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.

项目概要/摘要 由于以下原因，药物使用是拉丁裔和西班牙裔的一个严重问题 与此相关的身体伤害和负面后果的数量不成比例 相对于其他种族/族裔群体的物质使用。然而，西班牙裔的可能性较小 比其他种族/族裔群体寻求药物滥用治疗，无论其情况如何 他们使用的物质，完成海洛因治疗的可能性只有 White 的 75% 个人。治疗导航器（如患者门户）最初旨在抵消 获得治疗和保健的机会存在差异。不幸的是，最初采用这些 在受过教育的白人中产阶级中发现了面向患者的电子医疗工具 已经积极参与自己的医疗保健，而不是由社会弱势群体和 边缘化的少数群体，就好像医疗服务中存在的结构性障碍一样 处理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医疗有潜力提供帮助 边缘化人群寻求护理以克服这些障碍。过去的研究 十年来表明，边缘化人群采用电子卫生保健正在 受健康信息查找行为、电子医疗水平等因素影响 读写能力和技术接受度，因此我们设计了一个治疗导航器 这些发现告诉了西班牙裔美国人。 “Rumbo”是一种易于共享的双语 集成的网络和移动应用程序，可以帮助讲西班牙语和非西班牙语的人 患有药物滥用挑战的西班牙裔人士寻求并获得治疗 服务和相关支持资源。拟议的创新从其他创新中脱颖而出 电子医疗工具通过利用西班牙裔社区的集体效能来克服 障碍并支持个人参与治疗系统的自我效能。伦博的 简单、以用户为中心的设计为文化程度较低的西班牙裔人士提供了 在复杂的美国治疗中了解他们的需求的文化上适当的工具 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 基于社区、以用户为中心的迭代设计过程，将告知内容和 该应用程序的功能。我们将聚集伯纳利欧县治疗的主要利益相关者 系统（新墨西哥州人口最多的地区，50% 是西班牙裔）开发数据库 可用的、文化上适当的资源，并支持项目招募和 传播应用程序的初始版本。完成后，我们将评估 Rumbo 的 在自然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，以及使用的个人是否 随后，Rumbo 对获得服务的信心增强了。