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      Provider perspectives on the impact of COVID-19 on treatment of substance use and opioid use disorders among American Indian and Alaska Native adults

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          Abstract

          Introduction

          American Indian/Alaska Native (AI/AN) communities are more likely to suffer negative consequences related to substance misuse. The COVID-19 pandemic exacerbated the opioid poisoning crisis, in combination with ongoing treatment barriers resulting from settler-colonialism, systemic oppression and racial discrimination. AI/AN adults are at greatest risk of COVID-19 related serious illness and death. In collaboration with an Indigenous community advisory board and Tribal leadership, this study explored AI/AN treatment provider perceptions of client-relatives’ (i.e., SUD treatment recipients) experiences during the pandemic from 2020 to 2022.

          Methods

          Providers who underwent screening and were eligible to participate ( N = 25) represented 6 programs and organizations serving rural and urban areas in Washington, Utah, and Minnesota. Participants engaged in audio-recorded 60–90 min semi-structured individual interviews conducted virtually via Zoom. The interview guide included 15 questions covering regulatory changes, guidance for telemedicine, policy and procedures, staff communication, and client-relatives’ reactions to implemented changes, service utilization, changes in treatment modality, and perceptions of impact on their roles and practice. Interview recordings were transcribed and de-identified. Members of the research team independently reviewed transcripts before reaching consensus. Coding was completed in Dedoose, followed by analyses informed by a qualitative descriptive approach.

          Results

          Five main domains were identified related to client-relative experiences during the COVID-19 pandemic, as observed by providers: (1) accessibility, (2) co-occurring mental health, (3) social determinants of health, (4) substance use, coping, and harm reduction strategies, and (5) community strengths. Providers reported the distinctive experiences of AI/AN communities, highlighting the impact on client-relatives, who faced challenges such as reduced income, heightened grief and loss, and elevated rates of substance use and opioid-related poisonings. Community and culturally informed programming promoting resilience and healing are outlined.

          Conclusion

          Findings underscore the impact on SUD among AI/AN communities during the COVID-19 pandemic. Identifying treatment barriers and mental health impacts on client-relatives during a global pandemic can inform ongoing and future culturally responsive SUD prevention and treatment strategies. Elevating collective voice to strengthen Indigenous informed systems of care to address the gap in culturally-and community-based services, can bolster holistic approaches and long-term service needs to promote SUD prevention efforts beyond emergency response efforts.

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          Most cited references39

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          Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support.

          Paul A. Harris, Robert Taylor, Robert Thielke … (2009)
          Research electronic data capture (REDCap) is a novel workflow methodology and software solution designed for rapid development and deployment of electronic data capture tools to support clinical and translational research. We present: (1) a brief description of the REDCap metadata-driven software toolset; (2) detail concerning the capture and use of study-related metadata from scientific research teams; (3) measures of impact for REDCap; (4) details concerning a consortium network of domestic and international institutions collaborating on the project; and (5) strengths and limitations of the REDCap system. REDCap is currently supporting 286 translational research projects in a growing collaborative network including 27 active partner institutions.
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            The REDCap consortium: Building an international community of software platform partners

            Paul Harris, Robert Taylor, Brenda Minor … (2019)
            The Research Electronic Data Capture (REDCap) data management platform was developed in 2004 to address an institutional need at Vanderbilt University, then shared with a limited number of adopting sites beginning in 2006. Given bi-directional benefit in early sharing experiments, we created a broader consortium sharing and support model for any academic, non-profit, or government partner wishing to adopt the software. Our sharing framework and consortium-based support model have evolved over time along with the size of the consortium (currently more than 3200 REDCap partners across 128 countries). While the "REDCap Consortium" model represents only one example of how to build and disseminate a software platform, lessons learned from our approach may assist other research institutions seeking to build and disseminate innovative technologies.
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              Impact of COVID-19 Pandemic on Mental Health in the General Population: A Systematic Review

              Jiaqi Xiong, Orly Lipsitz, Flora Nasri … (2020)
              Highlights • The Coronavirus disease 2019 (COVID-19) pandemic has resulted in unprecedented hazards to mental health globally. • Relatively high rates of anxiety, depression, post-traumatic stress disorder, psychological distress, and stress were reported in the general population during the COVID-19 pandemic in eight countries. • Common risk factors associated with mental distress during the COVID-19 pandemic include female gender, younger age group (≤40 years), presence of chronic/psychiatric illnesses, unemployment, student status, and frequent exposure to social media/news concerning COVID-19. • Mitigation of COVID-19 induced psychological distress requires government intervention and individual efforts.
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                Author and article information

