Mobile health strategies to support longitudinal engagement in harm reduction services

项目摘要/摘要 响应RFA-DA-22-046，Heave倡议：减少伤害的政策、做法和交付方式 ，我们将进行一项为期5年的社区参与的研究项目， 旨在扩大和加强向难以接触到的使用阿片类药物的人提供减少伤害服务 和/或兴奋剂，以降低致命和非致命过量服药的风险。这项研究的主要目的是 设计并试点测试由互联网和移动捆绑包组成的移动健康(MHealth)干预 以手机为基础的工具，以降低过量服药风险。我们将建立一个富有成效的研究伙伴关系， 建立了全面的注射器服务计划，在威斯康星州的10个城市运营，以追求3个具体的 目标。首先，使用前瞻性队列研究设计和几种捕捉伤害的创新方法- 减少服务参与度、心理社会变量和行为结果，我们将描述 减少危害影响过量用药危险行为的重要机制。第二，我们将 研究减少伤害服务参与在将客户与卫生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，新颖地利用行政数据集之间的联系 政府机构。第三，我们将召集一个社区领导团队，由使用 阿片类药物和/或兴奋剂，并合作合成我们的研究结果，以告知开发和 实施创新战略，吸引那些在获得减少危害方面面临障碍的客户 服务。社区参与活动将在单臂飞行员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，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。这项研究以减少危害的中心原则为指导。 确保吸毒者在为他们服务的项目的创建中拥有真正的发言权。它 将产生对减少危害服务所通过的重要机制的深刻理解 降低服药过量的风险，并测试有希望的战略，将其扩展到服务不足的客户。

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.