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Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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White Paper/Brief
This brief lists interventions to support state public health efforts to address rural disparities and racial discrimination. It emphasizes the importance of localized data on social determinants of health and improving systemic and structural underpinnings of racial disparities. Suggested interventions address data collection and workforce issues, including representativeness and paid family leave.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Summary Report/Recommendations
This report details the immense toll the COVID-19 pandemic has taken, and continues to take, on Black communities. The report’s authors – physicians and public health and policy experts – note massive disparities experienced by Black Americans. The worse outcomes, are a predictable result of structural and social realities. The predicates that caused these disparities have long been present. These are cycles we have to break. The report highlights areas for immediate focus and attention, and presents a set of expert-generated recommendations for action.
Novel Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and are in the process of generating evidence of effectiveness or may not yet be tested.
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White Paper/Brief
This resource makes recommendations related to establishing crisis stabilization systems for persons living with mental illness. This article describes how pandemic-related changes and funding increases can be leveraged to strengthen statewide crisis stabilization systems for individuals living with mental illness and substance use disorder, including recommendations for specific stakeholders to engage and action steps. The practice strategy this article is focused on is policy and organizational change to improve public health infrastructure.
Novel Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and are in the process of generating evidence of effectiveness or may not yet be tested.
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Summary Report/Recommendations
This resources summarizes the impact of the COVID-19 pandemic on substance use and the experiences of people who used drugs during the COVID-19 pandemic. Highlights include: the pandemic increased the risk of overdose for people who use drugs, and in response people who use drugs reported using more harm reduction strategies. The pandemic also motivated change in wanting to quit drug use for study participants, but also highlighted the social determinants of health as barriers to sustainable recovery.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Case Study
This article describes the impact of COVID-19-specific adaptations at two sites delivering a federally funded substance use treatment program for people living with or at-risk of HIV in Massachusetts. The success of the adaptations varied based on the site. For example, the transition to telemedicine was successful at the STI clinic, but not the community-based organization. However, the article does identify some adaptations that were successful in each setting, and the authors report process outcomes for these adaptations. The practice strategy this article is focused on is continuity of care for people with substance use disorder who are living with or at-risk of HIV during the COVID-19 pandemic.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This article describes the implementation of a medical student-run, free virtual clinic providing medication assisted treatment (MAT) for opioid use disorder (OUD) in Miami, Florida during the COVID-19 pandemic. Eligibility criteria for accessing services through the clinic included Florida residency and an income below 200% of the federal poverty level. The article describes how the students promoted the clinic, the process for providing MAT virtually (under supervision of an attending physician), patient characteristics, and reports process evaluation data for the clinic. The practice strategy this article is focused on is access to MAT for people with OUD during the COVID-19 pandemic.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This article presents results from an intervention to provide medication assisted treatment (MAT) to individuals with opioid use disorder via telemedicine. This article describes outcomes for patients enrolled in the NYC Health+Hospitals Virtual Buprenorphine Clinic during the first nine weeks of the COVID-19 pandemic (March 26, 2020 through May 28, 2020). Results from this evaluation were mixed. Loss-to-follow-up was similar to rates observed in studies of in-person opioid treatment, but the authors note telemedicine-based opioid treatment poses barriers to patients who frequently change mobile phones or phone numbers, and patients with unreliable internet access. The authors also note that the generalizability of this intervention may be limited in settings with different patient populations or staff capacity.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This article evaluates a partnership between the University of Maryland, Baltimore – an urban academic treatment center – and multiple rural behavioral health treatment centers to provide medication assisted treatment (MAT) to individuals with opioid use disorder via videoconference. Retention rates and toxicology results for patients who received MAT via videoconference were comparable to those receiving face-to-face treatment. It should be noted that data for this study were collected prior to the onset of the COVID-19 pandemic.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
RELEASE DATE:
Peer Review Study
This article presents the results of a non-randomized cohort study comparing opioid agonist therapy (medication assisted treatment [MAT]) for opioid use disorder received via telemedicine, in-person, or a mix of telemedicine and in-person visits. The study was conducted between January 2011 and June 2012 in Ontario, Canada. The telemedicine group had the highest one-year treatment retention rate, followed by the mixed group, and the in-person group had the lowest one-year treatment retention rate. The results suggest telemedicine could be an effective means of increasing access to MAT for opioid use disorder. It should be noted that the study was conducted prior to the COVID-19 pandemic, and replicability will vary based on local resources and MAT regulations.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
RELEASE DATE:
Peer Review Study
This article presents the results of a non-randomized controlled trial comparing in-person vs. telemedicine treatment for pregnant women with opioid use disorder in South Carolina. The authors found no statistically significant difference in treatment outcomes for women who received care in-person vs. via telemedicine, and no statistically significant difference in outcomes for the newborns of women in these respective groups. The authors were unable to assign trial participants to telemedicine vs. in-person care at random due to the inability of some rural patients to attend treatment in person. Also, the sample size was not sufficient to achieve ~80% power to detect a difference between the two groups. At the same time, the practice strategy is considered useful for helping to deliver telehealth treatment for vulnerable populations, including pregnant and newly parenting people with substance use disorder, and people living in rural communities.