A network-based, mixed methods study to identify and support multiple overdose responders and inform overdose prevention interventions

07.项目摘要 该提案的目标是确定策略，以提高过量的有效性和可持续性 教育和纳洛酮分配（OEND）计划的人谁使用毒品（PWUD）。研究表明 一些PWUD热情地承担起“过量反应者”的角色，对多次过量作出反应， 在相对较短的时间内。然而，其他人对很少或没有过量反应。我们试图确定其 影响过量反应行为的个人、社会网络和背景因素， 改善对多次过量用药的PWUD的支持，并确定干预目标， 提高PWUD网络应对其成员过量用药的整体能力。 为了回答这些问题，我们提出了一项纵向混合方法研究，招募了300名残疾人， 内华达州的里诺（未充分研究的西部地区），以实现以下目标： 1.识别OD响应者的个人、社会网络和背景特征（相对于那些 不携带或不使用纳洛酮的人），包括物质使用行为，大小和 社交网络的组成、个人弹性因素以及地理和社会结构因素。 2.质量评估描述了应对OD的积极和消极经验，并确定（a） 残疾人需要的支持或服务，以可持续地应对其社区的ODs，以及（B） 在那些不回应或停止回应的人中，回应的障碍。 3.评估干预措施的可行性和可接受性，以改善应对者的可持续性和福祉， 并增加无应答者的应答行为的启动。 补充目的：收集定量和定性数据，为PWUD的基于代理的模型（ABM）提供信息， 测试不同的开放教育结束计划交付策略如何降低死亡率。

07. Project Summary The goal of this proposal is to identify strategies to improve the effectiveness and sustainability of overdose education and naloxone distribution (OEND) programs for people who use drugs (PWUD). Research suggests that some PWUD enthusiastically take up the role of “overdose responder”, responding to multiple overdoses over relatively short periods of time. Others, however, respond to few or no overdoses. We seek to determine the individual, social network, and contextual factors that influence overdose response behavior, with the goal of improving support for PWUD who respond to multiple overdoses and identifying intervention targets to improve the overall capacity of PWUD networks to respond to overdoses among their members. To answer these questions, we propose a longitudinal mixed methods study with 300 PWUDs recruited in Reno, Nevada (an understudied Western region), to address the following aims: 1. Identify the individual, social network, and contextual characteristics of OD responders (relative to those who do not carry or do not use the naloxone they have), including substance use behaviors, size and composition of social networks, personal resilience factors, and geographic and socio-structural factors. 2. Qualitatively describe the positive and negative experiences of responding to ODs, and identify (a) the support or services needed by PWUDs to sustainably respond to ODs in their communities, and (b) the barriers to response among those who do not respond or stop responding. 3. Assess feasibility and acceptability of interventions to improve sustainability and wellbeing of responders, and increase initiation of response behavior among non-responders. Supplemental Aim: Collect quantitative and qualitative data to inform an agent-based model (ABM) of PWUD to test how different OEND program delivery strategies could lead to reductions in fatal OD rates.