Protocol for community-driven selection of strategies to implement evidence-based practices to reduce opioid overdoses in the HEALing Communities Study: a trial to evaluate a community-engaged intervention in Kentucky, Massachusetts, New York and Ohio

April M. Young, Jennifer L. Brown, Timothy Hunt, Linda S. Sprague Martinez, Redonna Chandler, Emmanuel Oga, T. John Winhusen, Trevor Baker, Tracy Battaglia, Rachel Bowers-Sword, Amy Button, Amanda Fallin-Bennett, Laura Fanucchi, Patricia Freeman, La Shawn M. Glasgow, Jennifer Gulley, Charles Kendell, Michelle Lofwall, Michael S. Lyons, Maria QuinnBruce David Rapkin, Hilary L. Surratt, Sharon L. Walsh

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction Opioid-involved overdose deaths continue to surge in many communities, despite numerous evidence-based practices (EBPs) that exist to prevent them. The HEALing Communities Study (HCS) was launched to develop and test an intervention (ie, Communities That HEAL (CTH)) that supports communities in expanding uptake of EBPs to reduce opioid-involved overdose deaths. This paper describes a protocol for a process foundational to the CTH intervention through which community coalitions select strategies to implement EBPs locally. Methods and analysis The CTH is being implemented in 67 communities (randomised to receive the intervention) in four states in partnership with coalitions (one per community). Coalitions must select at least five strategies, including one to implement each of the following EBPs: (a) overdose education and naloxone distribution; expanded (b) access to medications for opioid use disorder (MOUD), (c) linkage to MOUD, (d) retention in MOUD and (e) safer opioid prescribing/dispensing. Facilitated by decision aid tools, the community action planning process includes (1) data-driven goal setting, (2) discussion and prioritisation of EBP strategies, (3) selection of EBP strategies and (4) identification of next steps. Following review of epidemiologic data and information on existing local services, coalitions set goals and discuss, score and/or rank EBP strategies based on feasibility, appropriateness within the community context and potential impact on reducing opioid-involved overdose deaths with a focus on three key sectors (healthcare, behavioural health and criminal justice) and high-risk/vulnerable populations. Coalitions then select EBP strategies through consensus or majority vote and, subsequently, suggest or choose agencies with which to partner for implementation. Ethics and dissemination The HCS protocol was approved by a central Institutional Review Board (Advarra). Results of the action planning process will be disseminated in academic conferences and peer-reviewed journals, online and print media, and in meetings with community stakeholders. Trial registration number NCT04111939.

Original languageEnglish
Article numbere059328
JournalBMJ Open
Volume12
Issue number9
DOIs
StatePublished - Sep 19 2022

Bibliographical note

Funding Information:
This research was supported by the National Institutes of Health through the NIH HEAL (Helping to End Addiction Long-term) Initiative under award numbers UM1DA049394, UM1DA049406, UM1DA049412, UM1DA049415, UM1DA049417 (ClinicalTrials.gov Identifier: NCT04111939 ). The Substance Abuse and Mental Health Services Administration (SAMHSA) is a non-funding sponsor of the study. This study protocol (Pro00038088) was approved by Advarra Inc., the HEALing Communities Study single Institutional Review Board. We wish to acknowledge the participation of the HEALing Communities Study communities, community coalitions, and Community Advisory Boards and state government officials who partnered with us on this study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Substance Abuse and Mental Health Services Administration or the NIH HEAL Initiative. R. Chandler was substantially involved in this paper, consistent with her role as Scientific Officer. SM SM

Funding Information:
The HEALing Communities Study (HCS), supported by the National Institutes of Health and the Substance Abuse and Mental Health Services Administration, launched in 2019 to develop and test an approach to support communities in expanding uptake and availability of EBPs to address opioid-involved overdose deaths and OUD. HCS is a multisite, parallel-group, cluster randomised waitlist-controlled trial involving 67 communities (34 in active intervention and 33 in waitlist control) in Kentucky (KY), Massachusetts (MA), New York (NY) and Ohio (OH). The study is designed to test the Communities That HEAL (CTH) intervention, which contains three components: a community-engaged process of data-driven decision-making to select EBP strategies for local implementation and monitoring; a menu of EBPs and technical assistance guides (Opioid-Overdose Reduction Continuum of Care Approach (ORCCA)), and a set of communication campaigns intended to address stigma and increase knowledge of and demand for EBPs. The CTH intervention is being implemented in the active intervention communities from January 2020 to June 2022 and will be implemented in waitlist control communities from July 2022 to December 2023.

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Keywords

  • PUBLIC HEALTH
  • STATISTICS & RESEARCH METHODS
  • Substance misuse

ASJC Scopus subject areas

  • Medicine (all)

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