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
Bruce David Rapkin,
April M Young,
Michael S Lyons,
Emmanuel Oga,
Jennifer L Brown,
Michelle Lofwall,
Sharon L Walsh,
Timothy Hunt,
Linda S Sprague Martinez,
Redonna Chandler,
T John Winhusen,
Trevor Baker,
Tracy Battaglia,
Rachel Bowers-Sword,
Amy Button,
Amanda Fallin-Bennett,
Laura Fanucchi,
Patricia Freeman,
LaShawn M Glasgow,
Jennifer Gulley,
Charles Kendell,
Maria Quinn,
Hilary L Surratt
Affiliations
Bruce David Rapkin
Epiemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
April M Young
College of Public Health, University of Kentucky, Lexington, Kentucky, USA
Michael S Lyons
Department of Emergency Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Emmanuel Oga
Center for Applied Public Health Research, Research Triangle Institute, Research Triangle Park, North Carolina, USA
Jennifer L Brown
Department of Psychological Sciences, Purdue University, West Lafayette, Indiana, USA
Michelle Lofwall
College of Medicine, University of Kentucky, Lexington, Kentucky, USA
Sharon L Walsh
College of Medicine, University of Kentucky, Lexington, Kentucky, USA
Timothy Hunt
School of Social Work, Columbia University, New York, New York, USA
Linda S Sprague Martinez
School of Social Work, Boston University, Boston, Massachusetts, USA
Redonna Chandler
National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, USA
T John Winhusen
Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
Trevor Baker
General Internal Medicine-CARE Unit, Boston Medical Center, Boston, Massachusetts, USA
Tracy Battaglia
Evans Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
Rachel Bowers-Sword
General Internal Medicine-CARE Unit, Boston Medical Center, Boston, Massachusetts, USA
Amy Button
Montefiore Hudson Valley Collaborative, Albert Einstein College of Medicine, Bronx, New York, USA
Amanda Fallin-Bennett
College of Nursing, University of Kentucky, Lexington, Kentucky, USA
Laura Fanucchi
College of Medicine, University of Kentucky, Lexington, Kentucky, USA
Patricia Freeman
College of Pharmacy, University of Kentucky, Lexington, Kentucky, USA
LaShawn M Glasgow
Community & Workplace Health, Research Triangle International, Research Triangle Park, North Carolina, USA
Jennifer Gulley
Clark County Health Department, Winchester, Kentucky, USA
Charles Kendell
Franklin County Agency for Substance Abuse Policy Board, Frankfort, Kentucky, USA
Maria Quinn
Center for Behavioral Health, Holyoke Medical Center, Holyoke, Massachusetts, USA
Hilary L Surratt
College of Medicine, University of Kentucky, Lexington, Kentucky, USA
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.
