Developing a Timely Opioid Overdose Detection Tool through a Tribally Engaged Approach

项目摘要 美国印第安人社区受到阿片类药物流行的极大影响，许多部落 被阿片类药物的使用和过量所淹没。在美国所有种族/民族中，美国印第安人和 阿拉斯加原住民因所有阿片类药物过量致死率最高。在南加州，一些地区 包括美洲印第安人部落在内的一些人经历了年龄调整后阿片类药物使用率最高的情况 过量死亡、住院和急诊科就诊。有效应对的关键组件 对阿片类药物流行的及时监测是有足够的粒度来揭示亚群和地点 最需要资源。然而，阿片类药物过量所需的时间有明显的滞后。 数据将被公布，使其难以实施及时的公共卫生应对措施，以防止额外的 发病率/死亡率。尽管在开发过量用药监测方面已经投入了大量的工作 纵观各邦和县机构，这样的工具在印度农村是缺乏的。此外，剖析和分析的历史 在物质使用方面污名化美洲印第安人部落阻碍了部落关系的发展 具体的数据收集和报告工作。目前的提案将通过采用以下方式克服这一限制 维护部落对信息所有权、管理和监督的主权的技术 收集并与包括过量预防利益攸关方在内的非部落成员分享。这样做的目的是 项目是采用商业化技术，为#年的阿片类药物危机提供基于研究的解决方案。 印第安人的国家。通过与部落消防局和一家提供数据的软件公司的合作 对于公共安全机构的分析，我们正在提议建立一个近乎实时的阿片类药物过量仪表盘 在部落边界内。我们的研究以以下具体目标为指导：1.评估语用价值 开发特定于部落的阿片类药物过量监测仪表板；和2.制定技术流程，以 采用商业化技术，利用部落消防应急呼叫和法医 建立部落特有的阿片类药物过量仪表板的数据。这项研究的公共卫生意义在于 建立部落能力，以访问、管理和使用来自现有来源的数据，并应用这些数据来促进 对规避阿片类药物流行的实时可操作反应。从课程中学到的知识 开发阿片类药物过量仪表板的形成过程将提供支持社区的蓝图- 被其他部落国家广泛采用。

Project Summary American Indian communities have been greatly affected by the opioid epidemic with many Tribes being overwhelmed by opioid use and overdose. Among all racial/ethnic groups in the U.S, American Indians and Alaska Natives have the highest rate of overdose fatalities from all opioids. Within Southern California, areas encompassing American Indian Tribes have experienced some of the highest age-adjusted rates of opioid overdose deaths, hospitalization, and emergency department visits. A key component to effectively responding to the opioid epidemic is timely surveillance with sufficient granularity to reveal subpopulations and locations in most need of resources. However, there is a significant lag in the amount of time it takes for opioid overdose data to be publicized, making it difficult to implement a prompt public health response to prevent additional morbidity/mortality. Although a substantial amount of work has gone into developing overdose surveillance across state and county agencies, such tools are lacking in Indian Country. Moreover, a history of profiling and stigmatizing American Indian Tribes with respect to substance use has hampered the development of Tribally specific data collection and reporting efforts. The current proposal will overcome this limitation by adopting technologies that upholds Tribal sovereignty in ownership, management, and oversight of how information is gathered and shared with non-Tribal members including overdose prevention stakeholders. The goal of this project is to adapt commercialized technologies to provide research-based solutions to the opioid crisis in Indian Country. Through a partnership with a Tribal Fire Department and a software company providing data analytics for public safety agencies, we are proposing to build a near real-time opioid overdose dashboard within Tribal boundaries. Our study is guided by the following Specific Aims: 1. Evaluate the pragmatic merit of developing a Tribally specific opioid overdose monitoring dashboard; and 2. Develop the technical process for adapting commercialized technology to leverage Tribal Fire emergency response calls and medical examiner data to build a Tribally specific opioid overdose dashboard. The public health significance of this study is to build Tribal capacity to access, manage, and use data from existing sources and to apply that data to facilitate real-time actionable responses towards circumventing the opioid epidemic. Knowledge gained from the formative process of developing an opioid overdose dashboard will provide a blueprint to support community- wide adoption by other Tribal Nations.