A Pilot Study Using Facebook to Support Opioid Recovery Among American Indian Women

This one-year, Phase I, pilot preparatory study aims to develop a culturally relevant Facebook intervention for American Indian and Alaska Native (AIAN) women in Minnesota recovering from illicit opioid use. The study will consist of three phases: (1) qualitative interviews, (2) intervention content refinement and a moderator exchange (i.e., bi-directional sharing of knowledge between intervention moderators and trainers), and (3) a beta-testing period. A study-specific Community Advisory Committee (CAC) was formed whose members contributed to the study protocol and will continue to provide guidance and input on the study implementation and dissemination. At the advice of the CAC, a Native Elder woman named the study. Wiidookaage'win is an Ojibwe word that means "the place for help and time for helping," and reflects healing and community. The investigators expect the participatory approach to treatment development will result in a social media intervention with cultural relevance for Native women to maintain recovery from opioid use.

Inclusion criteria

- Phase 1:

AIAN Women:

• AIAN based on self-reported race.
• Gender identity as a woman.
• Resides in Minnesota.
• At least 18 years of age age with no upper age limit.
• OUD based on the DSM-5 Checklist (American Psychiatric Association, 2013).
• Self-reports at least one month of opioid abstinence based on Timeline Follow-Back (TLFB) interview.
• Currently receiving MOUD.
• Is comfortable speaking and reading English.
• Is familiar with Facebook.
• Has access to broadband internet on a mobile phone/computer/tablet at any location.

AI/AN Health Care Providers and Stakeholders

• Health care provider or AIAN community stakeholder.
• Knowledge of Native culture and/or OUD treatment and recovery among AIAN people.
• Is comfortable speaking and reading English.
• Is familiar with Facebook.
• Has access to broadband internet on a mobile phone/computer/tablet at any location.

Having some familiarity with the Facebook platform is needed to provide feedback on content for a Facebook intervention. Access to the internet is needed to view online moderator postings for providing feedback during the interview.

Inclusion criteria

- Phase 3:

• AIAN person based on self-reported race/ethnicity.
• Gender identity as a woman.
• At least 18 years of age.
• Resides in Minnesota.
• OUD based on the DSM-5 Checklist (American Psychiatric Association, 2013).
• Self-reports at least one month of abstinence from opioid use based on TLFB interview and negative urine opiate screen.
• Currently receiving MOUD.
• Is comfortable speaking and reading English.
• Has an existing Facebook account or willing to set one up.
• Is willing and able to participate in the Facebook intervention for one month.
• Has access to broadband internet on a mobile phone/computer/tablet at any location.
• Is willing and able to travel to a community clinic in Minneapolis, Minnesota for the UDS.

Exclusion criteria

AIAN potential participants in Phases 1 and 3 meeting any of the exclusion criteria listed below will be excluded from study participation. Community stakeholder participants in - Phase 1 will only fail the screening if they meet the second exclusion criterion:

• Self-reports current suicidality.
• Inability or unwillingness of participant to provide verbal consent (Phase 1) or written informed consent (Phase 3).
• (Phase 3 only) Was a participant in Phase 1.

Pregnant women, lactating women, or women who plan to become pregnant will not be excluded because the treatment being evaluated is a behavioral intervention and does not involve medication or risk to the fetus.