Saturday, May 4, 2024
5/4/2024
PROJECT SUMMARY The war in Ukraine has provoked the world’s current largest humanitarian displacement: since February 2022, over 13 million people, i.e., one-third of Ukrainians, have been forced to leave their homes, resulting in nearly 6 million internally displaced persons (IDPs). War and humanitarian emergencies may exacerbate substance use, but the incidence and prevalence of unhealthy substance use in humanitarian settings, including Ukraine, are currently largely unknown. This lack of data limits the ability to tailor targeted, effective preventive substance use interventions for these mobile populations. Addressing this knowledge gap is an immense priority for Ukraine, where rates of substance use were high even prior to the Russian invasion in February 2022, and in other settings hosting large populations of IDPs, including the United States. We propose to conduct an epidemiological substance use survey among IDPs in Ukraine during the R61 phase, followed by R33-supported development and evaluation in a randomized controlled trial of a substance use prevention intervention for this population. Due to burgeoning evidence and our own preliminary data, we anticipate adapting an Acceptance and Commitment Therapy (ACT)-informed intervention, though final intervention decisions will be responsive to the needs identified in the epidemiological phase. ACT for substance use prevention will use acceptance, mindfulness, and behavior change processes to improve psychological flexibility and thus support people in refraining from use. Our transnational, multidisciplinary team of community partners, mental health experts, and behavioral clinical trial scientists has conducted studies with war-affected populations in Ukraine and successfully used ACT to improve health behaviors among disadvantaged populations in Eastern Europe. We will work closely with our community partner, the Alliance for Public Health (“Alliance,” a leading non-governmental organization in Ukraine) and academic experts in Ukraine. In the R61 phase of the grant, we will conduct an epidemiological survey (n=577) evaluating substance use patterns and risk factors among IDPs seeking medical services at mobile medical points established by the Alliance. Directly informed by findings from the epidemiology study, we will transition to the R33 phase and will engage community members to co-design the most appropriate prevention intervention. We will adapt the intervention using qualitative methods (focus groups and stakeholder interviews) and conduct a pilot randomized controlled trial (n=144) evaluating the intervention on preventing the development of substance use disorders among IDPs, with primary outcomes including feasibility and acceptability. The expected outcome of this award is a potentially effective and scalable intervention that could prevent at scale the development of substance use disorders among IDPs affected by humanitarian crises. The key innovation is that this study will expand on limited epidemiological data specific to substance use in humanitarian settings and be among the first to demonstrate the effectiveness of an intervention to prevent substance use disorders in humanitarian contexts.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
