Johns Hopkins University
The Prevention and Rapid Outreach for Treatment, Engagement, and Care Transition from the Emergency Department (PROTECT-ED) study evaluates an emergency department-based implementation strategy designed to improve delivery of evidence-based overdose and HIV prevention services during community re-entry.
1. Background Individuals returning to the community following incarceration experience one of the highest periods of preventable morbidity and mortality observed in clinical medicine. During the weeks and months following release from correctional facilities, rates of fatal opioid overdose increase by as much as 10- to 100-fold, while the risk of HIV acquisition is estimated to be 6- to 20-fold higher than that of the general population. These risks reflect the convergence of opioid use disorder, disrupted healthcare access, unstable housing, poverty, stigma, untreated mental illness, and fra…
Inclusion Criteria: * Are 18 years of age or older. * Present to the Johns Hopkins Hospital Emergency Department. * Have been released within the previous 180 days from a prison, jail, juvenile detention facility, immigration detention facility, halfway house, residential reentry center, or other correctional setting. Recent incarceration may be confirmed through participant self-report, electronic medical record documentation, the Victim Information and Notification Everyday (VINE) system, or other available documentation. Participant self-report alone is sufficient to establish eligibility.…
Participants will receive the PROTECT-ED intervention during the index emergency department encounter. The intervention consists of systematic identification; peer-delivered prevention services; same-day offer and initiation of MOUD and PrEP, when clinically appropriate; harm reduction services; and facilitated linkage to ongoing community care. Clinical decisions regarding medication initiation remain the responsibility of the treating emergency department clinician. The ED clinician would prescribe medication as part of ED care delivery, this would include reviewing eligibility and dosing with the ED pharmacist.
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