Primary Prevention of Drug Overdoses in Rural Low-Resource and Tribal Communities: A Cluster Randomized Trial.

IF 9.6 1区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of public health Pub Date : 2025-09-01 DOI:10.2105/ajph.2025.308205

Kelli A Komro,Melvin D Livingston,Juli R Skinner,Bethany J Livingston,Terrence K Kominsky,Ashna Jagtiani,Caroline M Barry,Alexander C Wagenaar,Hannah L F Cooper,Megan Harmon,Emily Ivanich,Hannah LaBounty,Ashley N Gassaway,Sierra L Talavera-Brown

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引用次数: 0

Abstract

Objectives. To determine the Connect intervention's effectiveness in reducing substance use among rural and tribal adolescents in northeastern Oklahoma. Methods. We conducted a 2-arm cluster randomized trial from 2021 to 2024, with 10 high schools per condition. Results. At baseline, 919 students were enrolled (mean age = 15 years), and the majority were American Indian or White. Alcohol-use days during the past 30 days was reduced by 18% per survey wave in the intervention compared with the control condition (rate ratio [RR] = 0.82; 95% confidence interval [CI] = 0.72, 0.93; t = -3.02; P = .003), binge drinking was reduced by 26% (RR = 0.74; 95% CI = 0.64, 0.86; t = -3.90; P < .001), cannabis use was reduced by 11% (RR = 0.89; 95% CI = 0.80, 1.00; t = -2.03; P = .04), and prescription opioid misuse was reduced by 40% (RR = 0.60; 95% CI = 0.43, 0.85; t = -2.86; P = .004). Model-predicted means revealed the control condition followed the expected developmental trajectory of increased substance use and the intervention condition showed a flat or decreasing use pattern. Conclusions. The Connect intervention prevented the typical escalation of substance use during adolescence. Trial Registration. ClinicalTrials.gov NCT04839978. Registered on April 9, 2021. Version 10, April 30, 2025. (Am J Public Health. 2025;115(9):1508-1517. https://doi.org/10.2105/AJPH.2025.308205).

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农村低资源和部落社区药物过量的初级预防：一项集群随机试验。

目标。确定Connect干预措施在减少俄克拉何马州东北部农村和部落青少年药物使用方面的有效性。方法。我们从2021年到2024年进行了一项双组随机试验，每种情况下有10所高中。结果。在基线时，919名学生被纳入（平均年龄= 15岁），大多数是美国印第安人或白人。与对照组相比，干预组每波调查中过去30天内的酒精使用天数减少18%(比率比[RR] = 0.82；95%置信区间[CI] = 0.72, 0.93；t = -3.02；P = 0.003)，酗酒减少26% (RR = 0.74；95% ci = 0.64, 0.86；t = -3.90；P < 0.001)，大麻的使用减少了11% (RR = 0.89；95% ci = 0.80, 1.00；t = -2.03；P = .04)，处方阿片类药物滥用减少40% (RR = 0.60；95% ci = 0.43, 0.85；t = -2.86；p = .004)。模型预测结果显示，控制组的药物使用呈增加趋势，干预组的药物使用呈平缓或减少趋势。结论。Connect干预措施防止了青少年时期药物使用的典型升级。试验注册。ClinicalTrials.gov NCT04839978。注册于2021年4月9日。10版，2025年4月30日。[J] .公共卫生杂志，2015;115(9):1508-1517。https://doi.org/10.2105/AJPH.2025.308205)。

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来源期刊

American journal of public health 医学-公共卫生、环境卫生与职业卫生

CiteScore

9.50

自引率

3.90%

发文量

1109

审稿时长

2-4 weeks

期刊介绍： The American Journal of Public Health (AJPH) is dedicated to publishing original work in research, research methods, and program evaluation within the field of public health. The journal's mission is to advance public health research, policy, practice, and education.