Facebook Intervention for Preventing Opioid Relapse Among American Indian Women

NIDA, 3UG1DA040316-07S3

4/15/21- 2/28/22

Lisa A. Marsch, PhD (Geisel School of Medicine at Dartmouth)

In 2017, American Indian and Alaska Native (AIAN) adults in Minnesota (MN) were six times more likely to die of an overdose involving opioids than whites, representing the greatest disparity observed between AIAN and whites in the US. Medication for opioid use disorder (MOUD) is an evidence-based approach, and strategies to promote continuation of pharmacotherapy and support OUD recovery are important. Gender- specific factors affecting opioid use relapse and recovery that are more prevalent in women compared with men include perceived stress, trauma, and social support for abstinence. AIAN gender-specific interventions for OUD do not exist. Research has documented the positive impact of social networks and social support on abstinence from substance use. However, understanding how best to leverage social support remains a key challenge for the addiction’s treatment field. We propose to address these gaps by developing a social digital (Facebook) intervention to promote stress management and social network support for opioid abstinence among AIAN women. Virtual digital platforms have potential for greater reach and scale. Consistent with the AIAN cultural value of interdependence, social media-formed groups to prevent opioid relapse could lead to greater adoption and sustainability by encouraging collaborative efforts across generations of AIAN women and leveraging community resilience for coping with stress. The overall objective of this one-year, Phase I, pilot preparatory study is to develop and beta-test a Facebook intervention for reducing opioid relapse among AIAN women. This project was designed with community partners at the MN Indian Women’s Resource Center (MIWRC). A study-specific community advisory committee will guide all project activities. The Specific Aim is to develop and beta-test the Facebook intervention content and prototype. In this formative work, we will conduct individual qualitative interviews by phone/video with a purposefully recruited sample of AIAN women with OUD, with at least one month of abstinence and receiving MOUD (n=12); as well as addiction care providers and AIAN community stakeholders (n=12). Participants will provide input on the cultural relevance and perceived effectiveness of intervention content. A Facebook intervention prototype will be developed, beta-tested, and iteratively refined with AIAN women (n=10). Results will inform development of a future pilot randomized control trial of the intervention. This project is innovative for developing a gender-specific, socially based, opioid relapse prevention intervention using social media technologies that are culturally relevant and already adopted. This proof-of-concept study is the first step to an intervention that could ultimately be widely disseminated through addiction health care and community-based settings as well as social media; and serve as a model for developing social digital addictions treatment in other populations, enhancing overall reach and impact.

Gender-specific interventions among American Indian and Alaska Native women (AIAN) to promote opioid use recovery do not exist. We propose to address this gap by developing a social digital (Facebook) intervention to promote stress management and social network support for opioid abstinence among AIAN women. We will develop and then beta-test the Facebook intervention among AIAN women who are receiving medication assisted treatment for opioid use disorder.