Effects of the Communities that Heal (CTH) intervention on perceived opioid-related community stigma in the HEALing Communities Study: results of a multi-site, community-level, cluster-randomized trial.

Autor:	Davis A; Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA., Knudsen HK; Department of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA., Walker DM; CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 4000, Columbus, OH, 43202, USA.; Department of Family and Community Medicine, College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 5000, Columbus, OH, 43202, USA., Chassler D; Boston University School of Social Work, 264-270 Bay State Road, Boston, MA, 02215, USA., Lunze K; Boston University Chobanian & Avedisian School of Medicine/Boston Medical Center, Department of Medicine, 801 Massachusetts Ave., Boston, MA, 02118, USA., Westgate PM; Department of Biostatistics, College of Public Health, University of Kentucky, 760 Press Avenue, Lexington, KY, 40536, USA., Oga E; RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA., Rodriguez S; Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA., Tan S; RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA., Holloway J; RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA., Walsh SL; Department of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA., Oser CB; Department of Sociology, Center on Drug and Alcohol Research, Center for Health Equity Transformation, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY, 40506, USA., Lefebvre RC; RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA., Fanucchi LC; Department of Medicine, Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Ave, Lexington, KY, 40508, USA., Glasgow L; RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA., McAlearney AS; CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 4000, Columbus, OH, 43202, USA.; Department of Family and Community Medicine, College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 5000, Columbus, OH, 43202, USA., Surratt HL; Department of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA., Konstan MW; Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH, 44106, USA., Huang TT; Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health & Health Policy, City University of New York, 55 W. 125 Street, Room 803, New York, NY, 10027, USA., LeBaron P; RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA., Nakayima J; Department of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA., Stein MD; Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA., Rudorf M; Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USA., Nouvong M; Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USA., Kinnard EN; Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USA., El-Bassel N; Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA., Tilley J; New England Drug Users Union, 36 Bedford Terrace, Suite 2, Northampton, MA, 01060, USA., Macoubray A; RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA., Savitzky C; Boston Medical Center, Section of Infectious Diseases, 801 Massachusetts Ave., Boston, MA, 02118, USA., Farmer A; The Ohio State University College of Medicine, HEALing Communities Research, 530 W. Spring St., Suite 275, Columbus, OH, 43215, USA., Beers D; Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USA., Salsberry P; The Ohio State University College of Public Health, 1841 Neil Ave., Columbus, OH, 43210, USA., Huerta TR; CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 4000, Columbus, OH, 43202, USA.; Department of Family and Community Medicine, College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 5000, Columbus, OH, 43202, USA.; Department of Biomedical Informatics, College of Medicine, The Ohio State University, 1585 Neil Ave, Columbus, OH, 43210, USA.
Jazyk:	angličtina
Zdroj:	Lancet regional health. Americas [Lancet Reg Health Am] 2024 Mar 12; Vol. 32, pp. 100710. Date of Electronic Publication: 2024 Mar 12 (Print Publication: 2024).
DOI:	10.1016/j.lana.2024.100710
Abstrakt:	Background: Community stigma against people with opioid use disorder (OUD) and intervention stigma (e.g., toward naloxone) exacerbate the opioid overdose crisis. We examined the effects of the Communities that HEAL (CTH) intervention on perceived opioid-related community stigma by stakeholders in the HEALing Communities Study (HCS). Methods: We collected three surveys from community coalition members in 66 communities across four states participating in HCS. Communities were randomized into Intervention (Wave 1) or Wait-list Control (Wave 2) arms. We conducted multilevel linear mixed models to compare changes in primary outcomes of community stigma toward people treated for OUD, naloxone, and medication for opioid use disorder (MOUD) by arm from time 1 (before the start of the intervention) to time 3 (end of the intervention period in the Intervention arm). Findings: Intervention stakeholders reported a larger decrease in perceived community stigma toward people treated for OUD (adjusted mean change (AMC) -3.20 [95% C.I. -4.43, -1.98]) and toward MOUD (AMC -0.33 [95% C.I. -0.56, -0.09]) than stakeholders in Wait-list Control communities (AMC -0.18 [95% C.I. -1.38, 1.02], p  = 0.0007 and AMC 0.11 [95% C.I. -0.09, 0.31], p  = 0.0066). The relationship between intervention status and change in stigma toward MOUD was moderated by rural-urban status (urban AMC -0.59 [95% CI, -0.87, -0.32], rural AMC not sig.) and state. The difference in stigma toward naloxone between Intervention and Wait-list Control stakeholders was not statistically significant ( p  = 0.18). Interpretation: The CTH intervention decreased stakeholder perceptions of community stigma toward people treated for OUD and stigma toward MOUD. Implementing the CTH intervention in other communities could decrease OUD stigma across diverse settings nationally. Funding: US National Institute on Drug Abuse. Competing Interests: All authors declare no conflicts of interest related to the topic of the manuscript. (© 2024 The Author(s).)
Databáze:	MEDLINE
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