Document text
Principal Investigator: Stephen E Lankenau
Organization: DREXEL UNIVERSITY
Fiscal Year: 2024
Award: $1,164,507
Funding agency: National Institute on Drug Abuse
PROJECT SUMMARY/ABSTRACT
Reducing overdose mortality immediately and long-term is a top public health priority as the overdose epidemic
in the U.S. continues to worsen. The COVID-19 pandemic, which began hitting the U.S. in early 2020, has
exacerbated the overdose crisis - particularly among African Americans and Latinxs. Opioid overdose deaths,
which accounted for the most overdose deaths in 2020, continue to drive the epidemic. Overdose deaths linked
to synthetic opioids, such as illicitly manufactured fentanyl, have increased significantly and comprised most of
the opioid-related deaths in 2020. Despite increasing availability and acceptability of naloxone among
laypersons, opioid overdose deaths remain catastrophically high in communities across the U.S. The UnityPhilly
smartphone app was developed in 2018-19 alongside several community-based organizations as a public health
intervention in response to the opioid overdose crisis in Philadelphia, which has the most acute overdose
epidemic among large cities in the U.S. UnityPhilly automatically connects bystanders and victims of opioid
overdose with nearby community members who can respond immediately with naloxone. The objective of this
proposal, following a successful feasibility study (R34) and clear evidence of overdose reversal supported by
UnityPhilly, is to create an easy-to-use, effective, sustainable, and scalable smartphone app to be deployed
across the city of Philadelphia. This objective will be achieved by studying subgroups of people equipped with
naloxone and UnityPhilly (n=450) and disseminating UnityPhilly to 3,000 citizen volunteers for everyday use to
respond to opioid overdose emergencies. The long-term goal of this research is to create a scalable app that
can be disseminated to communities across the U.S. experiencing high levels of opioid overdose death. The
rationale for this study is that expanding the availability of the UnityPhilly app to laypersons citywide will increase
the speed and delivery of naloxone to opioid overdose events across Philadelphia while laying the groundwork
for scalability and broader national uptake. Our goals will be achieved with three specific aims: 1) Redevelop
UnityPhilly to ensure ease of use; 2) Assess differences in the effectiveness of UnityPhilly across varied urban
environments and participant profiles; and 3) Build and study a sustainable environment for UnityPhilly to expand
city-wide. This 5-year study will have significant impact by providing actionable evidence regarding the
effectiveness of an app-based naloxone intervention to scale up for nationwide use. The study will be conducted
in partnership with long-standing community-based organizations to ensure usability and acceptability. This
intervention is highly significant since it directly addresses one of the most significant public health problems in
the U.S. – the opioid overdose epidemic – which is worsening due to the effects of COVID-19. This intervention
is highly innovative as it improves upon a previous developed successful mobile phone app and expands its use
to a broader population of users in a large city most impacted by the opioid crisis.
Terms: <Actiq><Acute><Address><Adoption><African American group><African American individual><African American people><African American population><African Americans><Android App><Android Application><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 affected><COVID-19 consequence><COVID-19 crisis><COVID-19 effect><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 impact><COVID-19 impacted><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Cell Communication and Signaling><Cell Phone Application><Cell Signaling><Cell phone App><Cellular Phone App><Cellular Phone Application><Cessation of life><Cities><Communities><Death><Diacetylmorphine><Diamorphine><Disease><Disorder><Duragesic><Effectiveness><Emergencies><Emergency Situation><Enrollment><Ensure><Environment><Epidemic><Equity><Event><Family member><Feasibility Studies><Fentanest><Fentanyl><Fentyl><Goals><Government Agencies><Health><Heroin><Intervention><Intervention Strategies><Intracellular Communication and Signaling><Latine><Latinx><Link><Local Government><Maintenance><Medical><Mission><Modeling><NIH><Naloxone><Narcan><Narcanti><National Institutes of Health><Neighborhoods><Outcome><Outcome Measure><Overdose><Overdose reduction><Overdose reversal><Participant><Pathway interactions><Pattern><Persons><Phentanyl><Philadelphia><Population><Process><Psyche structure><Public Health><RE-AIM><Reach, Effectiveness, Adoption, Implementation, and Maintenance><Recovery><Research><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Signal Transduction><Signal Transduction Systems><Signaling><Smart Phone App><Smart Phone Application><Smartphone App><Speed><Subgroup><United States National Institutes of Health><behavior study><behavioral study><biological signal transduction><cell phone based app><community based organizations><community organizations><coronavirus disease 2019 consequence><coronavirus disease 2019 crisis><coronavirus disease 2019 effect><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 impact><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 impact><coronavirus disease-19 pandemic><design><designing><distribute naloxone><enroll><experience><iOS app><iOS application><iPhone App><iPhone Application><improved><innovate><innovation><innovative><insight><interventional strategy><licit opioid><manufacture><measurable outcome><member><mental><mobile phone app><mortality><naloxone availability><naloxone dispensary><naloxone dispensation><naloxone dispensing><naloxone distribution><naloxone provision><non-medical opioid use><nonmedical opioid use><opiate consumption><opiate crisis><opiate deaths><opiate drug use><opiate intake><opiate medication><opiate misuse><opiate mortality><opiate overdose><opiate related overdose><opiate use><opioid consumption><opioid crisis><opioid deaths><opioid drug overdose><opioid drug use><opioid epidemic><opioid induced overdose><opioid intake><opioid intoxication><opioid medication><opioid medication overdose><opioid misuse><opioid mortality><opioid overdose><opioid overdose death><opioid poisoning><opioid related death><opioid related overdose><opioid toxicity><opioid use><outcome measurement><overdose death><overdose fatalities><overdose risk><pathway><pilot test><prescribed opiate><prescribed opioid><prescription opiate><prescription opioid><provide naloxone><public health intervention><public health priorities><reach, efficacy, adoption, implementation, and maintenance><reduce overdose><reduction in overdose><response><reverse overdose><scale up><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><smartphone application><smartphone based app><smartphone based application><synthetic opiate><synthetic opioid><uptake><urban environment><urban setting><usability><volunteer><willingness>