Adapting the HOPE social media intervention to reduce prescription drug abuse

描述(由申请人提供)：本提案旨在确定应用在线同伴教育(HOPE)干预或同伴支持社交媒体社区模式来减少慢性阿片类非癌症疼痛患者滥用处方药的可行性、可接受性和初步有效性。近年来，处方药滥用已经达到了流行的程度。慢性阿片类药物是所有处方药中最常被滥用的，是治疗慢性疼痛的处方。慢性阿片类药物滥用/滥用的并发症包括呼吸抑制、传染病传播、药物依赖/成瘾和致命的过量用药。具有以下危险因素的慢性非癌症疼痛患者发生并发症的风险最高：1)大剂量阿片类药物，2)阿片类药物同时使用镇静剂(多物质使用)，3)异常用药相关行为(例如，早期续药请求)。虽然需要低成本、新颖的干预措施来减少这些危险行为，以免它们导致成瘾和过量服药，但很少有研究集中在这一领域。以社区为基础的方法，如同行领导和同行支持干预，已成功地改变了健康行为，并可用于减少阿片类药物滥用。然而，由于同伴支持小组经常需要面对面的访问和大量的时间和财政资源，这些小组有很高的辍学率。 随着最近社交媒体/在线社区的增加，这些技术可以作为具有成本效益的平台，为阿片类药物滥用和过量提供同行支持干预措施。希望干预是通过Facebook提供的一种基于证据的、同行主导的社交媒体干预，已成功地用于改变健康行为。然而，还没有发表的研究研究HOPE方法或其他基于社交媒体的同伴社会支持干预措施是否可以用来减少处方药滥用，这使这成为一项重要的可行性研究。我们提出以下具体目标来解决这项研究：具体目标1：探索(定性)基于社交媒体的干预措施如何适用于慢性阿片类药物治疗患者的阿片类药物滥用/过量预防。具体目标2：评估应用HOPE模型降低高危慢性非癌症疼痛患者阿片类药物滥用/过量风险的可行性、可接受性和初步有效性。次要目标：探索利用参与者公开可见的社交媒体对话来更好地了解处方阿片类药物滥用和改善干预实施的可行性。从这项研究中收集的试点数据将被用于制定一项更大规模随机试验的R01提案，旨在评估使用社交媒体扩大同行主导的处方药滥用干预措施的有效性，以减少处方阿片类药物滥用和慢性阿片类药物使用者的多物质使用。

DESCRIPTION (provided by applicant): This proposal seeks to determine the feasibility, acceptability, and preliminary effectiveness of applying the Harnessing Online Peer Education (HOPE) intervention, or peer support social media community model, to reduce prescription drug abuse among chronic opioid non-cancer pain patients. Prescription drug abuse has reached epidemic proportions in recent years. Chronic opioid therapy, prescribed to treat patients experiencing chronic pain, is the most frequently abused of all prescription medications. Complications from chronic opioid misuse/abuse include respiratory suppression, infectious disease transmission, drug dependence/addiction, and fatal overdose. Chronic non-cancer pain patients with the following risk factors are at the highest risk for complications: 1) High dosage of opiods, 2) opioid use with concomitant use of sedatives (polysubstance use), and 3) aberrant medication-related behaviors (e.g. early refills requests). Although low cost, novel interventions are needed to reduce these risk behaviors before they lead to addiction and overdose, few studies have focused on this area. Community-based approaches, such as peer leader and peer support interventions, have been successful in creating health behavior change and could be applied to reduce opioid abuse. However, because peer support groups often require in-person visits and a great deal of time and financial resources, these groups have high drop-out rates. With the recent increase in social media/online communities, these technologies could be used as cost-effective platforms to deliver peer support interventions for opioid abuse and overdose. The HOPE intervention is an evidenced-based peer-led social media intervention provided over Facebook that has been successfully used to change health behaviors. However, no published research has studied whether the HOPE approach, or other social media-based peer social support interventions can be adapted to reduce prescription drug abuse, making this an important feasibility study. We propose the following specific aims to address this research: Specific Aim 1: Explore (qualitatively) how the HOPE social media-based intervention can be adapted for opioid abuse/overdose prevention among patients on chronic opioid therapy. Specific Aim 2: Assess the feasibility, acceptability, and preliminary effectiveness of applying th HOPE model to reduce opioid abuse/overdose risk among high-risk chronic non- cancer pain patients. Secondary aim: Explore the feasibility of using participants' publicly-viewable social media conversations to better understand prescription opioid abuse and to improve intervention implementation. The pilot data collected from this study will be used to develop an R01 proposal for a larger randomized trial designed to assess the effectiveness of using social media to scale peer-led prescription drug abuse interventions to reduce prescription opioid abuse and polysubstance use among chronic opioid users.