This announcement seeks applications from public and private nonprofit entities to address the primary and/or secondary prevention of prescription and non-prescription opioid misuse by women across the lifespan by identifying underserved audiences and the potential gaps in the ability to reach these
As background and for consideration, two such underserved populations are adolescent girls (ages 10 to 17) and women age 50 and older.
By the time an adolescent girl reaches legal age, she has already had many opportunities to experiment and develop a substance use disorder to prescription or non-prescription opioids.
Girls at this age are using harmful substances at a rate equal to and surpassing boys at this stage.
Data from the 2014 and 2015 National Survey on Drug Use and Health, show that girls, age 12 to 17, consistently used prescription and psychotherapeutics than boys in the same age group.
Older women are often overlooked as a target population by their health care providers because they often do not fit the stereotype of a misuser.
But, older women are more prone to chronic pain, can have multiple health care providers for multiple chronic conditions, lack coordinated care, and have greater access to prescription drugs.
Additionally, according to the National Institute on Drug Abuse, as of 2014, increased medication sensitivity, and slower metabolism and elimination coupled with cognitive decline can lead to improper use of medications.
This makes this audience vulnerable targets for opioid misuse.
For projects targeting the health professional audience, applicants may want to consider using the Screening, Brief Intervention, and Referral to Treatment (SBIRT) - www.samhsa.gov/sbirt - approach to substance use disorders as well as the exploration of opportunities for prevention identified by breaches in health service delivery.
Gaps in health service delivery might include, failure to integrate prevention into primary care, and learning how and when to screen for misuse.
Existing and new partnerships, developed between regional, state, local, and/or community-based organizations should propose organized activities to address the prevention of opioid misuse disorders in women across the lifespan.
Projects can be designed to target consumers, health professionals or both audiences.
Partnership, for these awards, is defined as an arrangement between two or more entities or organizations that share a joint interest, where skills, talents, finances, and other resources are shared to achieve a common outcome.
Additionally, partners will have entered into a documented contract or agreement to work together.
Long-term partnerships are defined as existing for three to five years, prior to the application for these awards.
OWH expects that these partnerships will increase the capacity of municipalities across the nation to provide care to women, education for women and health professionals, and contribute to existing policy regarding the misuse of opioids.
A successful applicant will have at least (3) partnerships included in the application to include at least one long-term partner.
Additional partners can be brought on board later if needed.
Applicants should submit signed letters of commitment from community-based and other partnering entities that are identified as subrecipients.
The signed letters of commitment must detail the length of the relationship, specific role and resources that will be provided, and/or activities that will be undertaken, in support of the applicant.
The organization expertise, experience, and access to the targeted population(s) should also be described in the letter of support.
Additionally, applicants should submit signed letters of support from community-based and other partnering entities that are not subrecipients.
These letters of support are general in nature that speak to the writer belief in the capability of an applicant to accomplish a goal/task.
Letters of support also may indicate an intent or interest to work together in the future, but they lack specificity.
ALL letters should attest to the partner experience and commitment to socio-economic diversity and cultural and social determinants that may function as barriers to prevention and treatment, such as the fear of criminalization of substance abuse, negative stigma associated with substance abuse, as well as the implicit and systemic bias of health professionals and health.
Applicants must demonstrate that they have experience (including through partnership) working in the field of behavioral health, substance abuse prevention, and opioid misuse.
In particular, applicants must demonstrate experience understanding and integrating the unique factors related to women health and opioid misuse Related factors include, but are not limited to chronic pain factors, trauma, and caretaking roles in women lives.
Applicants must also demonstrate that they have long-term partnerships with relevant organizations at the regional, state, local, and/or community-based level in order to coordinate activities, maximize work, and build capacity.
Applicants may propose original projects for primary and/or secondary prevention of opioid misuse in women, but OWH also encourages applicants to customize and build upon publically available projects and/or strategy models, as well as existing tools and materials, while avoiding the duplication of existing materials.
OWH expects applicants to implement and evaluate projects.
Applicants are encouraged to make end product materials, programs, or strategies available without cost to users.
No human subject clinical trials (Phase I, II, and III) will be funded through this funding opportunity.
Development, and evaluation of an activity or series of activities followed by piloting (which includes evaluation) and implementation Development and piloting of a tool (tangible, electronic, or social media-based), decision aid, or other format that is required by the target community.
Development, further refinement, or wider awareness and adaptation of a health policy with measurement of impact.
Whether a prevention strategy, activity, tool, decision aid, or other format, all end products must be evidence-based, patient-centered, and encourage communication between women and health professionals that will advance shared decision making around primary and/or secondary prevention.
All proposals must describe and specify the target audience and justify the selection of the audience based on evidence of need and supported by credible data.
Successful applicants must be knowledgeable about and include provisions to address, manage, or mitigate social and cultural determinants, including but not limited to stigma, the fear of criminalization-of substance use disorder, negative stigma associated with substance use disorder, the implicitand systemic bias of health professionals-and health systems that can pose as barriers to prevention of opioid misuse.
Applicants are strongly encouraged to identify existing, evidence-based frameworks and strategies supported by other federal agencies to prevent duplication of effort and redundancy.
Finally, applicants are strongly encouraged to reference and integrate findings and guidelines found in the following federal references:
2016 Centers for Disease Control and Prevention pain management guidelines for prescribing opioids for chronic pain National Pain Management Strategy, https://iprcc.nih.gov/National_Pain_Strategy/NPS_Main.htm The Surgeon General Report on substance use and misuse in the United States, Facing Addiction:
The Surgeon Generals Report on Alcohol, Drugs, and Health OWH White Paper on Women and Opioids The Agency for Healthcare Research and Quality Academy:
Integrating Behavioral Health and Primary Care Screening, Brief Intervention, and Referral to Treatment (SBIRT) - www.samhsa.gov/sbirt This announcement supports the HHS recommendations to strengthen prescription drug monitoring to avoid the transition to non-prescription misuse, enable safe disposal of unneeded drugs, accelerate research on pain and opioid misuse and overdose, advance prescriber education, encourage safe pain management approaches, and expand telemedicine in rural America.