Department of Pharmacy Practice, Auburn University Harrison College of Pharmacy, 2316 Walker Building, Auburn, AL, 36849, USA.
Department of Pharmacy Practice, Thomas Jefferson University College of Pharmacy, 901 Walnut Street, Health Professions Academic Building, Philadelphia, PA, 19107, USA.
BMC Public Health. 2022 May 4;22(1):886. doi: 10.1186/s12889-022-13248-z.
Deep South states, particularly Alabama, experience disproportionately higher opioid prescribing rates versus national rates. Considering limited opioid use disorder (OUD) providers in this region, collaborative efforts between non-healthcare professionals is critical in mitigating overdose mortality. The Alabama Opioid Training Institute (OTI) was created in 2019 to empower community members to take action in combatting OUD in local regions. The OTI included: 1) eight full-day in-person conferences; and 2) an interactive mobile-enabled website ( https://alabamaoti.org ). This study assessed the impact of the OTI on influential community members' knowledge, abilities, concerns, readiness, and intended actions regarding OUD and opioid overdose mitigation.
A one-group prospective cohort design was utilized. Alabama community leaders were purposively recruited via email, billboards, television, and social media advertisements. Outcome measures were assessed via online survey at baseline and post-conference, including: OUD knowledge (percent correct); abilities, concerns, and readiness regarding overdose management (7-point Likert-type scale, 1 = strongly disagree to 7 = strongly agree); and actions/intended actions over the past/next 6 months (8-item index from 0 to 100% of the time). Conference satisfaction was also assessed. Changes were analyzed using McNemar or Marginal Homogeneity tests for categorical variables and two-sided paired t-tests for continuous variables (alpha = 0.05).
Overall, 413 influential community members participated, most of whom were social workers (25.7%), female (86.4%), and White (65.7%). Community members' OUD knowledge increased from mean [SD] 71.00% [13.32] pre-conference to 83.75% [9.91] post-conference (p < 0.001). Compared to pre-conference, mean [SD] ability scale scores increased (3.72 [1.55] to 5.15 [1.11], p < 0.001) and concerns decreased (3.19 [1.30] to 2.64 [1.17], p < 0.001) post-conference. Readiness was unchanged post-conference. Attendees' intended OUD-mitigating actions in the next 6 months exceeded their self-reported actions in the past 6 months, and 92% recommended the OTI to others.
The Alabama OTI improved community leaders' knowledge, abilities, and concerns regarding OUD management. Similar programs combining live education and interactive web-based platforms can be replicated in other states.
与全国水平相比，美国南部各州，尤其是阿拉巴马州，开出的阿片类药物处方比例过高。考虑到该地区阿片类药物使用障碍（OUD）治疗人员有限，非医疗专业人员之间的合作对于减轻过量死亡至关重要。阿拉巴马州阿片类药物培训学院（OTI）成立于 2019 年，旨在授权社区成员在当地地区采取行动打击 OUD。OTI 包括：1）八次为期一整天的现场会议；2）一个互动式移动启用网站（https://alabamaoti.org）。本研究评估了 OTI 对有影响力的社区成员在 OUD 和阿片类药物过量缓解方面的知识、能力、关注点、准备情况和预期行动的影响。
采用单组前瞻性队列设计。通过电子邮件、广告牌、电视和社交媒体广告有针对性地招募阿拉巴马州社区领导人。在基线和会议后通过在线调查评估结果衡量标准，包括：阿片类药物使用障碍知识（正确百分比）；管理阿片类药物过量的能力、关注点和准备情况（7 点李克特量表，1=强烈不同意，7=强烈同意）；以及过去/未来 6 个月的行动/预期行动（0 到 100%时间的 8 项指数）。还评估了会议满意度。使用 McNemar 或边际同质性检验对分类变量进行分析，使用双侧配对 t 检验对连续变量进行分析（α=0.05）。
总体而言，共有 413 名有影响力的社区成员参加，其中大多数是社会工作者（25.7%）、女性（86.4%）和白人（65.7%）。社区成员的阿片类药物使用障碍知识从会前的平均[标准差]71.00%[13.32]增加到会后的 83.75%[9.91]（p<0.001）。与会前相比，能力量表的平均[标准差]得分增加（3.72[1.55]至 5.15[1.11]，p<0.001），关注点减少（3.19[1.30]至 2.64[1.17]，p<0.001）。会议后准备情况保持不变。与会者在未来 6 个月内的阿片类药物缓解预期行动超过了过去 6 个月内的自我报告行动，92%的人向他人推荐 OTI。
阿拉巴马州 OTI 提高了社区领导人对阿片类药物管理的知识、能力和关注。类似的结合现场教育和互动式网络平台的项目可以在其他州复制。
