CE24-013 - Developing and Evaluating the Concerned Caregivers Education for Resource Navigation (ConCERN) Intervention for Preventing Overdose

University Of Michigan At Ann Arbor, Ann Arbor MI

Investigators

Abstract

ABSTRACT Despite scientific evidence supporting reduction in overdose risk with medications for opioid use disorder (MOUD) and engagement with harm reduction approaches, uptake remains low. The social networks of people who use drugs (PWUD) can have profound impacts on their engagement with treatment and other supportive services. The consequential role of concerned significant others (CSOs) supporting PWUD suggests they may be key intervention points for altering overdose risk behavior through promoting uptake of evidence-based treatments and harm reduction for opioid use. CSOs of PWUD often want to provide effective support, but they may lack sufficient knowledge, skills, or resources, especially when supporting individuals who are unable or unwilling to stop drug use and who may benefit from MOUD or harm reduction. For example, CSOs commonly report difficulties navigating community and health system services and may perpetuate stigma towards evidence-based treatments by equating MOUD to illicit opioid use. Existing programs focused on the CSOs of PWUD have commonly been designed in the context of alcohol use disorder, which differs from opioid use with respect to treatments and stigma manifestations, or they require lengthy multi-session engagement that may not be practical or scalable to deliver in diverse contexts. Using community engaged research methodology, we propose to develop and evaluate a novel brief digital intervention for the CSOs of people who recently experienced an opioid-related overdose. Our goal is to systematically develop the Concerned Caregivers Education for Resource Navigation (ConCERN) intervention that leverages 1) education addressing stigmatizing misinformation and low knowledge regarding MOUD and harm reduction, 2) supports improved navigation of these resources, and 3) improves caregiver well-being and communication skills to promote treatment and harm reduction engagement among PWUD. To achieve this goal, this study will address three specific aims. Aim 1: Use community-engaged human-centered design to develop a brief multicomponent digital CSO intervention that reduces stigma, enhances system navigation, builds positive communication skills, and improves caregiver well-being. Aim 2: Test the effectiveness of ConCERN versus treatment as usual on reducing overdose risk behavior and improving engagement in harm reduction practices and MOUD. Aim 3: Evaluate implementation outcomes, barriers, and facilitators to inform future efforts to scale up ConCERN. We will employ a mixed methods dyad design guided by evidence-based implementation frameworks to examine outcomes in both PWUD and CSOs allowing for measurement of drug use behaviors as well as reduction in CSO stigma, and improvement in their support skills and well-being. The ConCERN intervention is significant because it will provide influential resources and reduce stigma operating in the social networks of PWUD. It is also innovative as there is little research on brief scalable interventions to reduce stigma and support CSOs as a mechanism to reduce overdose risk for PWUD.