# Drug Injection Surveillance and Care Enhancement for Rural Northern New England (DISCERNNE)

> **NIH NIH UH3** · BAYSTATE MEDICAL CENTER, INC. · 2021 · $983,737

## Abstract

PROJECT SUMMARY/ABSTRACT
 In New England’s rural northern states, the epidemic of opioid use disorder (OUD) and its related sequelae
- overdose, HIV, hepatitis C virus (HCV), sexually transmitted infections (STIs) and other infectious
comorbidities - present the most substantial challenges to public health and health care in decades. This two-
stage, mixed-methods study will examine the epidemiology of IDU, its infectious consequences, and service
accessibility among young persons who inject drugs (PWID) (UG3 phase) in 15 rural counties in Maine, New
Hampshire and Vermont, and then implement an integrated telemedicine approach to treat OUD and reduce
HIV, HCV, STIs, major bacterial infections (e.g. infective endocarditis, septic arthritis, osteomyelitis, epidural
abscess) and overdose (UH3 phase). The UG3 phase will employ qualitative, quantitative, social network,
geospatial, and laboratory methods to characterize the risk environment and epidemiology of OUD, its
infectious complications, opioid overdose, risk behaviors, service use and needs in a respondent-driven
sample (n=360) of young PWID in these rural counties. An environmental assessment of policy and
infrastructure will examine available services, needs and gaps. This phase will also build capacity to collect
and deliver specimens for centralized HCV transmission investigation and molecular epidemiologic analysis.
 In the UH3 phase, a Hybrid Type 1 implementation study will evaluate the effectiveness of a regionalized,
integrated model of expanded service delivery for rural PWID. Using a stepped wedge design, the UH3 study
will roll-out expanded services into primary care clinics and practices (PCCP) in these 15 rural northern New
England counties using regional real-time tele-consultation, assessment and triage for HIV, hepatitis and OUD;
and virtual, expert-facilitated bi-weekly case conferences around key topics (e.g., overdose prevention and HIV
pre-exposure prophylaxis [PrEP]). PWID recruited during the UG3 phase in intervention counties will be
recontacted and referred to these PCCP sites. Primary outcomes will be the proportion of PWID: (1) with an
initial assessment at a PCCP site ("intake"); (2) with an initial visit who initiated any treatment service within 30
days ("initiation”); (3) who initiated then received 3 more services within 180 days of initiation ("engagement”);
and (4) discussed and followed via telemedicine (“retention”). Process evaluation will assess barriers,
facilitators,implementationproblemsandnecessaryadaptations.Secondaryoutcomesincludetheproportion
of PWID who receive: HAV/HBV vaccination and STI testing; naloxone rescue kits; and OUD, HIV and HCV
treatment, including HIV suppression and sustained HCV response (SVR) among those who receive services.
 This project is uniquely responsive to RFA-DA-17-014 in that it will provide in-depth understanding of high-
risk rural PWID, inform community response strategies, and implement a comprehensive, integrated a...

## Key facts

- **NIH application ID:** 10241286
- **Project number:** 5UH3DA044830-05
- **Recipient organization:** BAYSTATE MEDICAL CENTER, INC.
- **Principal Investigator:** William Edward Soares
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $983,737
- **Award type:** 5
- **Project period:** 2017-08-15 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10241286

## Citation

> US National Institutes of Health, RePORTER application 10241286, Drug Injection Surveillance and Care Enhancement for Rural Northern New England (DISCERNNE) (5UH3DA044830-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10241286. Licensed CC0.

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