人: Stephen E Lankenau
• 金额: $ 97.99万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10585638
• 关键词: Acute; Address; Adoption; African American population; COVID-19 impact; COVID-19 pandemic; Cessation of life; Cities; Communities; Disease; Effectiveness; Emergency Situation; Enrollment; Ensure; Environment; Epidemic; Equity; Event; Family member; Feasibility Studies; Fentanyl; Goals; Government Agencies; Health; Heroin; Intervention; Latinx; Link; Local Government; Maintenance; Medical; Mission; Modeling; Naloxone; Neighborhoods; Outcome; Outcome Measure; Overdose; Overdose reduction; Overdose reversal; Participant; Pathway interactions; Pattern; Persons; Philadelphia; Population; Process; Psyche structure; Public Health; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recovery; Research; Signal Transduction; Speed; Subgroup; United States National Institutes of Health; behavioral study; community organizations; design; experience; improved; innovation; insight; manufacture; member; mortality; opioid epidemic; opioid misuse; opioid mortality; opioid overdose; opioid use; overdose death; overdose risk; pilot test; prescription opioid; public health intervention; public health priorities; response; scale up; smartphone application; synthetic opioid; uptake; urban setting; usability; volunteer; willingness

PROJECT SUMMARY/ABSTRACT Reducing overdose mortality immediately and long-term is a top public health priority as the overdose epidemic in the U.S. continues to worsen. The COVID-19 pandemic, which began hitting the U.S. in early 2020, has exacerbated the overdose crisis - particularly among African Americans and Latinxs. Opioid overdose deaths, which accounted for the most overdose deaths in 2020, continue to drive the epidemic. Overdose deaths linked to synthetic opioids, such as illicitly manufactured fentanyl, have increased significantly and comprised most of the opioid-related deaths in 2020. Despite increasing availability and acceptability of naloxone among laypersons, opioid overdose deaths remain catastrophically high in communities across the U.S. The UnityPhilly smartphone app was developed in 2018-19 alongside several community-based organizations as a public health intervention in response to the opioid overdose crisis in Philadelphia, which has the most acute overdose epidemic among large cities in the U.S. UnityPhilly automatically connects bystanders and victims of opioid overdose with nearby community members who can respond immediately with naloxone. The objective of this proposal, following a successful feasibility study (R34) and clear evidence of overdose reversal supported by UnityPhilly, is to create an easy-to-use, effective, sustainable, and scalable smartphone app to be deployed across the city of Philadelphia. This objective will be achieved by studying subgroups of people equipped with naloxone and UnityPhilly (n=450) and disseminating UnityPhilly to 3,000 citizen volunteers for everyday use to respond to opioid overdose emergencies. The long-term goal of this research is to create a scalable app that can be disseminated to communities across the U.S. experiencing high levels of opioid overdose death. The rationale for this study is that expanding the availability of the UnityPhilly app to laypersons citywide will increase the speed and delivery of naloxone to opioid overdose events across Philadelphia while laying the groundwork for scalability and broader national uptake. Our goals will be achieved with three specific aims: 1) Redevelop UnityPhilly to ensure ease of use; 2) Assess differences in the effectiveness of UnityPhilly across varied urban environments and participant profiles; and 3) Build and study a sustainable environment for UnityPhilly to expand city-wide. This 5-year study will have significant impact by providing actionable evidence regarding the effectiveness of an app-based naloxone intervention to scale up for nationwide use. The study will be conducted in partnership with long-standing community-based organizations to ensure usability and acceptability. This intervention is highly significant since it directly addresses one of the most significant public health problems in the U.S. – the opioid overdose epidemic – which is worsening due to the effects of COVID-19. This intervention is highly innovative as it improves upon a previous developed successful mobile phone app and expands its use to a broader population of users in a large city most impacted by the opioid crisis.

项目总结/摘要 立即和长期减少过量死亡率是公共卫生的首要任务，因为过量流行病 美国的情况继续恶化。2020年初开始袭击美国的COVID-19大流行， 加剧了过量用药的危机，特别是在非洲裔美国人和拉丁美洲人中。阿片类药物过量死亡， 2020年过量死亡人数最多的地区，继续推动这一流行病。过量死亡与 合成阿片类药物，如非法制造的芬太尼，已显着增加，其中大部分是 2020年阿片类药物相关死亡人数尽管纳洛酮的可用性和可接受性在 外行，阿片类药物过量死亡仍然是灾难性的高在美国各地的社区。 智能手机应用程序是在2018-19年与几个社区组织一起开发的，作为公共卫生 针对费城阿片类药物过量危机的干预措施，费城的阿片类药物过量最严重。 美国大城市中的流行病UnityPhilly自动连接旁观者和阿片类药物的受害者 与附近的社区成员谁可以立即与纳洛酮反应过量。的目的 在成功的可行性研究（R34）和明确的药物过量逆转证据支持下， UnityPhilly的目标是创建一个易于使用、有效、可持续和可扩展的智能手机应用程序， 穿过费城这一目标将通过研究配备有 纳洛酮和UnityPhilly（n=450），并向3，000名公民志愿者分发UnityPhilly，供日常使用， 应对阿片类药物过量紧急情况。这项研究的长期目标是创建一个可扩展的应用程序， 可以传播到美国各地经历高水平阿片类药物过量死亡的社区。的 这项研究的理由是，扩大UnityPhilly应用程序的可用性，以全市范围内的外行将增加 纳洛酮在费城阿片类药物过量事件中的速度和交付， 可扩展性和更广泛的国家吸收。我们的目标将通过三个具体目标实现：1）重建 UnityPhilly以确保易用性; 2）评估UnityPhilly在不同城市的有效性差异 环境和参与者概况; 3）建立和研究一个可持续的环境，为团结费城扩大 全市范围内这项为期5年的研究将通过提供有关 基于应用程序的纳洛酮干预措施的有效性，以扩大全国范围的使用。本研究的开展将 以确保可用性和可接受性。这 干预是非常重要的，因为它直接解决了一个最重要的公共卫生问题， 美国-阿片类药物过量流行病-由于COVID-19的影响正在恶化。这种干预 是高度创新的，因为它改进了以前开发的成功的移动的手机应用程序，并扩大了其使用 在一个受阿片类药物危机影响最大的大城市，