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 trialResearch in context
Summary: 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 stakehol...
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-04-01
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| Series: | The Lancet Regional Health. Americas |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667193X24000371 |
| _version_ | 1797262794686464000 |
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| author | Alissa Davis Hannah K. Knudsen Daniel M. Walker Deborah Chassler Karsten Lunze Philip M. Westgate Emmanuel Oga Sandra Rodriguez Sylvia Tan JaNae Holloway Sharon L. Walsh Carrie B. Oser R. Craig Lefebvre Laura C. Fanucchi LaShawn Glasgow Ann Scheck McAlearney Hilary L. Surratt Michael W. Konstan Terry T.-K. Huang Patricia LeBaron Julie Nakayima Michael D. Stein Maria Rudorf Monica Nouvong Elizabeth N. Kinnard Nabila El-Bassel Jess Tilley Aaron Macoubray Caroline Savitzky Amy Farmer Donna Beers Pamela Salsberry Timothy R. Huerta |
| author_facet | Alissa Davis Hannah K. Knudsen Daniel M. Walker Deborah Chassler Karsten Lunze Philip M. Westgate Emmanuel Oga Sandra Rodriguez Sylvia Tan JaNae Holloway Sharon L. Walsh Carrie B. Oser R. Craig Lefebvre Laura C. Fanucchi LaShawn Glasgow Ann Scheck McAlearney Hilary L. Surratt Michael W. Konstan Terry T.-K. Huang Patricia LeBaron Julie Nakayima Michael D. Stein Maria Rudorf Monica Nouvong Elizabeth N. Kinnard Nabila El-Bassel Jess Tilley Aaron Macoubray Caroline Savitzky Amy Farmer Donna Beers Pamela Salsberry Timothy R. Huerta |
| author_sort | Alissa Davis |
| collection | DOAJ |
| description | Summary: 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. |
| first_indexed | 2024-04-25T00:02:47Z |
| format | Article |
| id | doaj.art-7de3f645a6a5443d932bf656bcdc8594 |
| institution | Directory Open Access Journal |
| issn | 2667-193X |
| language | English |
| last_indexed | 2024-04-25T00:02:47Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Americas |
| spelling | doaj.art-7de3f645a6a5443d932bf656bcdc85942024-03-14T06:16:51ZengElsevierThe Lancet Regional Health. Americas2667-193X2024-04-0132100710Effects 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 trialResearch in contextAlissa Davis0Hannah K. Knudsen1Daniel M. Walker2Deborah Chassler3Karsten Lunze4Philip M. Westgate5Emmanuel Oga6Sandra Rodriguez7Sylvia Tan8JaNae Holloway9Sharon L. Walsh10Carrie B. Oser11R. Craig Lefebvre12Laura C. Fanucchi13LaShawn Glasgow14Ann Scheck McAlearney15Hilary L. Surratt16Michael W. Konstan17Terry T.-K. Huang18Patricia LeBaron19Julie Nakayima20Michael D. Stein21Maria Rudorf22Monica Nouvong23Elizabeth N. Kinnard24Nabila El-Bassel25Jess Tilley26Aaron Macoubray27Caroline Savitzky28Amy Farmer29Donna Beers30Pamela Salsberry31Timothy R. Huerta32Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA; Corresponding author. Columbia University School of Social Work, 1255 Amsterdam Avenue, Rm. 706, New York, NY, 10027, USA.Department of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USACATALYST, 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, USABoston University School of Social Work, 264-270 Bay State Road, Boston, MA, 02215, USABoston University Chobanian & Avedisian School of Medicine/Boston Medical Center, Department of Medicine, 801 Massachusetts Ave., Boston, MA, 02118, USADepartment of Biostatistics, College of Public Health, University of Kentucky, 760 Press Avenue, Lexington, KY, 40536, USARTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USAColumbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USARTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USARTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USADepartment of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USADepartment of Sociology, Center on Drug and Alcohol Research, Center for Health Equity Transformation, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY, 40506, USARTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USADepartment of Medicine, Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Ave, Lexington, KY, 40508, USARTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USACATALYST, 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, USADepartment of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USACase Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH, 44106, USACenter 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, USARTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USADepartment of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USADepartment of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USABoston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USABoston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USABoston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USAColumbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USANew England Drug Users Union, 36 Bedford Terrace, Suite 2, Northampton, MA, 01060, USARTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USABoston Medical Center, Section of Infectious Diseases, 801 Massachusetts Ave., Boston, MA, 02118, USAThe Ohio State University College of Medicine, HEALing Communities Research, 530 W. Spring St., Suite 275, Columbus, OH, 43215, USABoston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USAThe Ohio State University College of Public Health, 1841 Neil Ave., Columbus, OH, 43210, USACATALYST, 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, USASummary: 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.http://www.sciencedirect.com/science/article/pii/S2667193X24000371StigmaSubstance useOpioidNaloxoneMOUDCommunity |
| spellingShingle | Alissa Davis Hannah K. Knudsen Daniel M. Walker Deborah Chassler Karsten Lunze Philip M. Westgate Emmanuel Oga Sandra Rodriguez Sylvia Tan JaNae Holloway Sharon L. Walsh Carrie B. Oser R. Craig Lefebvre Laura C. Fanucchi LaShawn Glasgow Ann Scheck McAlearney Hilary L. Surratt Michael W. Konstan Terry T.-K. Huang Patricia LeBaron Julie Nakayima Michael D. Stein Maria Rudorf Monica Nouvong Elizabeth N. Kinnard Nabila El-Bassel Jess Tilley Aaron Macoubray Caroline Savitzky Amy Farmer Donna Beers Pamela Salsberry Timothy R. Huerta 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 trialResearch in context The Lancet Regional Health. Americas Stigma Substance use Opioid Naloxone MOUD Community |
| title | 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 trialResearch in context |
| title_full | 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 trialResearch in context |
| title_fullStr | 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 trialResearch in context |
| title_full_unstemmed | 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 trialResearch in context |
| title_short | 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 trialResearch in context |
| title_sort | 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 trialresearch in context |
| topic | Stigma Substance use Opioid Naloxone MOUD Community |
| url | http://www.sciencedirect.com/science/article/pii/S2667193X24000371 |
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