An mHealth Approach to Decreasing Opioid Abuse and Other Diseases of Despair in Rural Populations

项目摘要/摘要 与城市美国人相比，美国农村人面临着许多健康差距，他们的 可能死于慢性健康状况，包括药物滥用。事实上，与阿片类药物相关的死亡率 美国某些农村地区的最高峰，包括阿巴拉契亚、新英格兰和西部山区。一个 许多关于发病率和死亡率的研究提供了对受影响较少的健康问题的洞察 受过教育的农村人口。6-9，14-15没有高中文凭，精神疾病，酗酒和非法药物使用 在死者中的比例都要高得多，而患有这些问题的人 滥用阿片类药物的风险增加。22-29 本项目的目的是开发一种基于移动的阿片类药物预防方案，用于农村地区 蓝领工人提供旨在减少酒精消费的强有力的预防干预措施， 消极情绪状态的管理，包括焦虑和抑郁，以及非药物方法 为了控制疼痛。该计划旨在填补向有阿片类药物风险的农村成年人提供服务的一个重要缺口 滥用。该计划将利用农村社区可用的技术--即移动医疗-- 并将是媒体丰富的，包括一个节目《教练》和个人视频，用户可以与之相关的描述 他们处理疼痛、药物使用困难、压力和情绪问题的经验-以及 这些问题关系到他们的生活。类似于其他促进健康和预防药物滥用的计划 由我们的团队开发，该程序将是高度个性化的-根据用户特征和 体验，引导用户管理困难的情绪，自我管理疼痛的技术，以及 避免滥用酒精和其他物质，包括阿片类药物。 在第一阶段，在两个重点小组和我们的专家顾问的重要投入下，ISA工作人员将制定 并对嵌入更大健康促进计划的移动阿片类药物滥用预防计划进行试点测试。 将与将被招募的个人一起开展开发前重点小组，以帮助制定 节目的结构和内容。ISA工作人员和Redmon Group将开发原型程序， 充分发展我的健康简介、理解和管理的介绍和广泛的部分 心情，照顾好自己--永远不要放弃！用于第一阶段，在发展和专家审查之后 在原型程序中，20个最终用户将被要求对该程序进行试点测试，包括可用性测试， 对计划进行量化评分，并采访他们使用该计划的经验。晋级到 第二阶段，必须有80%的无错误率，所有项目的量化评级必须为4或更高。

Project Summary/Abstract Rural Americans face numerous health disparities compared to their urban counterparts and are more likely to die from chronic health conditions, including substance abuse. Indeed, opioid-related mortality is highest in certain rural areas of the U.S., including Appalachia, New England, and the mountain west. A number of studies looking at morbidity and mortality provide insight into the health problems afflicting less educated, rural populations.6-9,14-15 Lack of high school diploma, mental illness, alcohol use, and illicit drug use were all substantially higher in the population of decedents, and individuals suffering from these problems are at heightened risk for opioid misuse.22-29 The purpose of this project is to develop a mobile-based opioid prevention program for rural-based blue-collar workers that provides robust preventive interventions aimed at reduction in alcohol consumption, management of negative mood states including anxiety and depression, and non-pharmacologic approaches to managing pain. The program aims to fill an important gap in service provision to rural adults at risk for opioid misuse. The program will capitalize on technologies available in rural communities – namely mobile health – and will be media rich, including a program ‘coach’ and videos of individuals that users can relate to describing their experiences dealing with pain, substance use difficulties, stress and mood issues - and the impact of these issues on their lives. Similar to other health promotion and substance abuse prevention programs developed by our group, the program will be highly individualized - tailored by user characteristics and experiences, directing users to management of difficult moods, techniques in the self-management of pain, and avoidance of abusing alcohol and other substances, including opioids. In Phase I, with crucial input from two focus groups and our expert consultants, ISA staff will develop and pilot test a mobile opioid misuse prevention program embedded within a larger health promotion program. Pre-development focus groups will be conducted with individuals who will be recruited to help shape the structure and content of the program. ISA staff and the Redmon Group will develop the prototype program, fully developing the Introduction, and extensive sections of My Health Profile, Understanding and Managing Moods, and Taking Care of Yourself – Never Give Up! for Phase I. Following development and expert review of the prototype program, 20 end users will be asked to pilot test the program, including a usability test, quantitative rating of the program, and interview about their experience using the program. To advance to Phase II, there must be an 80% error-free rate and quantitative ratings must be 4 or higher for all items.