Optimizing HEALing in Ohio Communities (OHiO)-Health Equity Supplement

项目摘要/摘要 本附录旨在探讨健康公平原则的灌输对预防过量用药的影响 实施社区康复(Cth)干预作为康复的一部分的策略 社区研究(HCS)。HCS是一项多站点、平行臂、整群随机、等待名单对照试验 评估Cth干预与等待名单社区常规护理对过量用药的影响 死亡。HCS的总体目标是将67个HCS社区的阿片类药物过量死亡人数减少40% 横跨四个州。社区组成联盟，就预防服药过量做出共同决定 实施战略以及如何最好地实施这些战略，特别是促进吸毒过量的战略 预防教育和纳洛酮分配(OEND)和阿片类药物使用障碍(MOUD)。 虽然众所周知，小型化的社区(无论是由于种族、族裔、性别或LGBTQIA+地位) 获得阿片类药物使用障碍(OUD)治疗的机会越来越少， 结果，初级保健服务从一开始就没有明确的目标是缩小差距或衡量集中的影响 预防服药过量的公平。随着对种族和民族的敏锐认识，这种方法在2020年发生了变化 COVID疫情和乔治·弗洛伊德被杀事件引发的种族觉醒之间的差异。这 附录将利用其母研究的现有基础设施和研究人员来分析调查和 其他已收集的定性数据。主要数据来源将包括对联盟成员的调查， 在研究期间的四个时间点完成；阿片类药物过量减少连续护理 方法跟踪器(ORCCAT)，由研究人员每月完成，其中包括过量服药预防信息 按战略、部门、地点、服务人口、联盟批准日期、制定的实施计划、日期 已启动、与战略相关的合作伙伴/实践的数量、交付模式；以及可获得的数据； 由研究人员在每个策略实施后每月完成，其中包括以下信息 被联系的人和被联系的人的人口统计(例如，种族、民族、性别、年龄)。数据分析将包括 这两种定量分析都考察了关于健康公平主题的调查答案与 将股权纳入战略，以及对联盟如何讨论和 确定股权主题的优先顺序。本研究将以家长研究的PRISM/RE-AIM(S)概念为指导 框架和一个新的健康公平透镜，以检查多样化的联合和注入阿片类药物过量 具有健康公平原则的预防战略可能有助于到达小规模社区，以及这些战略如何 背景因素和进程可能相互作用，以促进或阻碍健康公平。这项研究的结果可能 用于在以下情况下为纳入健康公平原则的政策、战略和实践提供信息 实施过量用药预防策略。

Project Summary/Abstract This supplement aims to explore the impact of the infusion of health equity principles on overdose prevention strategies during implementation of the Communities That Heal (CTH) intervention as part of the HEALing Communities Study (HCS). The HCS is a multi-site, parallel arm, cluster randomized, wait-list controlled trial evaluating the impact of the CTH intervention compared with usual care in wait-list communities, on overdose deaths. The overall goal of the HCS is to reduce opioid overdose deaths by 40% in 67 HCS communities across four states. Communities form coalitions to make shared decisions about what overdose prevention strategies to implement and how best to implement them, particularly strategies that promote Overdose Prevention Education and Naloxone Distribution (OEND) and Medications for Opioid Use Disorder (MOUD). While it is known that minoritized communities (whether due to race, ethnicity, gender, or LGBTQIA+ status) have less and poorer access to treatment for Opioid Use Disorder (OUD) and associated disparities in outcomes, at its outset, HCS did not explicitly aim to reduce disparities or measure the effect of centering equity on overdose prevention. This approach changed in 2020 with acute awareness of the racial and ethnic disparities within the COVID epidemic and the racial awakening in response to the George Floyd killing. This supplement will leverage the existing infrastructure and study staff of its parent study to analyze survey and other qualitative data already collected. The primary data sources will include surveys of coalition members, completed at four time points during the study period; the Opioid-Overdose Reduction Continuum of Care Approach Tracker (ORCCAT), completed monthly by study staff, that includes overdose prevention information by strategy, sector, venue, population served, coalition approval date, implementation plan developed, date started, number of partners/practices associated with strategy, and mode of delivery; and REACH data, completed by study staff monthly once each strategy is implemented that includes information on number of persons reached and demographics of those reached (e.g., race, ethnicity, sex, age). Data analysis will include both quantitative analysis examining associations between survey answers regarding health equity topics and incorporation of equity into strategies, as well as qualitative analysis examining how coalitions discussed and prioritized equity topics. This study will be guided by the parent study’s PRISM/RE-AIM(S) conceptual framework with a novel health equity lens to examine how diversifying coalitions and infusing opioid overdose prevention strategies with health equity principles may help reach minoritized communities and how these contextual factors and processes may interact to promote or impede health equity. Results from this study may be used to inform policies, strategies, and practices for incorporating health equity principles when implementing overdose prevention strategies.