Development of an Opioid Misuse Prevention Program for Young Adult Workers in the Construction Industry

摘要 2016年，超过1100万12岁或以上的美国人报告了阿片类药物滥用。超过4万人死于 2016年阿片类药物相关过量，从2001年到2016年增加了345%。预防阿片类药物滥用至关重要 对于年轻人来说，他们代表了去年250万阿片类药物滥用者。阿片类药物滥用在这种发展 月经周期可能对心理、身体和社会福祉产生负面影响，并可能导致因 吸毒过量进入劳动力市场的年轻人特别容易受到药物使用的影响。在 在工作场所，每年因非医疗使用药物或酒精而过量死亡的人数比2013年增加了38% 到2016年，70%的雇主报告了阿片类药物滥用的负面后果。尽管这些比率 使用和负面后果，只有24%的雇主提供工作场所预防这些危险。 建筑业工人因阿片类药物过早死亡的比例死亡率最高 服药过量疼痛、损伤、肌肉骨骼疾病和心理困扰的广泛正常化 与慢性疼痛、安全条件、工作不安全和不满意的工作安排有关的疾病， 导致这部分劳动力滥用阿片类药物。目前，初级预防工作还没有 讨论了滥用类阿片对青年建筑业工人的重大影响。的目标 本研究旨在开发一种优化的、高效的、移动友好的基于Web的 可立即扩展的干预措施，重点是预防年轻人滥用阿片类药物 建筑业工人。本I期研究将使用多阶段优化的准备阶段 社会变革管理战略（MOST）方法，其中包括制定一个全面的循证框架 确定了进行干预的因果途径，这对发展有效和可持续的 行为干预。这一形成性工作将指导行为的发展和评估。 干预是可行的，文化能力，并针对经验建立的调解人。具体 本研究的目的是：1）根据我们的理论和专家， 知情的概念模型; 2）制作一个功能齐全的干预组件原型; 3）试点测试 评估初步科学和技术价值以及有效性的干预部分原型 的概念模型。这些目标的实现将最终使研究小组提出一个 第二阶段SBIR拨款重点关注优化试验（即确定最有效的干预措施 包括在全面干预措施中的组成部分），并严格评估可行的、技术上合理的， 商业上可行的阿片类药物滥用预防计划。

Abstract Over 11 million Americans aged 12 or older reported opioid misuse in 2016. Over 40,000 people died due to opioid-related overdoses in 2016, up 345% from 2001 to 2016. Preventing the onset of opioid misuse is critical for young adults, who represent 2.5 million past year opioid misusers. Opioid misuse in this developmental period can negatively affect mental, physical, and social well-being and can lead to morbidity and mortality due to overdose. Young adults entering the workforce are especially susceptible to substance use. In the workplace, annual overdose deaths from the non-medical use of drugs or alcohol have risen by 38% from 2013 to 2016 and 70% of employers have reported negative consequences of opioid misuse. Despite these rates of use and negative consequences, only 24% of employers offer workplace prevention of these dangers. Construction trade workers have the highest proportional mortality ratio for premature death by opioid overdose. Broad normalization of pain, injury, musculoskeletal disorders, and psychological distress associated with chronic pain, safety conditions, job insecurity, and unsatisfactory work arrangements may contribute to opioid misuse among this workforce. At the present time, primary prevention efforts have not addressed the significant impact of opioid misuse on young adult construction trade workers. The objective of this study is to is to develop an optimized, highly effective and efficient mobile-friendly web-based intervention that is immediately scalable and focused on preventing opioid misuse among young adult construction trade workers. This Phase I study will use the Preparation phase of the Multiphase Optimization Strategy (MOST) approach which includes the development of a comprehensive, evidence-based framework that identifies causal pathways to intervene on which is essential to developing effective and sustainable behavioral interventions. This formative work will guide the development and assessment of a behavioral intervention that is feasible, culturally competent, and targets empirically established mediators. The specific aims of this study are to 1) Develop a storyboard for a behavioral intervention based on our theory- and expert- informed conceptual model; 2) Produce a fully functional intervention component prototype; and 3) Pilot test the intervention component prototype to assess preliminary scientific and technical merit as well as the validity of the conceptual model. Fulfillment of these aims will ultimately position the research team to propose a Phase II SBIR grant focused on an optimization trial(s) (i.e. identification of the most effective intervention components to be included in the full intervention) and rigorous evaluation of a feasible, technically sound, and commercially viable opioid misuse prevention program.