Rumbo: An Integrated Mobile and Web-Based Application to Overcome Barriers to Receive Substance Use Disorder (SUD) Treatment and Improve Outcomes for Spanish-Speaking, Hispanic and Latinx Individuals

PROJECT SUMMARY/ABSTRACT Substance use is a significant problem among Latinx and Hispanics due to the disproportionate number of physical harms and negative consequences associated with substance use relative to other racial/ethnic groups. However, Hispanics are less likely than other racial/ethnic groups to seek treatment for substance use, regardless of the substance(s) they use, and only 75% as likely to complete treatment for heroin as White individuals. Treatment navigators, like patient portals, were originally intended to offset disparities in access to treatment and health care. Unfortunately, initial uptake of these patient-facing eHealth tools was found among white, educated, middle-class individuals already actively engaged in their own health care and not by socially disadvantaged and marginalized minority populations, as though the structural barriers to care that exist in the treatment system were carried forward in the solution meant to overcome them. Nonetheless, there are still many who believe that eHealth has the potential to help marginalized people seeking care to surmount these barriers. Research over the last decade has revealed that adoption of eHealth among marginalized populations is influenced by factors such as health information-seeking behaviors, level of eHealth literacy, and technology acceptance, so we have designed a treatment navigator for Hispanics that is informed by these findings. “Rumbo” is an easily shared bi-lingual integrated web and mobile application that helps both Spanish-speaking and non-Spanish- speaking Hispanic individuals with substance use challenges find and access treatment services and related supportive resources. The proposed innovation stands out from other eHealth tools by leveraging the collective efficacy of the Hispanic community to overcome barriers and support individuals’ self-efficacy for engaging the treatment system. Rumbo’s simple, user-centered design provides less-acculturated Hispanic individuals with a culturally appropriate tool to understand their needs within the complex US treatment system. In this Phase I project we will develop the app’s content and functions with a community-based, user-centered, iterative design process that will inform the content and functions of the app. We will gather key stakeholders in the Bernalillo County treatment system (the most populous area in New Mexico and 50% Hispanic) to develop a database of available, culturally appropriate resources, and to support both project recruitment and dissemination of the initial version of the app. Once completed, we will evaluate Rumbo’s acceptability and capability as a treatment navigator in a naturalistic implementation study, as well as how it is shared among users, and whether the individuals who use Rumbo subsequently have increased confidence in accessing services.