The research examining factors associated with the opioid crisis among urban adults (REFOCUS): a mixed methods study protocol

Introduction: Deaths due to opioid-related overdoses have increased across the United States. Specifically in the state of Kentucky, African Americans are the only population that continues to experience an increase in opioid-related deaths. Previous literature highlights African Americans having unique drug use patterns due to systematic barriers and how these barriers limit access to protective factors and substance use treatment. The current study aims to specify patterns of African American non-medical prescription opioid use (NMPOU) and how these patterns may differ based on biological sex and generational cohort. Also, this study plans on using this data on patterns to inform treatment modalities for African Americans. Methods: This study is a multi-aim, mixed-methods study that examines the patterns and factors of NMPOU and opioid misuse. Across the three aims, quantitative and qualitative data are collected to gain insight into the lived experiences of African Americans who use opioids, build upon public health knowledge of factors impacting African American opioid use, and outline substance use interventions for African Americans. Across the three aims, about 900 African American participants who self-identify as misusing opioids will be interviewed for data collection. Data analysis consists of power analyses to determine sample size, thematic analyses, and other quantitative data analyses to test the hypotheses in the study. Discussion: The REFOCUS study uses protective factors such as race-matching, experienced research assistants, and innovative recruitment strategies to attain and retain large sample sizes. Using these protective factors, the aims of the study are more likely to be successfully obtained.