Social Network Intervention for Syringe Exchange Registrants

对注射器交换注册者的社交网络干预

• 批准号: 8991957
• 负责人: MICHAEL S KIDORF
• 金额: $ 28.35万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-15 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8991957
• 关键词: Address; Alcohol or Other Drugs use; Attitude; Behavior; Behavioral; Communities; Community Outreach; Data; Diffuse; Drug usage; Drug user; Educational Curriculum; Educational process of instructing; Enrollment; Equipment; Exposure to; Family; Friends; Funding; Goals; Harm Reduction; Health Care Costs; Individual; Injecting drug user; Injection of therapeutic agent; Intervention; Manuals; Modeling; National Institute of Drug Abuse; Nature; Needle-Exchange Programs; Outcome; Participant; Pathway interactions; Persons; Pharmaceutical Preparations; Phase; Psychological reinforcement; Public Health; Readiness; Recovery; Reporting; Research; Research Support; Risk; Risk Behaviors; Risk Reduction; Sampling; Sex Behavior; Social Network; Social Welfare; Social support; Structure; Substance Use Disorder; Surveys; Syringes; Testing; Time; Treatment Efficacy; Work; base; cost; design; improved; injection drug use; member; network models; novel; primary outcome; public health relevance; sex; skills; substance abuse treatment

 DESCRIPTION (provided by applicant Participants of syringe exchange programs (SEPs) routinely suffer from untreated or under-treated substance use disorder, a situation that is associated with significant individual and public health costs (Degenjardt et al., 2010). These individuals are also routinely embedded within social networks that reinforce continued drug use and risk behaviors (Latkin et al., 2013a). The welfare of these individuals and the public's health can be improved by interventions directed toward reducing drug use risks and expanding drug-free support (Kidorf & King, 2008). Previous work by our research group has demonstrated that an intervention combining a risk reduction/treatment readiness group with behavioral contingencies is highly associated with increased rates of treatment enrollment and re-engagement, and reduced rates of drug use and injection behaviors, for up to one year (e.g., Kidorf et al., 2009). The present R34 application extends this work by adding a new component to the risk reduction/treatment readiness group designed to expand social support and facilitate social network change. This intervention requires SEP registrants to attend the group with a drug-free family or friend from their personal network that can provide stable support and encourage harm reduction and treatment seeking. This intervention uses an alteration network change model (Valente, 2012) and posits that repeated exposure to drug-free community support collaterally reduces exposure to network members that support risk behaviors. This model also provides a pathway to modifying existing social networks by facilitating interaction with the personal social networks of drug-free family and friends. The intervention is supported by research showing that substance users report substantial pockets of drug-free family or friends in their social networks (Bohnert et al., 2010; Kidorf et al., 2005b). It is also supportedby community reinforcement principles that have shown efficacy in treatment samples (Roozen et al., 2004), but have not been applied to out-of-treatment drug users. The study will activate and characterize drug-free support in the personal social networks of SEP participants, evaluate the feasibility of a 6-week Community Supported Risk Reduction intervention that partners with drug- free family and friends, and evaluate the efficacy of this intervention over 6-months. Primary outcomes include changes in 1) network support for reducing drug use, and 2) injection risk behaviors (sharing equipment, rates of use), while secondary analyses will evaluate changes in time spent with drug using and non-using individuals. Data will be used to support an RCT isolating the benefits of community involvement for reducing risks, expanding drug-free support, and facilitating social network change.

 描述（由申请人提供）注射器交换计划（SEP）的参与者通常患有未经治疗或治疗不足的物质使用障碍，这种情况与显著的个人和公共健康成本有关（Degenjardt等人，2010年）。这些人还经常嵌入社交网络中，从而加强了持续的药物使用和风险行为（Latkin等人，2013年a）。这些人的福利和公众的健康 可以通过旨在减少吸毒风险和扩大无毒品支持的干预措施加以改善（Kidorf和King，2008年）。我们研究小组以前的工作已经证明，将风险降低/治疗准备小组与行为应急相结合的干预措施与治疗登记率和重新参与率的增加以及药物使用率和注射行为的减少高度相关，长达一年（例如，Kidorf等人，2009年）。目前的R34应用程序扩展了这项工作，为减少风险/治疗准备小组增加了一个新的组成部分，旨在扩大社会支持和促进社会网络的变化。这项干预措施要求SEP登记者与来自其个人网络的无毒家庭或朋友一起参加该小组，这些家庭或朋友可以提供稳定的支持，并鼓励减少伤害和寻求治疗。这种干预使用改变网络变化模型（Valente，2012年），并假定重复接触无毒社区支持会间接减少接触支持风险行为的网络成员。这种模式还提供了一种途径，通过促进与无毒品家庭和朋友的个人社交网络的互动来修改现有的社交网络。该干预得到了研究的支持，该研究表明，物质使用者报告在他们的社交网络中有大量的无毒家庭或朋友（博纳特et al.，2010; Kidorf等人，2005年b）。它也被在处理样品中显示出功效的社区强化原则所证实（Roozen等人，2004年），但尚未适用于治疗结束的吸毒者。本研究将在SEP参与者的个人社交网络中激活和表征无毒品支持，评价与无毒品家人和朋友合作的6周社区支持风险降低干预的可行性，并评价该干预在6个月内的疗效。主要结果包括1）减少药物使用的网络支持和2）注射风险行为（共享设备，使用率）的变化，而次要分析将评估与药物使用和非使用个体花费的时间的变化。数据将用于支持一项随机对照试验，分离社区参与的益处，以降低风险，扩大无毒品支持，并促进社会网络的变化。