Kapler Simon, Hassan Hira, Jeremiah Alexander, Bryant Katurah, Crespo Presto, Felix Nesta, Lopez Sónyi Elena, Morales Antonio, Reeves Sean, Jordan Ayana
NYU Grossman School of Medicine, New York City, USA.
The ZOLA Experience, New Haven, USA.
Harm Reduct J. 2025 May 12;22(Suppl 1):74. doi: 10.1186/s12954-025-01214-y.
Death from opioid use is a growing public health concern, with stark racial and ethnic disparities. The randomized controlled trial described here aims to improve initiation and engagement in harm reduction services for Black and Latine people who use drugs to minimize mortality in these populations. The trial is informed by a Community Advisory Board (CAB) of stakeholders from racial and ethnic minoritized backgrounds committed to promoting health equity in populations disproportionately impacted by the drug overdose crisis. CABs are an underutilized mechanism for engaging communities in research to improve health outcomes. Hence, in this manuscript we outline the process and methods employed in creating a CAB, describe its impact on our research study, and recognize the challenges and adaptations made to the CAB during the study.CAB recruitment targeted active community members from Black and Latine communities in the Bronx, NY and New Haven, CT. After attending community organizational meetings in each place, follow-up email efforts were unsuccessful, prompting a revised approach. Emphasizing the study's focus on historically excluded voices, "research-naïve" individuals were sought through online searches and local grassroots organizations, excluding those affiliated with harm reduction groups to minimize bias. Once CAB members were identified, a remote orientation was held, and the CAB began providing regular feedback on research activities, from participant recruitment to educational script details. CAB members' diverse identities and life experiences generated nuanced discussions, which were distilled into feedback improving research materials and recruitment strategies. In the future, the CAB will also guide data analysis and research publications. Other areas of emphasis have included straightforward language in study materials, balanced messaging about harm reduction recommendations, and specific community outreach opportunities. Practical barriers that needed to be addressed for optimal CAB functioning included timely compensation with minimal institutional burden and assistance with meeting coordination and communication.The CAB has ensured that Black and Latine community voices are included in guiding our study, promoting equitable and ethical research. As harm reduction research advances, it is essential to center this work around the intersectional identities of people who use drugs to prevent the disproportionate burden and deaths among Black and Latine people.
阿片类药物使用导致的死亡是一个日益严重的公共卫生问题，存在明显的种族和族裔差异。本文所述的随机对照试验旨在改善为吸毒的黑人和拉丁裔人群提供的减少伤害服务的启动和参与情况，以尽量降低这些人群的死亡率。该试验由一个社区咨询委员会（CAB）提供信息支持，该委员会由来自少数族裔背景的利益相关者组成，致力于在受药物过量危机影响尤为严重的人群中促进健康公平。社区咨询委员会是让社区参与研究以改善健康结果的一种未得到充分利用的机制。因此，在本手稿中，我们概述了创建社区咨询委员会所采用的过程和方法，描述了其对我们研究的影响，并认识到在研究期间对社区咨询委员会所面临的挑战及做出的调整。社区咨询委员会的招募对象是纽约布朗克斯区和康涅狄格州纽黑文市黑人和拉丁裔社区的活跃社区成员。在参加了各地的社区组织会议后，后续的电子邮件招募工作未成功，促使我们采取了修订后的方法。强调该研究关注历史上被排除的声音，通过在线搜索和当地基层组织寻找“对研究了解甚少”的个人，排除与减少伤害团体有关联的人以尽量减少偏差。一旦确定了社区咨询委员会成员，就举行了一次远程培训，该委员会开始就研究活动提供定期反馈，从参与者招募到教育脚本细节。社区咨询委员会成员的不同身份和生活经历引发了细致入微的讨论，这些讨论被提炼为改进研究材料和招募策略的反馈。未来，社区咨询委员会还将指导数据分析和研究出版物。其他重点领域包括研究材料中使用直白的语言、关于减少伤害建议的平衡信息传递以及特定的社区外展机会。为使社区咨询委员会发挥最佳作用而需要解决的实际障碍包括及时给予报酬且机构负担最小，以及在会议协调和沟通方面提供协助。社区咨询委员会确保了黑人和拉丁裔社区的声音被纳入指导我们的研究，促进了公平和符合伦理的研究。随着减少伤害研究的推进，至关重要的是围绕吸毒者的交叉身份开展这项工作，以防止黑人和拉丁裔人群承担不成比例的负担和死亡。
