Primary Prevention of Drug Overdoses in Rural Low-Resource and Tribal Communities

A Cluster Randomized Trial

Datos Bibliográficos

ID11035185
AutoresKelli A Komro (0000-0002-7893-9558, At the time of the study, Kelli A. Komro, Melvin D. Livingston, Bethany J. Livingston, Ashna Jagtiani, Caroline M. Barry, Alexander C. Wagenaar, Hannah L. F. Cooper, Emily Ivanich, and Sierra L. Talavera-Brown were with the Rollins School of Public Health, Emory University, Atlanta, GA. Juli R. Skinner, Terrence K. Kominsky, Hannah LaBounty, and Ashley N. Gassaway were with Cherokee Nation Behavioral Health, Cherokee Nation Health, Tahlequah, OK. Megan Harmon was with Neighbors Building Neighborhoods, Musko), Melvin D Livingston (0000-0002-6327-8910, At the time of the study, Kelli A. Komro, Melvin D. Livingston, Bethany J. Livingston, Ashna Jagtiani, Caroline M. Barry, Alexander C. Wagenaar, Hannah L. F. Cooper, Emily Ivanich, and Sierra L. Talavera-Brown were with the Rollins School of Public Health, Emory University, Atlanta, GA. Juli R. Skinner, Terrence K. Kominsky, Hannah LaBounty, and Ashley N. Gassaway were with Cherokee Nation Behavioral Health, Cherokee Nation Health, Tahlequah, OK. Megan Harmon was with Neighbors Building Neighborhoods, Musko), Juli R Skinner (At the time of the study, Kelli A. Komro, Melvin D. Livingston, Bethany J. Livingston, Ashna Jagtiani, Caroline M. Barry, Alexander C. Wagenaar, Hannah L. F. Cooper, Emily Ivanich, and Sierra L. Talavera-Brown were with the Rollins School of Public Health, Emory University, Atlanta, GA. Juli R. Skinner, Terrence K. Kominsky, Hannah LaBounty, and Ashley N. Gassaway were with Cherokee Nation Behavioral Health, Cherokee Nation Health, Tahlequah, OK. Megan Harmon was with Neighbors Building Neighborhoods, Musko), Bethany J Livingston (0000-0002-8957-8647, At the time of the study, Kelli A. Komro, Melvin D. Livingston, Bethany J. Livingston, Ashna Jagtiani, Caroline M. Barry, Alexander C. Wagenaar, Hannah L. F. Cooper, Emily Ivanich, and Sierra L. Talavera-Brown were with the Rollins School of Public Health, Emory University, Atlanta, GA. Juli R. Skinner, Terrence K. Kominsky, Hannah LaBounty, and Ashley N. Gassaway were with Cherokee Nation Behavioral Health, Cherokee Nation Health, Tahlequah, OK. Megan Harmon was with Neighbors Building Neighborhoods, Musko), Terrence K Kominsky (0000-0003-4869-4235, At the time of the study, Kelli A. Komro, Melvin D. Livingston, Bethany J. Livingston, Ashna Jagtiani, Caroline M. Barry, Alexander C. Wagenaar, Hannah L. F. Cooper, Emily Ivanich, and Sierra L. Talavera-Brown were with the Rollins School of Public Health, Emory University, Atlanta, GA. Juli R. Skinner, Terrence K. Kominsky, Hannah LaBounty, and Ashley N. Gassaway were with Cherokee Nation Behavioral Health, Cherokee Nation Health, Tahlequah, OK. Megan Harmon was with Neighbors Building Neighborhoods, Musko), Ashna Jagtiani (0009-0006-8290-5277, At the time of the study, Kelli A. Komro, Melvin D. Livingston, Bethany J. Livingston, Ashna Jagtiani, Caroline M. Barry, Alexander C. Wagenaar, Hannah L. F. Cooper, Emily Ivanich, and Sierra L. Talavera-Brown were with the Rollins School of Public Health, Emory University, Atlanta, GA. Juli R. Skinner, Terrence K. Kominsky, Hannah LaBounty, and Ashley N. Gassaway were with Cherokee Nation Behavioral Health, Cherokee Nation Health, Tahlequah, OK. Megan Harmon was with Neighbors Building Neighborhoods, Musko), Caroline M Barry (0000-0001-8071-1483, At the time of the study, Kelli A. Komro, Melvin D. Livingston, Bethany J. Livingston, Ashna Jagtiani, Caroline M. Barry, Alexander C. Wagenaar, Hannah L. F. Cooper, Emily Ivanich, and Sierra L. Talavera-Brown were with the Rollins School of Public Health, Emory University, Atlanta, GA. Juli R. Skinner, Terrence K. Kominsky, Hannah LaBounty, and Ashley N. Gassaway were with Cherokee Nation Behavioral Health, Cherokee Nation Health, Tahlequah, OK. Megan Harmon was with Neighbors Building Neighborhoods, Musko), Alexander C Wagenaar (0000-0003-1674-6774, At the time of the study, Kelli A. Komro, Melvin D. Livingston, Bethany J. Livingston, Ashna Jagtiani, Caroline M. Barry, Alexander C. Wagenaar, Hannah L. F. Cooper, Emily Ivanich, and Sierra L. Talavera-Brown were with the Rollins School of Public Health, Emory University, Atlanta, GA. Juli R. Skinner, Terrence K. Kominsky, Hannah LaBounty, and Ashley N. Gassaway were with Cherokee Nation Behavioral Health, Cherokee Nation Health, Tahlequah, OK. Megan Harmon was with Neighbors Building Neighborhoods, Musko), Heather L Cooper (0000-0002-0521-2438), Hannah L F Cooper (At the time of the study, Kelli A. Komro, Melvin D. Livingston, Bethany J. Livingston, Ashna Jagtiani, Caroline M. Barry, Alexander C. Wagenaar, Hannah L. F. Cooper, Emily Ivanich, and Sierra L. Talavera-Brown were with the Rollins School of Public Health, Emory University, Atlanta, GA. Juli R. Skinner, Terrence K. Kominsky, Hannah LaBounty, and Ashley N. Gassaway were with Cherokee Nation Behavioral Health, Cherokee Nation Health, Tahlequah, OK. Megan Harmon was with Neighbors Building Neighborhoods, Musko), Megan Harmon (At the time of the study, Kelli A. Komro, Melvin D. Livingston, Bethany J. Livingston, Ashna Jagtiani, Caroline M. Barry, Alexander C. Wagenaar, Hannah L. F. Cooper, Emily Ivanich, and Sierra L. Talavera-Brown were with the Rollins School of Public Health, Emory University, Atlanta, GA. Juli R. Skinner, Terrence K. Kominsky, Hannah LaBounty, and Ashley N. Gassaway were with Cherokee Nation Behavioral Health, Cherokee Nation Health, Tahlequah, OK. Megan Harmon was with Neighbors Building Neighborhoods, Musko), Emily Ivanich (At the time of the study, Kelli A. Komro, Melvin D. Livingston, Bethany J. Livingston, Ashna Jagtiani, Caroline M. Barry, Alexander C. Wagenaar, Hannah L. F. Cooper, Emily Ivanich, and Sierra L. Talavera-Brown were with the Rollins School of Public Health, Emory University, Atlanta, GA. Juli R. Skinner, Terrence K. Kominsky, Hannah LaBounty, and Ashley N. Gassaway were with Cherokee Nation Behavioral Health, Cherokee Nation Health, Tahlequah, OK. Megan Harmon was with Neighbors Building Neighborhoods, Musko), Emily A Ivanich, Hannah LaBounty (At the time of the study, Kelli A. Komro, Melvin D. Livingston, Bethany J. Livingston, Ashna Jagtiani, Caroline M. Barry, Alexander C. Wagenaar, Hannah L. F. Cooper, Emily Ivanich, and Sierra L. Talavera-Brown were with the Rollins School of Public Health, Emory University, Atlanta, GA. Juli R. Skinner, Terrence K. Kominsky, Hannah LaBounty, and Ashley N. Gassaway were with Cherokee Nation Behavioral Health, Cherokee Nation Health, Tahlequah, OK. Megan Harmon was with Neighbors Building Neighborhoods, Musko), Ashley N Gassaway (At the time of the study, Kelli A. Komro, Melvin D. Livingston, Bethany J. Livingston, Ashna Jagtiani, Caroline M. Barry, Alexander C. Wagenaar, Hannah L. F. Cooper, Emily Ivanich, and Sierra L. Talavera-Brown were with the Rollins School of Public Health, Emory University, Atlanta, GA. Juli R. Skinner, Terrence K. Kominsky, Hannah LaBounty, and Ashley N. Gassaway were with Cherokee Nation Behavioral Health, Cherokee Nation Health, Tahlequah, OK. Megan Harmon was with Neighbors Building Neighborhoods, Musko), Sierra L Talavera-Brown (At the time of the study, Kelli A. Komro, Melvin D. Livingston, Bethany J. Livingston, Ashna Jagtiani, Caroline M. Barry, Alexander C. Wagenaar, Hannah L. F. Cooper, Emily Ivanich, and Sierra L. Talavera-Brown were with the Rollins School of Public Health, Emory University, Atlanta, GA. Juli R. Skinner, Terrence K. Kominsky, Hannah LaBounty, and Ashley N. Gassaway were with Cherokee Nation Behavioral Health, Cherokee Nation Health, Tahlequah, OK. Megan Harmon was with Neighbors Building Neighborhoods, Musko)
Año2025
Volumen115
Número9
Páginas1508-1517
Fecha de publicación2025-09-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaAmerican Journal of Public Health (JOURNAL)
Identificadores de la revistaISSN: 0090-0036 • E-ISSN: 1541-0048
EditorialAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2025.308205
PMID40768695
OpenAlexW4413013202
IdiomaEN
Citas recibidas1
Referencias citadas29

