Culturally Response Integrated Harm Reduction Services for Black and Latinx People Who use Drugs

为黑人和拉丁裔吸毒者提供文化响应综合减害服务

• 批准号: 10590442
• 负责人: Ayana Jordan
• 金额: $ 212.56万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2025-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10590442
• 关键词: Address; Adherence; Affect; Aftercare; Belief; Black Populations; Black race; Caring; Cessation of life; Cocaine; Collaborations; Communities; Community Services; Coupled; Data; Death Rate; Drug usage; Drug user; Elements; Environment; Evidence based treatment; Face; Foundations; Geography; Goals; Harm Reduction; Health; Health Services; Health Services Accessibility; Helping to End Addiction Long-term; Housing; Imprisonment; Improve Access; Individual; Intervention; Knowledge; Latinx; Latinx population; Legal; Link; Mediator of activation protein; Mental Health; Methamphetamine; Modeling; Morbidity - disease rate; National Institute of Drug Abuse; New York City; Opiate Addiction; Opioid; Outcome; Overdose; Participant; Pathway interactions; Persons; Pharmaceutical Preparations; Plant Roots; Police; Policies; Population; Public Health; Quality of life; Research; Rights; Risk; Role; Services; Social Justice; Social Work; Social support; Speed; Stimulant; Structural Racism; System; Trust; United States National Institutes of Health; addiction; base; effective therapy; effectiveness evaluation; effectiveness testing; efficacy evaluation; expectation; experience; flexibility; follow-up; health disparity; improved; mortality; opioid misuse; opioid overdose; opioid user; overdose death; participant retention; patient engagement; racial and ethnic; reduced substance use; response; satisfaction; secondary outcome; service intervention; service programs; services as usual; social determinants; social health determinants; social movement; substance misuse; substance use; substance use treatment; treatment program

This study is part of the NIH’s Helping to End Addiction Long-term (HEAL) initiative to speed scientific solutions to the national opioid public health crisis. The NIH HEAL Initiative bolsters research across NIH to improve treatment for opioid misuse and addiction. Over 100,000 people died from drug overdoses in 2021, underscoring the need for urgent action. While the rates of overdose deaths among White people have begun to plateau, there has been a drastic surge in deaths among racial/ethnic minoritized individuals. There are also stark disparities from other substance use, including stimulants among Black and Latinx people who use drugs (PWUD). While effective treatment exists for problematic substance use, along with harm reduction (HR) services that decrease substance-related harms, studies demonstrate that racial/ethnic minoritized people are less likely to have access to these services. They not only experience more negative consequences related to substance misuse but are also less likely to receive HR services or be retained in evidence-based treatment such as MAT. To tackle these unique problems, we created an integrated harm reduction intervention (IHRI) to be mobile and flexible to the needs of Black and Latinx PWUD. This culturally responsive IHRI will employ a HR care coordinator that can assess vulnerabilities in the social determinants of health (SDOH) and link people to needed services. Data from community partners who operate HR services and serve largely Black and Latinx PWUD suggests that participants who receive HR services have significant improvements in health and engagement. Yet, systemic barriers to additional social services NOT directly related to substance use persist, which often influence health outcomes and quality of life. Thus, offering a low barrier, geographically distributed, culturally informed HR intervention in historically excluded communities may prove a highly disseminable strategy, for improving access to HR services and MAT. We plan to evaluate the efficacy of this integrated HR intervention (by providing legal, housing and mental health treatment support, along with linkage to MAT) on participant retention and engagement of HR services among n=200 Black and Latinx PWUD compared to services as usual in two mobile Community Harm Reduction Organizations. The escalating overdose death rates among Black and Latinx PWUD is a serious public health. The focus on health disparities in addiction is of high priority to NIDA and may prove a useful model for decreasing harm and broadening MAT access for Black and Latinx PWUD, who have been historically excluded these services in traditional settings.

这项研究是NIH帮助结束长期成瘾（HEAL）计划的一部分，旨在加速科学解决国家阿片类药物公共卫生危机。NIH HEAL倡议支持整个NIH的研究，以改善阿片类药物滥用和成瘾的治疗。2021年有超过10万人死于药物过量，这凸显了采取紧急行动的必要性。虽然白色人的过量死亡率已经开始趋于稳定，但种族/民族少数群体的死亡人数急剧上升。与其他物质的使用也有明显的差异，包括黑人和拉丁裔吸毒者（PWUD）中的兴奋剂。虽然对有问题的物质使用有有效的治疗，沿着减少物质相关伤害的减少伤害服务，但研究表明，种族/民族少数群体不太可能获得这些服务。他们不仅经历更多与药物滥用相关的负面后果，而且也不太可能接受人力资源服务或保留在基于证据的治疗，如MAT。为了解决这些独特的问题，我们创建了一个集成的减少伤害干预（IHRI），该干预是移动的，并且灵活地满足黑人和拉丁裔PWUD的需求。这一具有文化敏感性的国际人权研究所将雇用一名人权保健协调员，该协调员可以评估健康的社会决定因素的脆弱性，并将人们与所需服务联系起来。数据从 经营人力资源服务并主要为黑人和拉丁裔PWUD服务的社区合作伙伴表明，接受人力资源服务的参与者在健康和参与方面有显着改善。然而，与物质使用没有直接关系的额外社会服务的系统性障碍仍然存在，这往往影响健康结果和生活质量。因此，提供一个低障碍，地理分布，文化知情的人力资源 对历史上被排斥的社区进行干预，可能是一项推广性很强的战略，有助于改善获得人力资源服务和MAT的机会。我们计划评价这种综合人力资源干预（通过提供法律的、住房和心理健康治疗支持，沿着与MAT的联系）与两个移动的社区减害组织的常规服务相比，在n=200名黑人和拉丁裔PWUD中对参与者保留和人力资源服务参与的有效性。黑人和拉丁裔PWUD的过量死亡率不断上升是一个严重的公共卫生问题。关注成瘾方面的健康差异是NIDA的高度优先事项，并且可能成为减少伤害和扩大黑人和拉丁裔PWUD获得MAT机会的有用模式，他们已经 在传统环境中，这些服务历来被排除在外。