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Community Trial in the Cherokee Nation

Emory University logo

Emory University

Status

Completed

Conditions

Opioid Abuse

Treatments

Behavioral: Connect Program
Behavioral: Communities Mobilizing for Change and Action (CMCA)

Study type

Interventional

Funder types

Other
NIH

Identifiers

NCT04839978
STUDY00000404
UG3DA050234 (U.S. NIH Grant/Contract)
UH3DA050234 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The target population is students attending high schools in small rural towns in the 14 counties that partially or fully fall within the Cherokee Nation reservation. Following recruitment of 20 school-based clusters, clusters are allocated to either the intervention condition or delayed-intervention control condition using constrained randomization. Constrained randomization helps to ensure balanced cluster sizes as well as similar levels of risk between the intervention and control at baseline. Study participants include all 10th grade students enrolled in the participating study high schools and students will be followed into the first year after their expected graduation.

Full description

The national public health opioid crisis has disproportionately burdened rural White populations, and disproportionately burdened American Indian populations. Therefore, the Cherokee Nation (CN) and Emory University public health scientists have designed an opioid prevention trial to be conducted in at-risk rural communities in the CN (in northeast Oklahoma) with primarily White and American Indian adolescents and young adults. The goal of this study is to implement and evaluate a theory-based, integrated multi-level community intervention designed to prevent the onset and escalation of opioid and other drug misuse. The researchers propose a cluster randomized trial building directly on the success of their most recent previous trial, which demonstrated that the intervention effectively reduced alcohol and other drug use among American Indian and other youth living within the CN. Two distinct intervention approaches-community organizing as implemented in the established Communities Mobilizing for Change and Action (CMCA) intervention protocol, and universal school-based brief intervention and referral as implemented in the established Connect intervention protocol -will be expanded and integrated to further enhance effects in preventing and reducing opioid misuse. The CMCA and Connect interventions were originally designed to target adolescent alcohol use but nevertheless showed significant beneficial effects on use of other drugs, including prescription drug misuse. The proposed study will: (1) further improve the design of the interventions with increased focus on opioids, (2) test the expanded, integrated versions in a cluster randomized trial, and (3) design and test new systems for sustained implementation within existing structures of the Cherokee Nation. Building upon the extant prevention science evidence, this study will respond to a gap in evidence concerning opioid misuse prevention among at-risk adolescents transitioning to young adulthood among American Indian and other rural youth.

Enrollment

919 patients

Sex

All

Ages

15 to 17 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Tenth grade students enrolled in the participating high schools

Exclusion criteria

  • unable to understand written or verbal English

Inclusion criteria for high schools:

  • Counties that partially or fully fall within the Cherokee Nation reservation
  • Town population of 3,000 or less
  • Class size between 30 to 100 students

Exclusion criteria for high schools:

  • Metropolitan and micropolitan cores (Rural-Urban Commuting Area codes of 1 and 4)
  • Existence of a community drug prevention coalition

Trial design

Primary purpose

Prevention

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

919 participants in 2 patient groups

Preventive Intervention
Experimental group
Description:
Students in schools assigned to the preventive intervention study condition will take part in the Connect school-based prevention program and the community-level Communities Mobilizing for Change and Action (CMCA) intervention.
Treatment:
Behavioral: Communities Mobilizing for Change and Action (CMCA)
Behavioral: Connect Program
Control Group
No Intervention group
Description:
Students in schools assigned to the control group will not receive the Connect and CMCA interventions. Schools in the control group will receive usual school and community prevention and will be offered the trial's programs after the end of this three-year study.

Trial documents
2

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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