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.

Community engagement Implementation science Medication for opioid use disorder Naloxone Opioid epidemic Opioid overdose Overdose prevention

Journal

Preventive medicine
ISSN: 1096-0260
Titre abrégé: Prev Med
Pays: United States
ID NLM: 0322116

Informations de publication

Date de publication:
08 Jun 2024
Historique:
received: 14 02 2024
revised: 04 06 2024
accepted: 05 06 2024
medline: 11 6 2024
pubmed: 11 6 2024
entrez: 10 6 2024
Statut: aheadofprint

Résumé

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. 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. 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. 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.

Sections du résumé

BACKGROUND 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 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 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 CONCLUSIONS
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.

Identifiants

DOI: 10.1016/j.ypmed.2024.108034 PMID: 38857770
pubmed: 38857770
pii: S0091-7435(24)00189-0
doi: 10.1016/j.ypmed.2024.108034
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

108034

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Hannah K Knudsen (HK)

Department of Family and Community Medicine, Ohio State University, Suite 5000, 700 Ackerman Rd, Columbus, OH 43202, USA. Electronic address: hkknud2@uky.edu.

Daniel M Walker (DM)

Department of Family and Community Medicine, Ohio State University, Suite 5000, 700 Ackerman Rd, Columbus, OH 43202, USA. Electronic address: daniel.walker@osumc.edu.

Nicole Mack (N)

Center for Official Statistics, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: nmack@rti.org.

Elizabeth N Kinnard (EN)

Section of Infectious Diseases, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA. Electronic address: elizabeth.kinnard@bmc.org.

Timothy R Huerta (TR)

CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, Department of Family and Community Medicine, Department of Biomedical Informatics, The Ohio State University, 540 W. Spring St., Columbus, OH 43215, USA. Electronic address: timothy.huerta@osumc.edu.

LaShawn Glasgow (L)

Center for Program and Policy Evaluation to Advance Community Health, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: lglasgow@rti.org.

Louisa Gilbert (L)

School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: lg123@columbia.edu.

Bryan R Garner (BR)

Department of Internal Medicine, The Ohio State University, 2050 Kenny Road Columbus, OH 43221, USA. Electronic address: bryan.garner@osumc.edu.

Anindita Dasgupta (A)

School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: ad3341@columbia.edu.

Redonna Chandler (R)

National Institute on Drug Abuse, 301 North Stonestreet Ave, Bethesda, MD 20892, USA. Electronic address: redonna.chandler@nih.gov.

Sharon L Walsh (SL)

Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Room 202, Lexington, KY 40508, USA. Electronic address: sharon.walsh@uky.edu.

Yjuliana Tin (Y)

General Internal Medicine, University of Colorado School of Medicine, 12631 E 17th Ave Aurora, CO 80045, USA. Electronic address: yjuliana.tin@cuanschutz.edu.

Sylvia Tan (S)

Center for Clinical Research, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: stan@rti.org.

Joel Sprunger (J)

Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Ave, Suite 204, Cincinnati, OH 45229, USA. Electronic address: joel.sprunger@uc.edu.

Linda Sprague-Martinez (L)

School of Social Work, Boston University, 264 Bay State Road, Boston, MA 02215, USA. Electronic address: lsmarti@bu.edu.

Pamela Salsberry (P)

College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA. Electronic address: salsberry.1@osu.edu.

Merielle Saucier (M)

Clinical Addiction Research and Evaluation Unit, Section of General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA.

Maria Rudorf (M)

General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA. Electronic address: maria.rudorf@bmc.org.

Sandra Rodriguez (S)

School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: sr3717@columbia.edu.

Carrie B Oser (CB)

Department of Sociology, Center on Drug & Alcohol Research, Center for Health Equity Transformation, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY 40506, USA. Electronic address: carrie.oser@uky.edu.

Emmanuel Oga (E)

Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: eoga@rti.org.

Julie Nakayima (J)

Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, USA. Electronic address: julie.nakayima@uky.edu.

Beth S Linas (BS)

Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: blinas@rti.org.

R Craig Lefebvre (RC)

Communication Practice Area, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: clefebvre@rti.org.

Sarah Kosakowski (S)

General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA. Electronic address: sarah.kosakowski@bmc.org.

Rachel E Katz (RE)

Communication Practice Area, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA.

Timothy Hunt (T)

School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: th2258@columbia.edu.

Ari Holman (A)

Addiction Services, Clinical & Support Options, 8 Atwood Dr Suite 201, Northampton, MA 01060, USA.

JaNae Holloway (J)

Center for Clinical Research, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: jlholloway@rti.org.

Dawn Goddard-Eckrich (D)

School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: dg2121@columbia.edu.

Naleef Fareed (N)

Biomedical Informatics, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA. Electronic address: Naleef.fareed@osumc.edu.

Mia Christopher (M)

Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: mchristopher@rti.org.

Alison Aldrich (A)

CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, The Ohio State University, Suite 5000, 700 Ackerman Rd, Columbus, OH 43202, USA. Electronic address: alison.aldrich@osumc.edu.

Joella W Adams (JW)

Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: jadams@rti.org.

Mari-Lynn Drainoni (ML)

Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine/Boston Medical Center, and Department of Health Law, Policy and Management, Boston University School of Public Health, 801 Massachusetts Avenue, Room 2014, Boston, MA, 02118, USA. Electronic address: drainoni@bu.edu.

Classifications MeSH