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

项目总结/摘要 物质使用是拉丁裔和西班牙裔之间的一个重大问题， 不成比例的人身伤害和负面后果， 相对于其他种族/族裔群体的物质使用。然而，西班牙裔不太可能 比其他种族/族裔群体寻求治疗的物质使用，无论 他们使用的物质，只有白色人完成海洛因治疗的可能性的75 个体治疗导航器与患者门户网站一样，最初旨在抵消 在获得治疗和保健方面的差距。不幸的是，最初对这些 在白色、受过教育的中产阶级人群中发现了面向患者的电子健康工具 已经积极从事自己的医疗保健，而不是社会弱势群体， 边缘化的少数群体，因为尽管存在的结构性障碍，照顾 该处理系统在旨在克服这些问题的解决方案中得到了推广。 尽管如此，仍有许多人认为电子健康有可能提供帮助 边缘化的人寻求照顾，以克服这些障碍。过去的研究 十年来的研究表明，在边缘化人群中采用电子健康是 受健康信息寻求行为、电子健康水平等因素的影响， 文化和技术接受度，所以我们设计了一个治疗导航器， 西班牙裔美国人被这些发现所告知。“Rumbo”是一个很容易分享的双语 集成的Web和移动的应用程序，可帮助讲西班牙语和非西班牙语的人， 有物质使用挑战的讲西班牙语的人找到并获得治疗 服务和相关支持资源。这项创新从其他 通过利用西班牙裔社区的集体功效， 障碍和支持个人的自我效能参与治疗系统。兰博餐厅 一个简单的，以用户为中心的设计提供了较少的文化适应的西班牙裔个人， 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的项目中，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，迭代设计过程，将告知内容， 应用程序的功能。我们将聚集在贝纳里洛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和50%的西班牙裔）开发一个数据库， 现有的、文化上适当的资源，并支持项目招聘和 传播的应用程序的初始版本。一旦完成，我们将评估Rumbo的 在自然实施中作为治疗导航器的可接受性和能力 研究，以及它是如何在用户之间共享，以及使用的个人是否 Rumbo随后增加了获得服务的信心。

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.