Identifying and responding to policy-related barriers, facilitators, and misunderstandings in the HEALing communities study: A community-driven approach

IF 4.4 2区 医学 Q1 SUBSTANCE ABUSE
Anita Silwal , Robert Bohler , Timothy Hunt , Ramona G. Olvera , Michelle R. Lofwall , Christopher D. Cook , Katherine R. Marks , Carly Bridden , Patricia R. Freeman , Monica Nouvong , Laura C. Fanucchi , Nabila El-Bassel , Lisa A. Frazier , Sharon L. Walsh , Jeffery C. Talbert
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引用次数: 0

Abstract

Introduction

The HEALing (Helping to End Addiction Long-Term®) Communities Study (HCS) aimed to reduce opioid-involved overdose deaths across four states (Kentucky, Massachusetts, New York, and Ohio) via community-engaged implementation of three evidence-based practices (EBPs): (1) opioid overdose education and naloxone distribution, (2) medication for opioid use disorder expansion/linkage/retention, and (3) safer opioid prescribing and dispensing practices. A policy workgroup (PWG) was convened and developed a procedure to identify and address policies potentially impacting EBP implementation.

Methods

A five-step method was developed to identify, track, and respond to relevant policies at three of the research sites (Kentucky, Massachusetts, and New York) in collaboration with community partners and stakeholders. Policies possibly impacting EBPs were reported, reviewed, and documented, including any actions taken to address the policy issue. Policies were discussed with local, state, and federal level stakeholders in attempts to resolve barriers, clarify misunderstandings, and disseminate facilitators.

Results

A total of 87 (Kentucky = 37; Massachusetts = 19; New York = 31) policies were identified and addressed; 42 were identified as barriers, 24 as facilitators, and 21 as misunderstandings. PWG efforts resolved over 73 % (n = 31) of policy barriers, clarified 90 % (n = 19) of policy misunderstandings, and disseminated 100 % (n = 24) of policy facilitators.

Conclusions

A community-driven approach in policy surveillance identified, addressed, and disseminated several different types of policy issues that could impact implementation of EBPs for opioid-involved overdose prevention. Many policy barriers persisted during the HCS study, which may have adversely affected study outcomes.
在康复社区研究中识别和应对与政策相关的障碍、促进因素和误解:社区驱动的方法
康复(帮助结束长期成瘾®)社区研究(HCS)旨在通过社区参与实施三种基于证据的实践(ebp),减少四个州(肯塔基州,马萨诸塞州,纽约州和俄亥俄州)的阿片类药物过量死亡:(1)阿片类药物过量教育和纳洛酮分发,(2)阿片类药物使用障碍扩大/联系/保留的药物治疗,以及(3)更安全的阿片类药物处方和分发实践。成立了一个政策工作组(PWG),并制定了一个程序,以确定和处理可能影响EBP实施的政策。方法与社区伙伴和利益相关者合作,在三个研究地点(肯塔基州、马萨诸塞州和纽约州)开发了一种五步法来识别、跟踪和响应相关政策。对可能影响ebp的政策进行了报告、审查和记录,包括为解决政策问题而采取的任何行动。与地方、州和联邦层面的利益相关者讨论政策,试图解决障碍,澄清误解,并传播促进因素。结果共87例(肯塔基州= 37例;马萨诸塞州= 19人;纽约= 31)政策得到确认和处理;42个被确定为障碍,24个被确定为促进者,21个被确定为误解。PWG的努力解决了73% (n = 31)的政策障碍,澄清了90% (n = 19)的政策误解,传播了100% (n = 24)的政策促进因素。结论:社区驱动的政策监测方法确定、处理并传播了几种不同类型的政策问题,这些问题可能影响ebp在阿片类药物过量预防方面的实施。在HCS研究期间,许多政策障碍持续存在,这可能对研究结果产生不利影响。
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来源期刊
CiteScore
7.80
自引率
11.40%
发文量
307
审稿时长
62 days
期刊介绍: The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.
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