Mobile health strategies to support longitudinal engagement in harm reduction services

项目总结/摘要 响应RFA-DA-22-046，HEAL倡议：针对以下产品的伤害减少政策、实践和交付模式 与物质使用障碍的人，我们将进行为期5年的，社区参与的研究项目， 旨在扩大和加强向难以接触的阿片类药物使用者提供减少伤害服务 和/或兴奋剂，以减少致命和非致命过量的风险。本研究的主要目的是 设计和试点测试一个由互联网和移动的捆绑组成的移动的健康（mHealth）干预 基于电话的工具，以减少过量的风险。我们将建立一个富有成效的研究伙伴关系， 在威斯康星州的10个城市建立了全面的注射器服务计划， 目标。首先，使用前瞻性队列研究设计和几种创新方法来捕获伤害- 减少服务参与，心理社会变量和行为结果，我们将描述最 减少危害影响过量风险行为的重要机制。二是 研究减少伤害服务参与在将客户与医疗保健和成瘾来源联系起来方面的作用 治疗服务，与国家合作， 其他企事业单位提供第三，我们将召集一个社区领导小组， 阿片类药物和/或兴奋剂，并合作合成我们的研究结果，以告知发展和 实施一项创新战略，吸引在减少伤害方面面临障碍的客户参与 服务社区参与活动将在单臂试点干预试验中达到高潮， 评估一套基于互联网和智能手机的工具的可行性和可接受性， 改善获得更安全的药物使用行为和设备的途径，填补知识空白，并提供社会支持 通过连接到受信任的对等网络。这项研究是由中央减少危害的原则， 确保吸毒者在制定为他们服务的方案时有真实的发言权。它 将产生对重要机制的深刻理解，通过这些机制， 减少过量用药的风险，并测试有希望的策略，以扩大其覆盖面，以服务不足的客户。

PROJECT SUMMARY / ABSTRACT In response to RFA-DA-22-046, HEAL Initiative: Harm Reduction Policies, Practices, and Modes of Delivery for Persons with Substance Use Disorders, we will conduct a 5-year, community-engaged research project that aims to extend and enhance the delivery of harm reduction services to hard-to-reach people who use opioids and/or stimulants, to reduce their risk of fatal and nonfatal overdose. The main objective of this research is to design, and pilot test a mobile health (mHealth) intervention comprised of a bundle of internet and mobile phone-based tools for reducing overdose risk. We will build upon a productive research partnership with an established, comprehensive syringe services program operating in 10 cities in Wisconsin to pursue 3 specific aims. First, using a prospective cohort study design and several innovative methods for capturing harm- reduction service engagement, psychosocial variables, and behavioral outcomes, we will characterize the most important mechanisms through which harm reduction influences overdose risk behaviors. Second, we will study the role of harm reduction service engagement in linking clients to sources of health care and addiction treatment services, making novel use of linkages between administrative datasets in partnership with state government agencies. Third, we will convene a Community Leadership Team consisting of people who use opioids and/or stimulants, and collaboratively synthesize our research findings to inform the development and implementation of an innovative strategy for engaging clients who face barriers to accessing harm reduction services. The community engagement activities will culminate in a single-arm pilot intervention trial that evaluates the feasibility and acceptability of a suite of internet and smartphone-based tools designed to improve access to safer drug use behaviors and equipment, fill knowledge gaps, and deliver social support through connection to trusted peer networks. This research is guided by the central harm reduction principle of ensuring that people who use drugs have a real voice in the creation of programs designed to serve them. It will generate a robust understanding of the important mechanisms through which harm reduction services reduce overdose risk, and test promising strategies for extending their reach to under-served clients.