Abstract
Pacific Islanders are an indigenous/colonized U.S. racial group that carries very high risk for opioid use
disorders (OUD) due to their many social, economic, and health disparities and heavy burden of mental health
and substance use disorders. Unfortunately, Pacific Islanders rarely seek OUD treatment for reasons that
remain unexplored and unknown, resulting in high levels of unmet treatment need that increases Pacific
Islanders’ likelihood for experiencing opioid-related harms such as overdose and death. Despite their urgent
need for OUD treatment, Pacific Islanders remain absent from current opioid research and do not seek formal
treatment services during this severe public health crisis.
The proposed R34 study will address this research and clinical gap by applying multifaceted methods to
develop and pilot test the first intervention components designed to prevent untreated OUDs by increasing
Pacific Islander OUD treatment seeking. Drawing from this team’s earlier behavioral health research with
Pacific Islanders, we will use a culturally tailored intervention development approach that includes
constructivist grounded theory, focus groups, and a deliberative public decision-making process called citizens’
panels to engage lay Pacific Islanders in culturally grounding existing evidence-based practices to increase
Pacific Islander OUD treatment seeking.
By combining this collected information with feedback from a council of Pacific Islander experts and a
Cochrane-style systematic review of the literature on OUD, substance use, and mental health treatment-
seeking interventions, we will create a conceptual model containing culturally grounded components for the
first OUD treatment-seeking intervention for Pacific Islanders. Simultaneously, we will create a set of questions
to measure the effects of these intervention components. The intervention components and our measurement
questions will then be pilot tested with a small group of lay Pacific Islander adults for feasibility, acceptability,
and perceived efficacy in preparation for a future efficacy trial. Research findings will be disseminated back to
our participants and target communities, community partners (organizations and clinics), and the scientific
community via brochures, technical reports, community forums, and academic presentations and papers.