# Implementing a Community-Based Response to the Opioid Epidemic in Rural Ohio

> **NIH NIH UH3** · OHIO STATE UNIVERSITY · 2021 · $847,166

## Abstract

PROJECT SUMMARY/ABSTRACT
 Ohio is experiencing one of the worst opioid injection epidemics in the country. The epidemic has severely
affected rural Appalachian counties in southern Ohio, leading to a surge in overdose fatalities. Ohio’s heroin-
related overdose rate is five times the national rate. In addition to overdose deaths, HCV has increased 400%
between 2009-2013 and neonatal abstinence syndrome (NAS) has increased 9-fold between 2004-2014. Many
evidence-based interventions (EBI), such as syringe service programs, medication-assisted treatment for
substance use, naloxone provision for overdose treatment, and testing for HCV, HIV and sexually transmitted
diseases (STD) are known to be effective in combating injection drug addiction and its consequences.
Unfortunately, little is known about how to apply lessons learned in urban injection drug epidemics to sparsely-
populated rural areas. In rural Ohio, as in much of the U.S., the delivery of EBI is limited or fragmented. A lack
of coordination between key agencies to address overlap and gaps in services, especially in the context of
severely constrained resources, has dire consequences for those struggling with opioid injection drug use.
 The proposed study will develop and implement a service delivery plan for EBI that can be scaled up in
rural Ohio as well as other rural areas in the US experiencing opioid epidemics. In the UG3 phase, we will use
a mixed methods approach to assess the socio-cultural and political context of the epidemic across multiple
levels, including agencies, health care and service providers, and people who inject drugs (PWID) within three
counties in rural Appalachia. We will use respondent-driven sampling (RDS) to assess injection behaviors and
HCV, HIV, and STD prevalence. Building on this multi-level formative data, we will identify service gaps and
work closely with key community stakeholders to build consensus around and prioritize the most relevant,
feasible and acceptable implementation strategies to deliver EBI that may include coalition building, data
synthesis across counties, crowdfunding models, and telemedicine. In the UH3 phase, we will implement,
monitor and evaluate our service delivery plan for opioid injectors, using a regression point displacement
design and repeat RDS surveys. Outcomes will include overdose deaths, NAS cases, HCV and HIV tests
performed, and referral for HCV and HIV care. Implementation outcomes will include acceptability, adoption,
feasibility, fidelity, penetration, sustainability, and cost. Scalability will be assessed by applying lessons learned
in the UG3 phase in three additional counties during the UH3.
 Upon completion of the study, we will have enhanced EBI service delivery in multiple counties in Ohio and
developed an exportable model of service needs assessment, community-engaged decision-making, and
implementation. This model will be suitable for use throughout rural American in settings where opioid
addiction has been...

## Key facts

- **NIH application ID:** 10242014
- **Project number:** 5UH3DA044822-05
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** VIVIAN F. GO
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $847,166
- **Award type:** 5
- **Project period:** 2017-08-15 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10242014

## Citation

> US National Institutes of Health, RePORTER application 10242014, Implementing a Community-Based Response to the Opioid Epidemic in Rural Ohio (5UH3DA044822-05). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10242014. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*