Substance use is a significant problem among Latinx and Hispanics due to the disproportionate number of physical harms and negative consequences associated with substance use relative to other racial/ethnic groups. However, Hispanics are less likely than other racial/ethnic groups to seek treatment for substance use, regardless of the substance(s) they use, and only 75% as likely to complete treatment for heroin as White individuals. Treatment navigators, like patient portals, were originally intended to offset disparities in access to treatment and health care. Unfortunately, initial uptake of these patient-facing eHealth tools was found among white, educated, middle-class individuals already actively engaged in their own health care and not by socially disadvantaged and marginalized minority populations, as though the structural barriers to care that exist in the treatment system were carried forward in the solution meant to overcome them. Nonetheless, there are still many who believe that eHealth has the potential to help marginalized people seeking care to surmount these barriers. Research over the last decade has revealed that adoption of eHealth among marginalized populations is influenced by factors such as health information-seeking behaviors, level of eHealth literacy, and technology acceptance, so we have designed a treatment navigator for Hispanics that is informed by these findings. "Rumbo" is an easily shared bi-lingual integrated web and mobile application that helps both Spanish-speaking and non-Spanish- speaking Hispanic individuals with substance use challenges find and access treatment services and related supportive resources. The proposed innovation stands out from other eHealth tools by leveraging the collective efficacy of the Hispanic community to overcome barriers and support individuals' self-efficacy for engaging the treatment system. Rumbo's simple, user-centered design provides less-acculturated Hispanic individuals with a culturally appropriate tool to understand their needs within the complex US treatment system. In this Phase I project we will develop the app's content and functions with a community-based, user-centered, iterative design process that will inform the content and functions of the app. We will gather key stakeholders in the Bernalillo County treatment system (the most populous area in New Mexico and 50% Hispanic) to develop a database of available, culturally appropriate resources, and to support both project recruitment and dissemination of the initial version of the app. Once completed, we will evaluate Rumbo's acceptability and capability as a treatment navigator in a naturalistic implementation study, as well as how it is shared among users, and whether the individuals who use Rumbo subsequently have increased confidence in accessing services.
Public Health Relevance Statement: PROJECT NARRATIVE Hispanic and Latinx individuals in the United States experience disproportionate levels of physical harms and negative consequences associated with substance use relative to other racial ethnic groups. Yet Hispanics are less likely than other racial/ethnic groups to seek treatment for substance use, and also less likely to complete treatment. The purpose of this project is to develop an easily shared mobile application that helps Spanish-speaking and less-acculturated Hispanics with substance use challenges find and access culturally appropriate treatment services and related resources. If successful, the proposed innovation will significantly enhance access to drug treatment resources for millions of individuals who currently live outside the U.S. healthcare system.
Project Terms: racial population; Racial Group; racial subgroup; marginalized population; marginalized group; marginalized individual; marginalized people; hispanic community; Hispanic Populations; Hispanic group; Hispanic individual; Hispanic people; Hispanics; Latinx population; Latinx group; Latinx individual; Latinx people; marginalization; access disparities; accessibility disparities; disparities in access; inequity in access; inequity in accessibility; Cultural Assimilation; Acculturation; Adoption; Alcohol Chemical Class; Alcohols; Censuses; Clinical Trials; Communities; Heroin; Diacetylmorphine; Diamorphine; Pharmacotherapy; Drug Therapy; drug treatment; Ethnic Population; Ethnic Group; Ethnic People; Ethnic individual; Ethnicity People; Ethnicity Population; ethnic subgroup; ethnicity group; Feedback; Focus Groups; Health; Healthcare Systems; Health Care Systems; Health Services Accessibility; Access to Care; access to health services; access to services; access to treatment; accessibility to health services; availability of services; care access; health service access; health services availability; service availability; treatment access; Health Insurance; health insurance plan; literacy; Massachusetts; Middle Class Populations; middle class group; middle class individual; middle class people; Minority Groups; Minority People; Minority Population; Minority individual; mortality; Persons; New Mexico; Overdose; Ownership; Patients; Race; Races; racial; racial background; racial origin; Research; Resources; Research Resources; Substance Use Disorder; substance use and disorder; Target Populations; Technology; Testing; United States; County; Treatment outcome; health care; Healthcare; Hispanic; Mediating; Site; Area; Clinical; Phase; Individual; Data Bases; data base; Databases; Measurement; participant recruitment; Patient Recruitments; uptake; Collaborations; bilingual; bilingualism; tool; Insurance Coverage; Insurance Status; Complex; Clinic; System; Country; Services; experience; information seeking behavior; success; care seeking; Self Efficacy; Participant; outreach; social stigma; stigma; Directories; Published Directory; Address; Data; Process; Development; developmental; designing; design; social disadvantage; social inequality; social disparities; Population; innovate; innovative; innovation; ethnic minority group; ethnic minority individual; ethnic minority people; ethnic minority population; interoperability; user centered design; usability; iterative design; prototype; overdose fatalities; overdose death; e-Health; electronic health; eHealth; mobile app; mobile device application; mobile application; Software Framework; improved outcome; medication-assisted therapy; medication-assisted treatment; racial minority; access to health care; access to healthcare; accessibility of health care; accessibility to health care; accessibility to healthcare; health care access; health care service access; health care service availability; healthcare access; healthcare accessibility; healthcare availability; healthcare service access; healthcare service availability; health care availability; online app; web application; web based app; web based application; web app; secondary analysis; opiate overdose; opiate related overdose; opioid drug overdose; opioid induced overdose; opioid intoxication; opioid medication overdose; opioid poisoning; opioid related overdose; opioid toxicity; opioid overdose; recruit; treatment services; barrier to health care; barrier to healthcare; barrier to treatment; obstacle to care; obstacle to healthcare; barrier to care; patient portal; implementation study; substance use treatment; feasibility testing; substance using; substance use; Latine; Latinx
