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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
Young, A. M., Brown, J. L., Hunt, T., Sprague Martinez, L. S., Chandler, R., Oga, E., Winhusen, T. J., Baker, T., Battaglia, T., Bowers-Sword, R., Button, A., Fallin-Bennett, A., Fanucchi, L., Freeman, P., Glasgow, L. M., Gulley, J., Kendell, C., Lofwall, M., Lyons, M. S., ... Walsh, S. L. (2022). 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. BMJ Open, 12(9), Article e059328. https://doi.org/10.1136/bmjopen-2021-059328
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.
