Increasing Referrals to Medications for Opioid Use Disorders from Drug Treatment Courts using Organizational Linkage Intervention

使用组织联系干预增加戒毒法庭对阿片类药物使用障碍药物的转诊

• 批准号: 10180932
• 负责人: Ekaterina Pivovarova
• 金额: $ 19.8万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10180932
• 关键词: Address; Adopted; Adoption; Case Manager; Cause of Death; Characteristics; Collaborations; Communication; Communities; Consolidated Framework for Implementation Research; Criminal Justice; Data; Development; Drug Courts; Drug abuse; Drug usage; Environment; Evaluation; Evidence based practice; Evidence based treatment; Focus Groups; Gold; Health Services Accessibility; Imprisonment; Individual; Intention; Intervention; Interview; Justice; Knowledge; Lawyers; Lead; Legal; Manuals; Massachusetts; Mentorship; Methods; Monitor; National Institute of Drug Abuse; Opioid; Overdose; Participant; Perception; Persons; Pharmaceutical Preparations; Pharmacotherapy; Population; Populations at Risk; Practice Guidelines; Procedures; Process; Program Development; Provider; Public Health; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Readiness; Recording of previous events; Recovery; Regulation; Relapse; Reporting; Research; Research Personnel; Resources; Scientist; Services; Substance Use Disorder; Supervision; Surveys; System; Time; Training; Work; acceptability and feasibility; addiction; archive data; archived data; base; career development; control trial; court; design; drug standard; efficacy evaluation; evidence based guidelines; experience; high risk; high risk population; implementation measures; implementation science; implementation strategy; improved; interest; medication-assisted treatment; offender; opioid epidemic; opioid overdose; opioid use disorder; parole; preference; prescription opioid; probation; probationer; programs; standard care; substance use; theories

PROJECT SUMMARY/ABSTRACT The proposed K23 Career Development program will provide Dr. Ekaterina Pivovarova with the training and pilot data necessary to conduct independent research in applying implementation science to increase access to empirically based substance use disorder (SUD) treatments for justice involved individuals. Opioid-related drug overdose is a leading cause of death for individuals with justice involvement. Yet, most individuals in the justice system fail to receive the gold standard treatment for opioid use disorder – medications for opioid use disorder (MOUDs). Drug treatment courts (DTC) are diversionary programs that leverage legal sanctions in exchange for mandatory and court-monitored engagement in SUD treatment. There are over 3,100 DTC programs nationwide that manage thousands of offenders in the community with SUDs. Despite their focus on addiction treatment, DTCs have been slow to incorporate MOUDs as standard practice. Systemic barriers to use of MOUD in DTCs have been well documented and include poor communication and lack of collaboration and relationships with MOUD providers in the community. The proposed study directly addresses barriers in communication and referral practices between DTC and community MOUD providers by adapting an implementation strategy, which has been previously shown as effective in community corrections programs. The Medication for Opioid Use Disorders Implementation – in Drug Treatment Courts (MOUDI-DTC) is an implementation strategy that aims to improve interagency relationships and increase access to MOUDs for high-risk individuals. Using the Consolidated Framework for Implementation Research (CFIR), a mixed-methods study will be conducted to achieve these specific aims: 1) evaluate current MOUD referral practices, barriers, facilitators, and readiness for change 2) develop MOUDI-DTC implementation strategy and manual, 3) implement MOUDI-DTC for 12 months in three DTCs and evaluate efficacy, acceptance and feasibility of the implementation strategy. The findings will provide preliminary data about efficacy of MOUDI-DTC on increasing referrals and acceptability and feasibility of MOUDI-DTCs to ultimate expand and evaluate the strategy nationwide. The findings will also provide pilot data for developing an R01 randomized clinical trial to compare MOUDI-DTC to referral practices as usual in DTCs. More broadly, this research will lead to development of best-practice guidelines about how DTCs should work with MOUD community providers to increase access to care and referrals to MOUDs. Completing this study will serve as one component of a rigorous training plan for Dr. Pivovarova to receive directed training in 1) implementation science, 2) MOUD, and 3) organizational theory and systems level intervention. During the K23, Dr. Pivovarova will receive individualized and team mentorship from leading researchers in the field of implementation science and SUD treatment in justice settings: Drs. Peter Friedmann (primary), Stephenie Lemon, David Smelson, and Faye Taxman.

项目概要/摘要 拟议的 K23 职业发展计划将为 Ekaterina Pivovarova 博士提供培训和试点 在应用实施科学以增加获取机会方面进行独立研究所需的数据 针对阿片类药物相关个体的基于经验的物质使用障碍（SUD）治疗。 然而，对于大多数参与司法的人来说，服药过量是导致死亡的主要原因。 系统未能获得阿片类药物使用障碍的金标准治疗 – 用于阿片类药物使用障碍的药物 （MOUD）是一种利用法律制裁来换取戒毒的转移计划。 强制参与 SUD 治疗并接受法院监督 全国有 3,100 多个 DTC 计划。 尽管他们专注于成瘾治疗，但他们还是用 SUD 管理社区中的数千名罪犯。 DTC 在将 MOUD 纳入标准实践方面进展缓慢。在 DTC 中使用 MOUD 存在系统性障碍。 已被充分记录，包括沟通不畅以及缺乏合作和关系 拟议的研究直接解决了社区中的 MOUD 提供者。 通过调整实施策略，在 DTC 和社区 MOUD 提供商之间进行转介实践， 先前已证明阿片类药物在社区矫正计划中有效。 药物治疗法庭疾病实施 (MOUDI-DTC) 是一项实施战略，旨在 改善机构间关系并增加高风险个人接触 MOUD 的机会。 实施研究综合框架（CFIR），将进行一项混合方法研究 实现这些具体目标：1) 评估当前 MOUD 转介实践、障碍、促进因素以及准备情况 变更 2) 制定 MOUDI-DTC 实施策略和手册，3) 实施 MOUDI-DTC 12 个月 三个 DTC 并评估实施策略的有效性、接受度和可行性。 提供有关 MOUDI-DTC 在增加转诊、可接受性和可行性方面的功效的初步数据 MOUDI-DTC 最终在全国范围内扩展和评估该战略。调查结果还将提供试点。 用于开发 R01 随机临床试验的数据，以将 MOUDI-DTC 与通常的转诊实践进行比较 更广泛地说，这项研究将导致制定关于如何使用 DTC 的最佳实践指南。 与 MOUD 社区提供者合作，增加获得护理和转诊至 MOUD 的机会。 将作为 Pivovarova 博士严格培训计划的一部分，以接受以下方面的定向培训：1) 实施科学，2) MOUD，以及 3) 组织理论和系统级干预 在 K23 期间， Pivovarova 博士将接受该领域领先研究人员的个性化和团队指导 司法环境中的实施科学和 SUD 治疗：Peter Friedmann（小学）、Stephenie 博士 莱蒙、大卫·斯梅尔森和费耶·塔克斯曼。