Graduation Year

2020

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Dean's Office

Major Professor

Kathleen Moore, Ph.D.

Co-Major Professor

Bruce Levin, Dr.P.H., M.P.H.

Committee Member

Khary Rigg, Ph.D.

Committee Member

Zev Schuman-Olivier, Ph.D.

Committee Member

Joe Bohn, Ph.D.

Keywords

addiction, community-level collaboration, religion

Abstract

While the opioid overdose crisis continues to impact individuals, families, and communities across the United States, there is a sense of urgency to identify effective, efficient, and feasible approaches for curbing the death toll. It is clear, however, that without community-level acceptance of treatment and harm reduction approaches shown to be successful, the services available remain underutilized and thus less impactful than clinical evidence demonstrates. To overcome an opioid use disorder (OUD), an overall treatment approach should be tailored to an individual’s needs but might include components of medication, psychosocial support services, community engagement, and the development of healthy social networks. In order to achieve this comprehensive approach to addiction recovery, the strategic inclusion of interdisciplinary approaches and stakeholder communication across areas of expertise can increase collaborative service approaches that are aligned with individual and community-level needs. With attention towards root causes and limited resources, building strong community networks and stronger cross-sectoral partnership are important components of addressing OUD. A partnership between faith-based organizations (FBOs) and behavioral health entities is one such partnership with potential for bridging gaps towards the delivery of comprehensive solutions for individuals with OUD. This dissertation, divided into three separate but related studies, serves to lay the groundwork towards a deeper understanding of the needs, priorities, similarities, and differences that exist amongst secular and non-secular stakeholders in West Central Florida as they relate to collaborative approaches for addressing an OUD epidemic. The first study serves as a pilot study and uses a mixed-methods approach to assess the needs and perspectives of cross-sectoral stakeholders through an evaluation of existing secular and non-secular collaboration efforts. Results indicate that shared priorities exist between stakeholders with implications for how these strategic education efforts could leverage these mutual goals. The second study consists of a geospatial mapping analysis of Hillsborough and Pinellas counties (FL) as a means of descriptively, visually, and quantitatively exploring the role that religious social capital may have on opioid-related overdose deaths. This study maps places of worship, OUD treatment facilities, the residencies of people who have died by opioid-related overdoses, and community-level social vulnerability indexes and explores the potential of their interconnected relationships with the use of density analyses and distance calculations. Findings support the feasibility of places of worship serving as accessible local resource satellites in communities at high-risk for opioid-related overdoses and offers recommendations for continued research to supplement these findings. The third study is an exploratory study that quantitatively evaluated responses to a survey of interdenominational faith leaders in Hillsborough and Pinellas Counties to assess how their perspectives, characteristics, and beliefs impact their views on OUD treatment and harm reduction approaches. The survey collected demographic and descriptive characteristics of 41 faith leader respondents, their perspectives on various OUD treatment and harm reduction modalities, and scores for five imbedded validated instruments. This study identified patterns in perceptions of stigma, recovery approach preferences, and views on cross-collaboration with secular behavioral health counterparts. Statistically significant relationships between political affiliation, religious fundamentalist orientations, perceptions of syringe exchange, safe injection facilities, and medications for OUD were also analyzed. The exploratory results for this study lay the groundwork for improving future facilitation of mutually beneficial partnerships based on the reported characteristics, values, and preferences of faith leaders. As a whole, this dissertation provides implications for future collaborative efforts and offers suggestions for strategies to effectively engage faith communities and leaders in order to improve community-level responses to the opioid epidemic. It is through inclusivity and understanding that all who seek help for an OUD will have access to these services on terms that suit their personal values and accessibility to resources. By respecting differences and prioritizing similarities, the shared intentions may be served by stakeholders across faith-based boundaries. This dissertation brings attention to legitimizing mutual problem solving and creating strategic mechanisms for establishing working partnerships that prevent deaths and rebuild lives.

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