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

摘要 太平洋岛民是一个土著/殖民的美国种族群体，使用阿片类药物的风险非常高 由于他们的许多社会，经济和健康差异以及沉重的心理健康负担， 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 仍然未被探索和未知，导致高水平的未满足的治疗需求， 岛民经历阿片类药物相关危害的可能性，如过量和死亡。尽管他们迫切 需要OUD治疗，太平洋岛民仍然没有参加目前的阿片类药物研究，也没有寻求正式的治疗。 在这场严重的公共卫生危机中提供治疗服务。 拟议的R34研究将通过应用多方面的方法来解决这一研究和临床差距， 开发和试点测试第一个干预组件，旨在防止未经处理的OUD，增加 太平洋岛民寻求治疗。从这个团队早期的行为健康研究中得出， 对于太平洋岛屿居民，我们将采用一种适合其文化的干预发展办法， 建构主义扎根理论，焦点小组，和一个深思熟虑的公共决策过程，称为公民的 让太平洋岛民参与以文化为基础的现有循证做法， 太平洋岛民寻求治疗。 通过将收集到的信息与太平洋岛民专家理事会和 关于OUD、物质使用和心理健康治疗的文献的Cochrane式系统综述- 为了寻求干预措施，我们将建立一个概念模型，其中包含文化基础的组成部分， 第一个OUD寻求治疗的干预太平洋岛民。同时，我们将创建一组问题， 来衡量这些干预措施的效果。干预的组成部分和我们的衡量标准 然后，将对一小群非专业太平洋岛民成年人进行可行性、可接受性 以及为将来的疗效试验做准备的感知疗效。研究结果将分发回 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 通过小册子、技术报告、社区论坛以及学术演讲和论文，为社区提供支持。

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.