Identifying and Testing Post-Overdose Outreach Adaptations to Enhance Survivor Engagement During the COVID-19 Pandemic

项目摘要/摘要 作为意外伤害死亡的主要原因，过量服药仍然是一个严重的公共卫生挑战，它已经 在新冠肺炎大流行期间恶化。在OEND和Moud礼物中接触服药过量的幸存者 这是减少随后致命的过量用药的关键机会。为了应对阿片类药物过量流行， 社区服药过量后外展计划，通常包括合作伙伴公共卫生和公共安全 专业人员亲自跟踪服药过量幸存者，已经出现了接触服药过量幸存者的情况 奥恩德和穆德。随着新冠肺炎大流行的爆发，大多数服药过量后的计划暂停或 最初减少了与服药过量幸存者的接触，然后调整了他们的外联活动，以继续 他们与高风险服药过量幸存者的接触。这些创新包括电话和短信联系， 向没有手机的人分发手机，分发OEND套件和口罩，以及远程医疗 低障碍穆德启蒙伙伴关系。识别、描述和测试这些创新对于 了解如何在COVID大流行期间及以后最好地吸引服药过量的幸存者。在这 R21，我们提出了一个为期两年的计划，以确定和描述创新的过量用药后参与策略 在新冠肺炎大流行期间开发的，并对最有希望的适应工具包进行试点测试。这个 具体目标是通过全州范围的 调查(目标1)，描述促进或阻碍成功相关新冠肺炎的行动机制 通过对过量服药幸存者和过量服药后外展工作人员的30次定性访谈进行适应(目标2)， 并在一次过量服药后的外展中试点测试最有希望的新冠肺炎适应战略工具包 计划，以增加过量接触幸存者的人数，提供纳洛酮救援包，并转诊至 穆德(目标3)。在PARiHS框架的指导下，我们的混合方法将提供关键的见解 是什么促进或阻碍了新冠肺炎相关改编的成功，并使成功和 在新冠肺炎大流行期间及以后的持续变化。我们的最终目标是开发一种有效的、 社区一级过量服药后外展干预工具包，通过以下方式减少阿片类药物过量死亡 在新奥尔良和穆德吸引吸毒过量的幸存者，以应对新冠肺炎大流行的社会和 经济挑战。

PROJECT SUMMARY / ABSTRACT As the leading cause of accidental injury death, overdose remains a critical public health challenge that has worsened in the midst of the COVID-19 pandemic. Engaging overdose survivors in OEND and MOUD presents a key opportunity to reduce subsequent fatal overdose. In response to the opioid overdose epidemic, community post-overdose outreach programs, which typically include partner public health and public safety professionals to follow-up with overdose survivors in-person, have emerged to engage overdose survivors in OEND and MOUD. With the onset of the COVID-19 pandemic, most post-overdose programs suspended or initially reduced their contact with overdose survivors and, then, adapted their outreach activities to continue their engagement with high-risk overdose survivors. These innovations included telephone and texting contact, distributing phones to those without, drop-off distribution of OEND kits and masks, and telemedicine partnerships for low barrier MOUD initiation. Identifying, describing, and testing these innovations is crucial to understand how to best engage overdose survivors in the midst of the COVID pandemic and beyond. In this R21, we propose a two-year plan to identify and describe innovative post-overdose engagement strategies developed during the COVID-19 pandemic, and to pilot test a toolkit of the most promising adaptations. The specific aims are to identify innovative adaptions in response to the COVID-19 pandemic through a statewide survey (Aim 1), describe mechanisms of action that promote or impede successful COVID-19 related adaptations through 30 qualitative interviews of overdose survivors and post-overdose outreach staff (Aim 2), and pilot test a toolkit of the most promising COVID-19 adaptive strategies within one post-overdose outreach program to increase the number of overdose survivor contacts, naloxone rescue kits provided, and referrals to MOUD (Aim 3). Guided by the PARiHS framework, our mixed-method approach will provide critical insight on what has promoted or impeded success of COVID-19 related adaptations and enable successful and sustained change during the COVID-19 pandemic and beyond. Our ultimate goal is to develop an effective, community-level post-overdose outreach intervention toolkit that reduces opioid overdose fatalities via engaging overdose survivors in OEND and MOUD that is resilient to the COVID-19 pandemic’s social and economic challenges.