Public Health Researchers to Participate in the HEALing Communities Study

Written by Amanda Torres

Published on September 10, 2019

Kathryn McCollister, Ph.D., and Daniel Feaster, Ph.D., professors at the Miller School of Medicine's Department of Public Health Sciences, will participate in the HEALing Communities Study. The study is one of four areas within the National Institutes of Health's Helping to End Addiction Long-term (HEAL), which is an initiative taking place to halt the national opioid public health crisis.

The HEALing Communities Study selected four proposals from the University of Kentucky, Columbia University, Boston Medical Center, and Ohio State University, universities located in four states that have been greatly affected by the opioid crisis. The goal within each proposal is to implement and evaluate evidence-based practices targeting opioid overdose fatalities and to reduce those fatalities in each of the four states.

“The goal is to reduce those fatalities by 40 percent in three years,” Dr. McCollister said. "There is a special focus on creating an integrated system approach, such as by integrating healthcare, public health, criminal justice, education, and social services."

Dr. McCollister, who is also the director of the Division of Health Services Research and Policy at the Department of Public Health Sciences, will be the lead economist at the University of Kentucky study, as well as co-investigator on the Data Coordinating Center. Dr. Feaster will be one of the principal investigators of the study led by Columbia University.

Since the study was announced in April 2019, it has been in a pre-implementation period. On October 1, 2019, they will begin the implementation process in 67 communities across all of the four states. There will be two groups. One group, which will consist of half of the communities in each of the states, will begin interventions in October and the other half will begin in 2020.

“That provides a way of doing a comparison between identifying impact. Each state is now trying to engage with their community members, people in treatment agencies, juvenile justice agencies, and with anyone that is going to be involved in facilitating or implementing practices to reduce opioid use and overdose,” Dr. McCollister said.

Because of this preparation, from an economic perspective, there are costs that are relevant to replicating interventions in other states. Pre-implementation costs, Dr. McCollister explained, are important as time and effort go into identifying community members that are willing to participate. 

Dr. McCollister will conduct two different levels of economic analysis. The first is overarching, such as what is going on in all of the sites, as well as evaluating cost data that can be brought in from the four sites.

“They are also going to pick what interventions to implement and then there's the cost of implementing those specific types of interventions, such as expanding the distribution of Naloxone, a drug overdose reversal,” Dr. McCollister said.  

In the study led by Columbia University, Dr. Feaster will be working with the modeling team to make sure that they have the data that they need, as they are focused on evaluating intervention outcomes based on the data.

Dr. Feaster explained that aside from implementing interventions, it is also about trying to get people that are involved to work together toward a common goal. New York in particular is focused on giving the counties feedback on their intervention efforts. An important component of this is also utilizing a data-driven dashboard, which is very different from standard trials. In most standard trials, data is collected and outcomes are not known until the very end. 

“We are not only going to be watching the data that comes in, but we're also going to be giving it to the people that are doing the intervention, so they know what works, what needs work, and what does not work. So, it's trying to use data-driven feedback,” Dr. Feaster said.

Feedback will be obtained in the 67 communities. Additionaly, they will assess qualitative data by interviewing people on their involvement in the pre-implementation interventions.

“We are all feeling that this work will significantly change the field of public health as it relates broadly to behavioral health and specifically to the opioid crisis,” Dr. McCollister said.

“I find it very exciting, as this could be very transformative to our approach to public health problems, specifically to the opioid crisis,” Dr. Feaster added.