An Integrated Geospatial and Community-based Model to Prevent Opioid Overdose among Black Americans

“Opioid overdose death (OOD) rates among Black Americans have increased unabated since 2015, outpacing national averages at a rate of two to one. Health disparities in the growth rate of OOD have been documented in at least 23 states, including Missouri, which has second highest rate of OOD among Black Americans: 44 per 100,000 (relative to 16 per 100,000 nationally).
There is a critical need to identify and mitigate environmental determinants of health (EDOH) that drive increasing health disparities in OOD and opioid use disorder treatment utilization. One strategy that addresses EDOH—such as low geographic access to treatment and high neighborhood deprivation—is community-based outreach, which dispatches peers and community health workers to provide overdose education, naloxone distribution, and linkage to evidence-based treatment. Although these efforts can improve psychoeducation and access to treatment for Black Americans, existing outreach interventions are limited by a lack of data-driven targets. There is an urgent need to identify and disseminate geographic and environmental drivers of OOD among Black Americans to improve the efficacy of existing outreach interventions and in turn, develop data-driven solutions to health disparities affecting this population. The current K08 addresses this need by integrating geospatial information systems (GIS) technology and community based participatory research to create a digital tool designed to 1) identify current EDOH that underlie OOD among Black Americans and 2) provide data-driven targets to improve the efficacy of community-based outreach interventions. The project aims and career development plan will concurrently support Dr. Banks’ transition to an independent clinical investigator focused on the integration of technology and community engagement to improve substance use treatment among populations facing health disparities. Specific aims of the project are to: 1) develop and evaluate the predictive validity of a GIS-enabled index (the “Community Overdose Prevention Index”) to model risk for OOD based on EDOH identified and rated by community experts and 2) demonstrate initial acceptability and utility of the Community Overdose Prevention Index to guide outreach interventions aimed at reducing health disparities in OOD via interviews with peers and community health workers. Aims and related training opportunities facilitated by the rich intellectual environment at Washington University in St. Louis will support Dr. Banks’ training goals to gain expertise in digital/mobile health therapeutics, opioid use disorder treatment, and implementation science. Outcomes include the identification of EDOH that underlie OOD among Black Americans and a replicable implementation model other regions can use to identify policy and intervention targets to reduce health disparities in OOD among various populations. The research will provide the training and data necessary for an R01 application that tests the effectiveness of a mobile version of the Community Overdose Prevention Index to improve community-based prevention outcomes.”

Grant Number: 3K08DA058080-04S1
NIH Institute/Center: NIH
Principal Investigator: Devin Banks