Objectives. To determine the Connect intervention’s effectiveness in reducing substance use among rural and tribal adolescents in northeastern Oklahoma. Methods. We conducted a 2-arm cluster randomized trial from 2021 to 2024, with 10 high schools per condition. Results. At baseline, 919 students were enrolled (mean age = 15 years), and the majority were American Indian or White. Alcohol-use days during the past 30 days was reduced by 18% per survey wave in the intervention compared with the control condition (rate ratio [RR] = 0.82; 95% confidence interval [CI] = 0.72, 0.93; t = −3.02; P = .003), binge drinking was reduced by 26% (RR = 0.74; 95% CI = 0.64, 0.86; t = −3.90; P Conclusions. The Connect intervention prevented the typical escalation of substance use during adolescence. Trial Registration. ClinicalTrials.gov NCT04839978. Registered on April 9, 2021. Version 10, April 30, 2025. ( Am J Public Health. 2025;115(9):1508–1517. https://doi.org/10.2105/AJPH.2025.308205 )

Binge drinking · Cannabis · Confidence interval · Environmental health · Injury prevention · Medical prescription · Poison control · Psychiatry · Public health · Randomized controlled trial · Rate ratio · Relative risk · Cannabis and Cannabinoid Research · Demography · Internal Medicine · Medicine · Prenatal Substance Exposure Effects · Substance Abuse Treatment and Outcomes