Protocol for community-driven selection of strategies to implement evidence-based practices to reduce opioid overdoses in the HEALing Communities Study: a trial to evaluate a community-engaged intervention in Kentucky, Massachusetts, New York and Ohio

April M Young, Jennifer L Brown, Timothy Hunt, Linda S Sprague Martinez, Redonna Chandler, Emmanuel Oga, T John Winhusen, Trevor Baker, Tracy Battaglia, Rachel Bowers-Sword, Amy Button, Amanda Fallin-Bennett, Laura Fanucchi, Patricia Freeman, LaShawn M Glasgow, Jennifer Gulley, Charles Kendell, Michelle Lofwall, Michael S Lyons, Maria Quinn, Bruce David Rapkin, Hilary L Surratt, Sharon L Walsh, April M Young, Jennifer L Brown, Timothy Hunt, Linda S Sprague Martinez, Redonna Chandler, Emmanuel Oga, T John Winhusen, Trevor Baker, Tracy Battaglia, Rachel Bowers-Sword, Amy Button, Amanda Fallin-Bennett, Laura Fanucchi, Patricia Freeman, LaShawn M Glasgow, Jennifer Gulley, Charles Kendell, Michelle Lofwall, Michael S Lyons, Maria Quinn, Bruce David Rapkin, Hilary L Surratt, Sharon L Walsh

Abstract

Introduction: Opioid-involved overdose deaths continue to surge in many communities, despite numerous evidence-based practices (EBPs) that exist to prevent them. The HEALing Communities Study (HCS) was launched to develop and test an intervention (ie, Communities That HEAL (CTH)) that supports communities in expanding uptake of EBPs to reduce opioid-involved overdose deaths. This paper describes a protocol for a process foundational to the CTH intervention through which community coalitions select strategies to implement EBPs locally.

Methods and analysis: The CTH is being implemented in 67 communities (randomised to receive the intervention) in four states in partnership with coalitions (one per community). Coalitions must select at least five strategies, including one to implement each of the following EBPs: (a) overdose education and naloxone distribution; expanded (b) access to medications for opioid use disorder (MOUD), (c) linkage to MOUD, (d) retention in MOUD and (e) safer opioid prescribing/dispensing. Facilitated by decision aid tools, the community action planning process includes (1) data-driven goal setting, (2) discussion and prioritisation of EBP strategies, (3) selection of EBP strategies and (4) identification of next steps. Following review of epidemiologic data and information on existing local services, coalitions set goals and discuss, score and/or rank EBP strategies based on feasibility, appropriateness within the community context and potential impact on reducing opioid-involved overdose deaths with a focus on three key sectors (healthcare, behavioural health and criminal justice) and high-risk/vulnerable populations. Coalitions then select EBP strategies through consensus or majority vote and, subsequently, suggest or choose agencies with which to partner for implementation.

Ethics and dissemination: The HCS protocol was approved by a central Institutional Review Board (Advarra). Results of the action planning process will be disseminated in academic conferences and peer-reviewed journals, online and print media, and in meetings with community stakeholders.

Trial registration number: NCT04111939.

Keywords: PUBLIC HEALTH; STATISTICS & RESEARCH METHODS; Substance misuse.

Conflict of interest statement

Competing interests: Competing interest disclosures include the following: LSM is a consultant for the Boston Public Health Commission, Action for Boston Area development and the Young Foundation, SLW has served as a scientific advisor to Opiant Pharmaceuticals, Titan Pharmaceuticals, Astra Zeneca, Cerevel, Arbor Pharmaceuticals, Brainsway, Summit Biosciences, Trevi and Camurus. JLB ad ML receive investigator-initiated support paid to the institution from Gilead Sciences, Inc. MRL has consulted for Titan Pharmaceuticals and Camurus. AF-B is the Program Director of Voices of Hope, a University of Kentucky HCS partner organisation. PF, HLS, AMY, EO, LMG, RC, JG, CK and LF have no competing interests.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.

Figures

Figure 1
Figure 1
Guidelines for HEALing Communities Study Community Action Planning Process to reduce opioid overdose deaths through overdose education and naloxone distribution, expansion of medications for opioid use disorder and safer opioid prescribing and dispensin. MOUD, medications for opioid use disorder; OEND, overdose education and naloxone distribution; ORCCA, Opioid-Overdose Reduction Continuum of Care Approach.
Figure 2
Figure 2
Core components of the HEALing Communities Study Community Action Planning Process to reduce opioid overdose deaths through overdose education and naloxone distribution, medications for opioid use disorder and safer opioid prescribing and dispensing. EBP, evidence-based practice; MOUD, medications for opioid use disorder; OEND, overdose education and naloxone distribution; ORCCA, Opioid-Overdose Reduction Continuum of Care Approach.

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