Reducing perceived barriers to scaling up overdose education and naloxone distribution and medications for opioid use disorder in the United States in the HEALing (helping end addiction long-term®) communities study

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL Preventive medicine Pub Date : 2024-06-08 DOI:10.1016/j.ypmed.2024.108034

Hannah K. Knudsen , Daniel M. Walker , Nicole Mack , Elizabeth N. Kinnard , Timothy R. Huerta , LaShawn Glasgow , Louisa Gilbert , Bryan R. Garner , Anindita Dasgupta , Redonna Chandler , Sharon L. Walsh , Yjuliana Tin , Sylvia Tan , Joel Sprunger , Linda Sprague-Martinez , Pamela Salsberry , Merielle Saucier , Maria Rudorf , Sandra Rodriguez , Carrie B. Oser , Mari-Lynn Drainoni

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引用次数: 0

Abstract

Background

Scaling up overdose education and naloxone distribution (OEND) and medications for opioid use disorder (MOUD) is needed to reduce opioid overdose deaths, but barriers are pervasive. This study examines whether the Communities That HEAL (CTH) intervention reduced perceived barriers to expanding OEND and MOUD in healthcare/behavioral health, criminal-legal, and other/non-traditional venues.

Methods

The HEALing (Helping End Addiction Long-Term®) Communities Study is a parallel, wait-list, cluster randomized trial testing the CTH intervention in 67 communities in the United States. Surveys administered to coalition members and key stakeholders measured the magnitude of perceived barriers to scaling up OEND and MOUD in November 2019–January 2020, May–June 2021, and May–June 2022. Multilevel linear mixed models compared Wave 1 (intervention) and Wave 2 (wait-list control) respondents. Interactions by rural/urban status and research site were tested.

Results

Wave 1 respondents reported significantly greater reductions in mean scores for three outcomes: perceived barriers to scaling up OEND in Healthcare/Behavioral Health Venues (−0.26, 95% confidence interval, CI: −0.48, −0.05, p = 0.015), OEND in Other/Non-traditional Venues (−0.53, 95% CI: - 0.84, −0.22, p = 0.001) and MOUD in Other/Non-traditional Venues (−0.34, 95% CI: −0.62, −0.05, p = 0.020). There were significant interactions by research site for perceived barriers to scaling up OEND and MOUD in Criminal-Legal Venues. There were no significant interactions by rural/urban status.

Discussion

The CTH Intervention reduced perceived barriers to scaling up OEND and MOUD in certain venues, with no difference in effectiveness between rural and urban communities. More research is needed to understand facilitators and barriers in different venues.

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在 HEALing（长期帮助戒除毒瘾®）社区研究中，减少对美国扩大用药过量教育、纳洛酮分发和阿片类药物使用障碍的认知障碍。

背景：为减少阿片类药物过量死亡，需要扩大过量教育和纳洛酮发放（OEND）以及阿片类药物使用障碍药物发放（MOUD）的规模，但障碍普遍存在。本研究探讨了 "帮助结束阿片类药物滥用的社区"（Communities That HEAL，CTH）干预措施是否减少了在医疗保健/行为健康、刑事法律和其他/非传统领域扩大阿片类药物滥用治疗和药物治疗的障碍：HEALing (Helping End Addiction Long-Term®) 社区研究是一项平行、等待名单、分组随机试验，在美国 67 个社区测试 CTH 干预措施。在 2019 年 11 月至 2020 年 1 月、2021 年 5 月至 6 月和 2022 年 5 月至 6 月期间，对联盟成员和主要利益相关者进行的调查测量了扩大 OEND 和 MOUD 的感知障碍的程度。多层次线性混合模型比较了第 1 波（干预）和第 2 波（候补对照）受访者。测试了城乡状况和研究地点的交互作用：结果：第 1 波受访者对以下三项结果的平均得分降低幅度明显更大：在医疗保健/行为健康场所推广 OEND 所面临的障碍（-0.26，95% 置信区间，CI：-0.48，-0.05，p = 0.015）、其他/非传统场所的 OEND（-0.53，95% CI：- 0.84，-0.22，p = 0.001）和其他/非传统场所的 MOUD（-0.34，95% CI：-0.62，-0.05，p = 0.020）。在刑事法律领域，不同研究地点对扩大 "开放式教育与发展 "和 "牟利性与多样性 "的认知障碍存在显着的交互作用。城乡之间没有明显的交互作用：讨论："共同语言 "干预措施减少了在某些场所推广 "开放式教育与发展 "和 "肢体语言发展 "的障碍，农村和城市社区之间的效果没有差异。需要开展更多研究，以了解不同场所的促进因素和障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Preventive medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.70

自引率

3.90%

发文量

审稿时长

42 days

期刊介绍： Founded in 1972 by Ernst Wynder, Preventive Medicine is an international scholarly journal that provides prompt publication of original articles on the science and practice of disease prevention, health promotion, and public health policymaking. Preventive Medicine aims to reward innovation. It will favor insightful observational studies, thoughtful explorations of health data, unsuspected new angles for existing hypotheses, robust randomized controlled trials, and impartial systematic reviews. Preventive Medicine''s ultimate goal is to publish research that will have an impact on the work of practitioners of disease prevention and health promotion, as well as of related disciplines.