USING THE TRANSTHEORETICAL MODEL TO UNDERSTAND MOUD PARTICIPANTS GOALS IN RURAL ILLINOIS.

Author

John Bresett, Southern Illinois University CarbondaleFollow

Date of Award

12-1-2024

Degree Name

Doctor of Philosophy

Department

Health Education

First Advisor

McDaniel, Justin

Abstract

Background: The opioid epidemic in the United States (U.S.) continues to be problematic. While the number of overdoses deaths have declined in recent, this is still a problem in the U.S. One of the recommended interventions to treat opioid-use disorder (OUD) is using Medications for Opioid-use Disorder (MOUD) to treat this. The Transtheoretical Model (TTM) is a public health model that can access an individuals readiness to change health behaviors. It is important to understand how individuals with OUD can move through the stages of TTM to access MOUD treatment in rural areas, and what barriers they face when trying to access MOUD treatment in rural areas.Methods: A case study was conducted in a rural Illinois region to understand current and/or past experiences individuals with OUD have had with MOUD in rural areas. Qualitative semi-structured interviews were conducted with individuals who have had experiences with MOUD in the selected rural areas to understand how they moved through the stages of change of MOUD, and what facilitators and barriers effected their movements through TTM. Results: A total of ten interviews were conducted. Eight were men, while two were women. All participants identified being white/Caucasian. Participants resided in the case study region. All participants disclosed being on Medicaid for insurance, while two discussed having Medicare as well. Themes from the interviews were stages of change at time of interview, movements through the stages of change, relapse, and experiences with MOUD treatment. Conclusions: The main facilitators and barriers that caused movements through TTM included opioid overdose experiences, legal issues, life changing events, lacking adequate supports and resources, and positive/negative experiences with MOUD treatment. While findings of the study were consistent with literature findings, there needs to be emphasis on looking at flexibility in delivery of interventions by MOUD treatment centers. Having different interventions to accommodate individuals could help with retention rates, while addressing barriers that prevent them from accessing treatment. Having a stronger understanding of treatment center practices could help with interventions. Future research should examine the possibility of utilizing peer-recovery coaches to coincide with treatment to see if it can offset barriers/concerns in rural areas.