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利用在线同伴教育（HOPE）干预或同伴支持社交媒体社区模型的可行性、可接受性和初步有效性，以减少慢性阿片类非癌症疼痛患者的处方药滥用。近年来，处方药滥用已达到流行病的程度。用于治疗慢性疼痛患者的慢性阿片类药物治疗是所有处方药中最常滥用的。慢性阿片类药物误用/滥用的并发症包括呼吸抑制、传染病传播、药物依赖/成瘾和致命过量。具有以下风险因素的慢性非癌症疼痛患者发生并发症的风险最高：1）高剂量阿片类药物，2）阿片类药物使用伴随镇静剂使用（多种物质使用），以及3）异常药物相关行为（例如，提前再填充请求）。虽然低成本，新的干预措施，需要减少这些风险行为之前，他们导致成瘾和过量，很少有研究集中在这一领域。 以社区为基础的方法，如同伴领导和同伴支持干预，已成功地创造健康行为的改变，并可用于减少阿片类药物滥用。然而，由于同侪支助小组往往需要亲自访问，并需要大量的时间和财政资源，因此这些小组的辍学率很高。 随着最近社交媒体/在线社区的增加，这些技术可用作具有成本效益的平台，为阿片类药物滥用和过量提供同伴支持干预措施。 HOPE干预是通过Facebook提供的基于证据的同行领导的社交媒体干预，已成功用于改变健康行为。然而，没有发表的研究已经研究了希望的方法，或其他基于社交媒体的同伴社会支持干预措施是否可以适应减少处方药滥用，使这一重要的可行性研究。 我们提出了以下具体目标来解决这项研究：具体目标1：探索（定性）基于HOPE社交媒体的干预如何适用于长期阿片类药物治疗患者的阿片类药物滥用/过量预防。具体目标二：评估应用HOPE模型降低高风险慢性非癌症疼痛患者中阿片类药物滥用/过量风险的可行性、可接受性和初步有效性。次要目的：探索使用参与者公开可见的社交媒体对话的可行性，以更好地了解处方阿片类药物滥用并改善干预措施的实施。从本研究中收集的试点数据将用于制定R 01提案，用于一项更大规模的随机试验，旨在评估使用社交媒体来扩大同行领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中的多种物质使用。

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.