Conducting an implementation intervention study with American Indian and Alaska Native communities: Methodological...

Area of Science:

• Implementation science
• Community-based participatory research (CBPR)
• Indigenous health

Background:

• American Indian and Alaska Native (AI/AN) communities face disproportionate drug overdose deaths due to historical and systemic factors.
• Medications for Opioid Use Disorder (MOUD) are highly effective in reducing mortality.
• Integrating AI/AN traditional practices with MOUD may improve treatment acceptance and use.

Purpose of the Study:

• To develop and evaluate a culturally centered implementation intervention for MOUD delivery in AI/AN communities.
• To address the disproportionate impact of opioid use disorder (OUD) in AI/AN populations.
• To enhance the acceptability and uptake of MOUD within AI/AN communities.

Main Methods:

• A two-phase community-based participatory research (CBPR) trial (NIDA CTN Protocol #0096).
• Intervention development guided by a Collaborative Board (Phase I completed).
• A stepped wedge design for intervention implementation across four AI/AN sites (Phase II ongoing), measuring MOUD initiation, screening, and retention.

Main Results:

• The study is the first to develop and evaluate a culturally centered MOUD implementation intervention for AI/AN communities.
• Data collection includes implementation outcomes, organizational predictors, and intervention acceptability through surveys and interviews.
• Phase II is ongoing, evaluating the effectiveness of the stepped wedge implementation.

Conclusions:

• Implementation science and CBPR effectively co-develop strategies with AI/AN communities.
• Integrating Indigenous and Western best practices can reduce opioid-related mortality.
• This approach has the potential to enhance Indigenous community wellness and address health disparities.