                Contributors
                Meenakshi Richardson: URI : https://loop.frontiersin.org/people/2363673/overviewRole: Role: Role: Role: Role: Role: Role: Role:
                Katherine Hirchak: URI : https://loop.frontiersin.org/people/1974968/overviewRole: Role: Role: Role: Role: Role: Role: Role: Role: Role: Role: Role: Role:
                Kelsey Bajet: URI : https://loop.frontiersin.org/people/2652173/overviewRole: Role: Role: Role: Role:
                Mariah Brigman: Role: Role: Role:
                Racquel Shaffer: Role: Role:
                Beverly Keyes: Role: Role:
                Karen Anderson Oliver: Role: Role:
                Frankie Kropp: Role: Role: Role:
                Michael G. McDonell: Role: Role:
                Kamilla L. Venner: Role: Role: Role: Role: Role: Role:
                Aimee N. C. Campbell: URI : https://loop.frontiersin.org/people/2713735/overviewRole: Role: Role: Role: Role: Role:
                Journal
                Journal ID (nlm-ta): Front Public Health
                Journal ID (iso-abbrev): Front Public Health
                Journal ID (publisher-id): Front. Public Health
                Title: Frontiers in Public Health
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-2565
                Publication date (Electronic): 05 June 2024
                Publication date Collection: 2024
                Volume: 12
                Electronic Location Identifier: 1356033
                Affiliations
                [1] 1Human Development, Washington State University Vancouver , Vancouver, WA, United States
                [2] 2Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University Spokane , Spokane, WA, United States
                [3] 3Promoting Research Initiatives in Substance Use and Mental Health (PRISM) Collaborative, Elson S. Floyd College of Medicine, Washington State University Spokane , Spokane, WA, United States
                [4] 4College of Education, Washington State University , Pullman, WA, United States
                [5] 5Independent Researcher , Tribal Lands, WA, United States
                [6] 6Independent Researcher , Seattle, WA, United States
                [7] 7Department of Psychiatry & Behavioral Neuroscience, College of Medicine, University of Cincinnati , Cincinnati, OH, United States
                [8] 8Department of Psychology and Center on Alcohol, Substance Use & Addiction, University of New Mexico , Albuquerque, NM, United States
                [9] 9Department of Psychiatry, Columbia University Irving Medical Center, Columbia University , New York, NY, United States
                Author notes

                Edited by: Anita Randolph, University of Minnesota, United States

                Reviewed by: Ramzi Haddad, Lebanese University, Lebanon

                Maria de Lourdes Noboa Lasso, University of Porto, Portugal

                *Correspondence: Meenakshi Richardson, meena.richardson@ 123456wsu.edu
                Article
                DOI: 10.3389/fpubh.2024.1356033
                PMC ID: 11186410
                PubMed ID: 38898893
                SO-VID: 701e6742-beef-472d-aa8b-bb97ccda8fd3
                Copyright © Copyright © 2024 Richardson, Hirchak, Bajet, Brigman, Shaffer, Keyes, Oliver, Kropp, McDonell, Venner and Campbell.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 14 December 2023
                Date accepted : 16 May 2024
                Page count
                Figures: 0, Tables: 1, Equations: 0, References: 46, Pages: 9, Words: 7656
                Funding
                The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the National Institute on Drug Abuse (UG1 DA049468, PI: Page; UG1 DA013035, PIs: Rotrosen, Nunes) and the National Institute on Alcohol Abuse and Alcoholism (K01 AA028831, PI: Hirchak).
                Categories
                Subject: Public Health
                Subject: Original Research
                Custom metadata
                section-at-acceptance Substance Use Disorders and Behavioral Addictions

                Keywords: american indian and alaska native,covid-19,medications for opioid use disorders,opioid use disorder,substance use disorders,harm reduction,access,health equity
                Data availability:
                Keywords: american indian and alaska native, covid-19, medications for opioid use disorders, opioid use disorder, substance use disorders, harm reduction, access, health equity

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