Strengthening Addiction Care Continuum through Community Consortium in Vietnam

摘要 目前的阿片类药物流行需要全球关注。阿片类药物使用障碍是一种慢性疾病， 需要长期全面的卫生服务，从评估、治疗、持续监测到 长期护理。药物辅助治疗，尽管可以作为治疗阿片类药物的有效策略 成瘾，由于使用阿片类药物的人很难接触到的性质，一直没有得到充分利用 (PWUO)和成瘾专家的短缺。扩大和加强成瘾治疗的推动力 是动员以社区为基础的医疗机构和PWUO的家庭成员。这项研究将需要 利用越南现有的社区卫生保健基础设施和家庭支持系统 开发和测试一种干预措施，以加强成瘾服务的连续性。这一干预措施名为 “社区关怀联盟(CCC)”的特色是社区卫生工作者与家庭成员共同努力 提供以患者为中心的个性化成瘾护理和支持。将制定和实施干预措施 在越南的三个地区(宁平、岘港和坎托)进行了三个阶段的测试。在第一阶段，我们 将与社区卫生工作者、社区代表、PWUO和他们的 家庭成员找出使用成瘾服务的障碍，并讨论建立 成瘾服务的连续体。根据形成性研究结果，CCC干预及其 将通过与研究人员、社区成员、 和目标用户。在第二阶段，CCC干预将在三个社区试行，并根据以下情况进行修订 可接受性/可行性数据、流程评估以及外地工作人员和参与者的反馈。在第三阶段， CCC干预的随机对照试验将在60个社区进行，将 随机分为干预条件或对照条件(每种条件30人)。总共720个 PWUO、他们的720名家庭成员和180名社区卫生工作者(CHW)将参与这项研究。 对PWUO、CHW和家庭成员的干预结果将通过以下网站收集的数据进行评估 基线、3个月、6个月、9个月和12个月的随访。

Abstract The current opioid epidemic calls for global attention. Opioid use disorder is a chronical condition that requires long-term comprehensive health services, from assessment, treatment, continuous monitoring, to extended care. Medication-assisted therapy, although available as an effective strategy to treat opioid addiction, has been significantly underutilized due to the hard-to-reach nature of people who use opioids (PWUO) and the shortage of addiction specialist. An impetus for expanding and enhancing addiction treatment is to mobilize community-based healthcare agencies and family members of PWUO. The study will take advantage of the existing community health care infrastructure and family support systems in Vietnam to develop and test an intervention to strengthen a continuum of addiction services. The intervention, entitled “Community Care Consortium (CCC),” features community health workers’ joint effort with family members to provide patient-centered, individualized addiction care and support. The intervention will be developed and tested through three phases in three regions of Vietnam (Ninh Binh, Da Nang, and Can Tho). In Phase 1, we will conduct formative studies with community health workers, community representatives, PWUO, and their family members to identify barriers to addiction service utilization and discuss potential strategies to establish a continuum of addiction services. Based on the formative study findings, the CCC intervention and its implementation plans will be developed through workgroup meetings with researchers, community members, and target users. In Phase 2, the CCC Intervention will be piloted in three communes and revised based on acceptability/feasibility data, process evaluation, and feedback from field staff and participants. In Phase 3, a randomized controlled trial of the CCC Intervention will be conducted in 60 communes, which will be randomized to either an intervention condition or a control condition (30 in each condition). A total of 720 PWUO, 720 of their family members, and 180 commune health workers (CHW) will participate in the study. The intervention outcomes on PWUO, CHW, and family members will be assessed with the data collected at baseline, 3-, 6-, 9- and 12-month follow-ups.