Project Summary American Indian communities have been greatly affected by the opioid epidemic with many Tribes being overwhelmed by opioid use and overdose. Among all racial/ethnic groups in the U.S, American Indians and Alaska Natives have the highest rate of overdose fatalities from all opioids. Within Southern California, areas encompassing American Indian Tribes have experienced some of the highest age-adjusted rates of opioid overdose deaths, hospitalization, and emergency department visits. A key component to effectively responding to the opioid epidemic is timely surveillance with sufficient granularity to reveal subpopulations and locations in most need of resources. However, there is a significant lag in the amount of time it takes for opioid overdose data to be publicized, making it difficult to implement a prompt public health response to prevent additional morbidity/mortality. Although a substantial amount of work has gone into developing overdose surveillance across state and county agencies, such tools are lacking in Indian Country. Moreover, a history of profiling and stigmatizing American Indian Tribes with respect to substance use has hampered the development of Tribally specific data collection and reporting efforts. The current proposal will overcome this limitation by adopting technologies that upholds Tribal sovereignty in ownership, management, and oversight of how information is gathered and shared with non-Tribal members including overdose prevention stakeholders. The goal of this project is to adapt commercialized technologies to provide research-based solutions to the opioid crisis in Indian Country. Through a partnership with a Tribal Fire Department and a software company providing data analytics for public safety agencies, we are proposing to build a near real-time opioid overdose dashboard within Tribal boundaries. Our study is guided by the following Specific Aims: 1. Evaluate the pragmatic merit of developing a Tribally specific opioid overdose monitoring dashboard; and 2. Develop the technical process for adapting commercialized technology to leverage Tribal Fire emergency response calls and medical examiner data to build a Tribally specific opioid overdose dashboard. The public health significance of this study is to build Tribal capacity to access, manage, and use data from existing sources and to apply that data to facilitate real-time actionable responses towards circumventing the opioid epidemic. Knowledge gained from the formative process of developing an opioid overdose dashboard will provide a blueprint to support community- wide adoption by other Tribal Nations.

Project Narrative A key component to effectively responding to the opioid epidemic is timely monitoring of overdose incidents with sufficient granularity to reveal subpopulations and locations in most need of resources. However, such tools are lacking for American Indian Tribes. Through a Tribally engaged approach, this study will build a near real-time opioid overdose monitoring tool while preserving Tribal control and autonomy over the process.