Institutes For Behavior Resources Inc

BRINGING RESOURCES INDIVIDUALLY TO EMPOWER RECOVERY (BRITER)

THE LONG-TERM GOAL OF THE PROPOSED RESEARCH IS TO DELIVER A SOFTWARE TOOL (CURRENTLY REFERRED TO BY ITS WORKING TITLE OF TEAM PERFORMANCE TASK OR T

EMPOWER - EXPANDING MEDICAL PREVENTION AND OUTREACH WHILE ENHANCING RECOVERY AND RETENTION - EMPOWER SEEKS TO REDUCE THE RACIAL DISPARITY IN SUD TREATMENT ENGAGEMENT AND RETENTION BY INCREASING ACCESS AND LINKAGE TO HIV AND HCV TESTING AND TREATMENT. PARTICIPANTS, 290 BLACK MEN AND WOMEN WITH SUD/COD WHO ARE AT RISK FOR OR LIVING WITH HIV, WILL RECEIVE CULTURALLY TAILORED, PATIENT-FOCUSED AND EVIDENCE-BASED INTERVENTIONS DESIGNED TO PROMOTE ENGAGEMENT AND RETENTION IN MEDICATIONS FOR OPIOID USE DISORDER (MOUD) TREATMENT. THE GOAL OF EMPOWER (EXPANDING MEDICAL PREVENTION AND OUTREACH WHILE ENHANCING RECOVERY AND RETENTION) PROGRAM IS TO INCREASE SUD TREATMENT ENGAGEMENT AND RETENTION AND RELATED CARE AMONG MEDICALLY UNDERSERVED BLACK INDIVIDUALS WITH OPIOID AND OTHER SUD AND CO-OCCURRING DISORDERS (COD) WHO ARE AT RISK FOR OR LIVING WITH HIV. THE PROJECT WILL SERVE ENGLISH-SPEAKING ADULT BLACK MEN AND WOMEN WITH: OPIOID/OTHER SUDS; COD; WITH PREDOMINANTLY LOW SOCIOECONOMIC STATUS; ANY SEXUAL ORIENTATION OR GENDER IDENTITY; AND AT RISK FOR OR LIVING WITH HIV; A GROUP THAT IS LESS LIKELY TO ENTER AND REMAIN IN TREATMENT AND LESS LIKELY TO RECEIVE MOUD THAN THEIR WHITE COUNTERPARTS. THE PROJECT WILL ENROLL PARTICIPANTS AT A STEPPED TARGET ANNUAL RATE (40 IN YEAR 1, 70 IN YEARS 2, 3, AND 4, AND 40 IN YEAR 5). EMPOWER BUILDS UPON THE SOLID FOUNDATION OF REACH, A LARGE OUTPATIENT SUD TREATMENT PROGRAM IN CENTRAL BALTIMORE CITY, PROVIDING MOUD (E.G., BUPRENORPHINE, METHADONE, NALTREXONE) AND A RANGE OF SERVICES TO A DIVERSE POPULATION OF ABOUT 700 PATIENTS. ALMOST THREE-FOURTHS OF REACH PATIENTS ARE BLACK, AND IT IS ESTIMATED THAT 20% ARE POSITIVE FOR HIV AND 60% ARE POSITIVE FOR HCV. EMPOWER WILL FOCUS ON EARLY TREATMENT ENGAGEMENT AND RETENTION AT REACH (MONTHS 1-6) WHERE DESPITE A MENU OF TREATMENT OPTIONS, STARK RACIAL DISPARITIES HAVE BEEN IDENTIFIED, WITH MORE BLACK MEN AND WOMEN DISCONTINUING TREATMENT EARLY, BEFORE HIV/HCV SCREENING AND MORTALITY (INCLUDING OVERDOSE DEATHS) AND IMPROVE PHYSICAL AND MENTAL HEALTH, PARTICULARLY FOR THE POPULATION OF FOCUS. TRAINED MULTIDISCIPLINARY EMPOWER STAFF WITH LIVED EXPERIENCE AND REPRESENTING THE POPULATIONS OF FOCUS WILL USE A COORDINATED TEAM APPROACH TO PROVIDE CULTURALLY TAILORED, PATIENT-FOCUSED, AND EVIDENCE-BASED INTERVENTIONS DESIGNED TO PROMOTE ENGAGEMENT AND RETENTION OF BLACKS IN SUD TREATMENT. INDIVIDUAL PLANS OF CARE WILL FOCUS ON BUILDING RAPPORT WITHIN THE THERAPEUTIC RELATIONSHIP TO STRENGTHEN PATIENT MOTIVATION AND SELF-EFFICACY, WHILE PROVIDING DIRECT ACCESS TO MEDICAL AND PSYCHOSOCIAL SERVICES NEEDED TO ACHIEVE EACH PARTICIPANT'S SUD- AND HIV/HCV-RELATED TREATMENT OBJECTIVES. EMPOWER GOALS INCLUDE: A) INCREASE SUD TREATMENT ENGAGEMENT (MONTH 1) AND RETENTION (MONTHS 2-6) FOR BLACK MEN AND WOMEN; B) INCREASE AWARENESS OF AND TESTING FOR HIV AND HCV; C) PROVIDE HIV AND VIRAL HEPATITIS RICK-REDUCTION EDUCATION; D) INCREASE ACCESS TO AND ENGAGEMENT IN COMPREHENSIVE CARE INCLUDING LINKAGE TO HIV AND HCV TREATMENT; E) IMPROVE HEALTH OUTCOMES FOR PROGRAM PARTICIPANTS; AND F) EVALUATE THE EFFECTIVENESS AND IMPACT OF THE EMPOWER PROGRAM. THE EMPOWER PROGRAM WILL WORK CLOSELY WITH THE BALTIMORE CITY HEALTH DEPARTMENT AND THE JOHNS HOPKINS JOHN G. BARTLETT SPECIALTY PRACTICE AS KEY REFERRAL SITES FOR PATIENTS DIAGNOSED WITH HIV AND NOT LINKED TO SPECIALTY OR PRIMARY CARE. IF SUCCESSFUL, EMPOWER WILL REDUCE HEALTH DISPARITIES FOR PROGRAM PARTICIPANTS, WITH LOWER MORTALITY RATES AND IMPROVEMENTS IN PHYSICAL AND MENTAL HEALTH AND QUALITY OF LIFE.

THE PURPOSE OF THIS RESEARCH EFFORT IS T