Objectives. To determine whether the Communities That HEAL (CTH) intervention is effective in increasing naloxone distribution compared with usual care. Methods. The HEALing (Helping to End Addiction Long-Term) Communities Study (HCS) is a cluster-randomized, parallel-arm, wait-list controlled implementation science trial testing the impact of the CTH intervention on increasing the use of evidence-based practices to lower opioid-related overdose deaths. Communities (n = 67) highly impacted by opioid overdose in Kentucky, Massachusetts, New York, and Ohio were allocated to CTH intervention (n = 34) or wait-list comparison (usual care; n = 33) arms. The primary outcome for this study was the number of naloxone units distributed in HCS communities during the comparison period (July 1, 2021‒June 30, 2022), examined using an intent-to-treat negative binomial regression model. Results. Naloxone distribution was 79% higher in the CTH intervention versus usual care arm (adjusted relative rate = 1.79; 95% confidence interval = 1.28, 2.51; P = .001; adjusted rates of naloxone distribution 3378 vs 1884 naloxone units per 100 000 residents), when controlling for urban‒rural status, state, baseline opioid-related overdose death rate, and baseline naloxone distribution rate. Conclusions. The CTH intervention increased naloxone distribution compared with usual care in communities highly impacted by the opioid crisis. Trial Registration. ClinicalTrials.gov identifier: NCT04111939. (Am J Public Health. Published online ahead of print October 10, 2024:e1-e12. https://doi.org/10.2105/AJPH.2024.307845).

中文翻译：

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HEAL 干预对过量教育和纳洛酮分发的社区影响：一项整群随机、候补名单对照试验。


目标。确定与常规护理相比，Communities That HEAL （CTH） 干预是否能有效增加纳洛酮的分布。方法。HEALing（帮助结束长期成瘾）社区研究 （HCS） 是一项整群随机、平行臂、候补名单对照实施科学试验，旨在测试 CTH 干预对增加使用循证实践以降低阿片类药物相关过量死亡的影响。肯塔基州、马萨诸塞州、纽约州和俄亥俄州受阿片类药物过量高度影响的社区 （n = 67） 被分配到 CTH 干预 （n = 34） 或候补名单比较 （常规护理;n = 33） 组。本研究的主要结果是比较期间（2021 年 7 月 1 日至 2022 年 6 月 30 日）在 HCS 社区中分布的纳洛酮单位数量，使用意向治疗阴性二项式回归模型进行检查。结果。与常规护理组相比，CTH 干预组的纳洛酮分布高 79%（调整后的相对率 = 1.79;95% 置信区间 = 1.28、2.51;P = .001;调整后的纳洛酮分布率 3378 对每 100 000 名居民 1884 个纳洛酮单位），在控制城市\农村状况、州、基线阿片类药物相关过量死亡率和基线纳洛酮分布率时。结论。与常规护理相比，CTH 干预增加了受阿片类药物危机严重影响的社区的纳洛酮分布。试用注册。ClinicalTrials.gov 标识符：NCT04111939。（美国公共卫生杂志。2024 年 10 月 10 日提前在线发布：e1-e12。https://doi.org/10.2105/AJPH.2024.307845）。