Rumbo: An Integrated Mobile and Web-Based Application to Overcome Barriers to Receive Substance Use Disorder (SUD) Treatment and Improve Outcomes for Spanish-Speaking, Hispanic and Latinx Individuals

Rumbo：一款基于移动和网络的集成应用程序，用于克服接受药物滥用障碍 (SUD) 治疗的障碍并改善西班牙语、西班牙裔和拉丁裔个人的治疗结果

• 批准号: 10601173
• 负责人: William P Campbell
• 金额: $ 27.57万
• 依托单位: VOLVER HEALTH LLC
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10601173
• 关键词: Acculturation; Address; Adoption; Alcohols; Area; Censuses; Clinic; Clinical; Clinical Trials; Collaborations; Communities; Complex; Country; County; Data; Databases; Development; Directories; Ethnic Population; Feedback; Focus Groups; Health; Health Insurance; Health Services Accessibility; Healthcare; Healthcare Systems; Heroin; Hispanic; Hispanic Populations; Individual; Insurance Coverage; Latinx; Latinx population; Massachusetts; Measurement; Mediating; Middle Class Populations; Minority Groups; New Mexico; Overdose; Ownership; Participant; Patient Recruitments; Patients; Persons; Pharmacotherapy; Phase; Population; Process; Race; Research; Resources; Self Efficacy; Services; Site; Software Framework; Substance Use Disorder; System; Target Populations; Technology; Testing; Treatment outcome; United States; access disparities; barrier to care; bilingualism; care seeking; design; eHealth; ethnic minority population; experience; feasibility testing; health care availability; hispanic community; implementation study; improved outcome; information seeking behavior; innovation; interoperability; iterative design; literacy; marginalization; marginalized population; medication-assisted treatment; mobile application; mortality; opioid overdose; outreach; overdose death; patient portal; prototype; racial minority; racial population; recruit; secondary analysis; social disparities; social stigma; substance use; substance use treatment; success; tool; treatment services; uptake; usability; user centered design; web app

PROJECT SUMMARY/ABSTRACT Substance use is a significant problem among Latinx and Hispanics due to the disproportionate number of physical harms and negative consequences associated with substance use relative to other racial/ethnic groups. However, Hispanics are less likely than other racial/ethnic groups to seek treatment for substance use, regardless of the substance(s) they use, and only 75% as likely to complete treatment for heroin as White individuals. Treatment navigators, like patient portals, were originally intended to offset disparities in access to treatment and health care. Unfortunately, initial uptake of these patient-facing eHealth tools was found among white, educated, middle-class individuals already actively engaged in their own health care and not by socially disadvantaged and marginalized minority populations, as though the structural barriers to care that exist in the treatment system were carried forward in the solution meant to overcome them. Nonetheless, there are still many who believe that eHealth has the potential to help marginalized people seeking care to surmount these barriers. Research over the last decade has revealed that adoption of eHealth among marginalized populations is influenced by factors such as health information-seeking behaviors, level of eHealth literacy, and technology acceptance, so we have designed a treatment navigator for Hispanics that is informed by these findings. “Rumbo” is an easily shared bi-lingual integrated web and mobile application that helps both Spanish-speaking and non-Spanish- speaking Hispanic individuals with substance use challenges find and access treatment services and related supportive resources. The proposed innovation stands out from other eHealth tools by leveraging the collective efficacy of the Hispanic community to overcome barriers and support individuals’ self-efficacy for engaging the treatment system. Rumbo’s simple, user-centered design provides less-acculturated Hispanic individuals with a culturally appropriate tool to understand their needs within the complex US treatment system. In this Phase I project we will develop the app’s content and functions with a community-based, user-centered, iterative design process that will inform the content and functions of the app. We will gather key stakeholders in the Bernalillo County treatment system (the most populous area in New Mexico and 50% Hispanic) to develop a database of available, culturally appropriate resources, and to support both project recruitment and dissemination of the initial version of the app. Once completed, we will evaluate Rumbo’s acceptability and capability as a treatment navigator in a naturalistic implementation study, as well as how it is shared among users, and whether the individuals who use Rumbo subsequently have increased confidence in accessing services.

项目摘要/摘要 物质使用在拉丁裔和西班牙裔中是一个严重的问题，因为 与之相关的不成比例的身体伤害和负面后果 相对于其他种族/民族群体的物质使用。然而，拉美裔美国人不太可能 比其他种族/民族群体更有权寻求药物使用治疗，而不考虑 他们使用的物质(S)，完成海洛因治疗的可能性只有怀特的75% 个人。治疗导航器，就像患者门户一样，最初是为了抵消 在获得治疗和保健方面的差距。不幸的是，最初对这些的理解 在白人、受过教育的中产阶级中发现了面向患者的电子健康工具 已经积极地从事自己的医疗保健，而不是由社会弱势群体和 被边缘化的少数群体，似乎存在着护理的结构性障碍 治疗系统在旨在克服这些问题的解决方案中得到了延续。 尽管如此，仍有许多人相信电子健康有潜力提供帮助 寻求护理以克服这些障碍的边缘化人群。过去一段时间的研究 十年来的研究表明，在边缘人群中采用电子健康 受健康信息寻求行为、电子健康水平等因素影响 识字率和技术接受度，所以我们设计了一个治疗导航器 从这些发现中得知的西班牙裔美国人。“Rumbo”是一种很容易分享的双语 集成的Web和移动应用程序，帮助讲西班牙语和非西班牙语的人- 对有药物使用困难的拉美裔个人寻找和获得治疗 服务和相关的支持资源。这项提议的创新从其他创新中脱颖而出 电子健康工具通过利用拉美裔社区的集体效能来克服 阻碍和支持个人参与治疗系统的自我效能。Rumbo的 简单、以用户为中心的设计为文化程度较低的西班牙裔个人提供了 文化上合适的工具，以了解他们在复杂的美国治疗中的需求 系统。在这个第一阶段项目中，我们将开发应用程序的内容和功能 以社区为基础、以用户为中心的迭代设计流程将向内容和 应用程序的功能。我们将召集伯纳利洛县治疗中的关键利益相关者 系统(新墨西哥州人口最多的地区和50%的西班牙裔)开发一个数据库 可利用的、符合文化需要的资源，并支持项目征聘和 该应用程序的初始版本的传播。一旦完成，我们将评估Rumbo的 在自然主义实施中作为治疗导航者的可接受性和能力 研究，以及如何在用户之间共享，以及使用 Rumbo随后增加了获得服务的信心。