Intervention Development and Pilot Study to Prevent Untreated Native Hawaiian and Pacific Islander Opioid Use Disorders

摘要 太平洋岛民是美国土著/殖民地种族群体，使用阿片类药物的风险非常高 由于社会、经济和健康方面的差异和沉重的精神健康负担而导致的精神障碍 和物质使用障碍。不幸的是，太平洋岛民很少寻求OUD治疗，原因是 仍未开发和未知，导致高水平的未得到满足的治疗需求，从而增加了太平洋地区 岛上居民经历阿片类药物相关伤害的可能性，如过量服药和死亡。尽管他们很紧急 由于需要治疗，太平洋岛民仍然没有参加目前的阿片类药物研究，也不寻求正式的治疗 在这场严重的公共卫生危机期间提供的治疗服务。 拟议的R34研究将通过应用多方面的方法来解决这项研究和临床差距 开发和试行第一批干预组件，旨在通过增加 太平洋岛民寻求治疗。来自该团队早期的行为健康研究 太平洋岛民，我们将使用文化定制的干预发展方法，包括 建构主义扎根的理论、焦点小组和被称为公民的审议公共决策过程 小组让太平洋岛民在文化上立足于现有的循证做法，以增加 太平洋岛民寻求治疗。 通过将收集的信息与太平洋岛民专家委员会和 Cochrane风格的关于OUD、物质使用和精神健康治疗的文献的系统回顾- 为了寻求干预，我们将创建一个概念模型，其中包含 首先是对太平洋岛民进行寻求治疗干预。同时，我们将创建一组问题 以衡量这些干预组件的效果。干预组件和我们的测量 然后，将对一小群太平洋岛民成年人进行试探性测试，以确定其可行性、可接受性、 和感知的有效性，为未来的疗效试验做准备。研究成果将传回至 我们的参与者和目标社区、社区合作伙伴(组织和诊所)以及科学 通过宣传册、技术报告、社区论坛、学术报告和论文建立社区。

Abstract Pacific Islanders are an indigenous/colonized U.S. racial group that carries very high risk for opioid use disorders (OUD) due to their many social, economic, and health disparities and heavy burden of mental health and substance use disorders. Unfortunately, Pacific Islanders rarely seek OUD treatment for reasons that remain unexplored and unknown, resulting in high levels of unmet treatment need that increases Pacific Islanders’ likelihood for experiencing opioid-related harms such as overdose and death. Despite their urgent need for OUD treatment, Pacific Islanders remain absent from current opioid research and do not seek formal treatment services during this severe public health crisis. The proposed R34 study will address this research and clinical gap by applying multifaceted methods to develop and pilot test the first intervention components designed to prevent untreated OUDs by increasing Pacific Islander OUD treatment seeking. Drawing from this team’s earlier behavioral health research with Pacific Islanders, we will use a culturally tailored intervention development approach that includes constructivist grounded theory, focus groups, and a deliberative public decision-making process called citizens’ panels to engage lay Pacific Islanders in culturally grounding existing evidence-based practices to increase Pacific Islander OUD treatment seeking. By combining this collected information with feedback from a council of Pacific Islander experts and a Cochrane-style systematic review of the literature on OUD, substance use, and mental health treatment- seeking interventions, we will create a conceptual model containing culturally grounded components for the first OUD treatment-seeking intervention for Pacific Islanders. Simultaneously, we will create a set of questions to measure the effects of these intervention components. The intervention components and our measurement questions will then be pilot tested with a small group of lay Pacific Islander adults for feasibility, acceptability, and perceived efficacy in preparation for a future efficacy trial. Research findings will be disseminated back to our participants and target communities, community partners (organizations and clinics), and the scientific community via brochures, technical reports, community forums, and academic presentations and papers.