Overdose Prevention Strategies for Substance Use Disorders
(FORTRESS Trial)

Recruiting in Palo Alto (17 mi)

Overseen byMatthew C Aalsma, PhD

Age: Any Age

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: Indiana University

No Placebo Group

Trial Summary

What is the purpose of this trial?This project seeks to address the overdose epidemic by working with overdose fatality review (OFR) teams. Current OFR practices rely on a case review model where OFR teams assess one or two overdose cases to make policy and program recommendations. However, the continued rise in overdose rates and number of preventable overdose deaths suggest a need to shift OFR teams away from case review and toward using timely population-level data to better inform their recommendations and actions. The goal of this project, Fatal Overdose Review Teams - Research to Enhance Surveillance Systems (FORTRESS), is to improve standard OFR practices by equipping OFRs with a data dashboard built on near real-time aggregate data, linked across multiple sources and presented in a way that helps identify common "overdose touchpoints," or opportunities to connect individuals at risk for overdose with evidence-based treatment. During the first project phase, the FORTRESS team will design the "Overdose Touchpoints Dashboard'' (Aim 1). The FORTRESS team will also train OFR team members in "Data-Driven Decision Making" (DDDM) to effectively use the dashboard. The FORTRESS team also includes individuals involved in developing the CDC's OFR best practice guidelines and a pilot study of OFR adherence to these guidelines, which will inform the FORTRESS team's development of an "OFR Fidelity Tool'' (Aim 2). This tool will be the first of its kind. For the second project phase, the FORTRESS team will conduct a cluster-randomized stepped-wedge trial comparing the impact of the intervention (dashboard + DDDM training) versus standard OFR practices on both implementation (Aim 3) and effectiveness outcomes (Aim 4). Implementation outcomes include implementation process fidelity (Stages of Implementation Completion), staff acceptance of harm reduction philosophies (qualitative interviews), OFR fidelity to CDC best practices (FORTRESS OFR Fidelity Tool), and usability of the Overdose Touchpoint Dashboard, (Systems Usability Scale). A statewide OFR data repository serves as a rich source of data on effectiveness outcomes, including OFR team recommendation quality and local actions to implement recommended overdose prevention strategies. The FORTRESS team will also survey OFR team members to assess changes in their attitudes toward evidence-based overdose prevention strategies. In sum, the FORTRESS team is uniquely qualified to help OFRs use more comprehensive available data to inform quality, action-oriented recommendations to reduce overdose. Funding for this project comes from the HEAL Initiative (https://heal.nih.gov/).

Eligibility Criteria

This trial is for members of local overdose fatality review (OFR) teams or leaders in Indiana organizations involved with OFR, such as public jail administrators and health directors. It also includes residents of Indiana who have had fatal or non-fatal overdoses.

Inclusion Criteria

FORTRESS staff personnel recruited to complete surveys, focus groups and/or interviews must be:

Residents of Indiana that have experienced fatal and/or non-fatal overdose as identified by administrative data sources

OR 2) local county leader of organizations represented by OFR (OFR facilitator, public jail administrators, chief of police, judge, addiction treatment CEO/CFO, public health director, etc.)

+1 more

Exclusion Criteria

N/A

Participant Groups

The FORTRESS project aims to improve how OFR teams work by giving them a data dashboard and training in Data-Driven Decision Making (DDDM). The study will compare these new tools against standard practices to see if they can better prevent overdoses.

2Treatment groups

Experimental Treatment

Active Control

Group I: FORTRESSExperimental Treatment2 Interventions

Participating counties receive both training in data-driven decision making and inventory of overdose-prevention strategies

Group II: OFR Team Practice as UsualActive Control1 Intervention

Data are collected regarding standard OFR Team practice and outcomes before implementation of the FORTRESS Intervention