Neighborhoods, Mental Health, and the Prevention of Opioid Overdose: A Mixed Methods Approach

社区、心理健康和阿片类药物过量的预防：混合方法

• 批准号: 10369171
• 负责人: Elizabeth Nesoff
• 金额: $ 11.61万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-15 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10369171
• 关键词: Neighborhoods; Mental; Health; Prevention; Opioid

PROJECT SUMMARY/ABSTRACT Increasing opioid use in the U.S. has led to a dramatic increase in opioid-related fatal and non-fatal overdoses (OD), and adults with mental health disorders, including anxiety and mood disorders, are significantly more likely to use nonprescription opioids. Mental health and associated drug use are directly and significantly impacted by the neighborhood environment, but few studies have examined the impact of modifiable neighborhood features on OD risk. The broad objective of this study is to investigate modifiable neighborhood factors which impact mental health and which may contribute to opioid OD risk. The proposed research will achieve the following interconnected specific aims using mixed quantitative/qualitative approaches with fatal OD data from New York City and original in-depth interviews with people who use drugs: (1) investigate the impact of modifiable physical and social neighborhood factors on opioid OD risk; (2) examine key mental health indicators as mediators of the relationship between modifiable neighborhood factors and opioid OD risk; (3) comparatively investigate the impact of modifiable neighborhood factors and mental health indicators on opioid OD risk comparing the locations where opioid users lived versus the locations where they overdosed. In-depth interviews with people who use drugs will provide context for quantitative results, identifying mechanisms by which neighborhood impacts drug using and associated OD risk and informing novel strategies for OD prevention. This K01 mentored research scientist development proposal will provide the training and expertise needed to transition to research independence in drug use research. Five specific training areas will be incorporated to carry out these research goals: (1) obtain advanced skills in spatial analysis methods, including structural equation modeling with spatial data and advanced spatial regression analyses methods; (2) develop expertise in mixed quantitative and qualitative methods research theory, design, and analysis, and build capacity in collecting and analyzing qualitative data; (3) develop subject matter expertise in psychiatric epidemiology and associated drug use risk factors, in particular, major depression, general anxiety disorders, and diagnostic criteria for psychiatric disorders; (4) obtain additional training in the ethical conduct of research among marginalized and stigmatized populations; (5) build professional skills for a successful research career as an independent scientist leading multidisciplinary teams to build new knowledge and address major challenges in drug use and abuse. These training goals will be achieved through a combination of didactic courses, specialized workshops, hands-on research, and mentoring from an interdisciplinary team of experts. This research and training will lead to a subsequent R01 proposal that formally tests implementation strategies and effectiveness of neighborhood-level interventions for OD prevention.

项目摘要/摘要 美国的阿片类药物使用量增加导致阿片类药物相关的致命和非致命性过量的急剧增加 （OD）和患有精神健康障碍的成年人，包括焦虑和情绪障碍，都更加多 可能使用非处方阿片类药物。心理健康和相关的药物使用直接而显着 受社区环境的影响，但是很少有研究检查了可修改的影响 OD风险的邻里功能。这项研究的广泛目的是调查可修改的社区 影响心理健康并可能导致阿片类OD风险的因素。拟议的研究将 使用致命的混合定量/定性方法实现以下相互联系的特定目标 来自纽约市的OD数据以及对使用毒品的人的深入访谈：（1）调查 可修改的物理和社会邻里因素对阿片类药物OD风险的影响； （2）检查关键心理健康 指标是可修改的邻里因素与阿片类药物风险之间关系的介体； （3） 相对研究可修改的邻里因素和心理健康指标对阿片类药物的影响 OD风险比较阿片类用户与过量服用的位置相比，将其居住的位置进行比较。深入 与使用药物的人的访谈将为定量结果提供背景，并确定机制 哪些社区会影响使用和与OD风险相关的药物，并为OD提供新的策略 预防。这项K01指导的研究科学家发展建议将提供培训和专业知识 需要过渡以研究药物使用研究的独立性。五个特定的培训领域将是 合并以实现这些研究目标：（1）获得空间分析方法的高级技能，包括 使用空间数据和高级空间回归分析方法的结构方程建模； （2）发展 混合定量和定性方法研究理论，设计和分析的专业知识，并建立能力 收集和分析定性数据； （3）发展精神病流行病学领域的主题专业知识和 相关的药物使用危险因素，尤其是严重抑郁症，一般焦虑症和诊断 精神疾病的标准； （4）在研究中的道德行为方面获得额外的培训 被边缘化和污名化的人群； （5）为成功的研究职业建立专业技能 独立科学家领导多学科团队建立新知识并应对主要挑战 吸毒和滥用。这些培训目标将通过教学课程的结合，专门实现 跨学科专家团队的讲习班，动手研究和指导。这项研究和 培训将导致随后的R01提案，以正式测试实施策略和有效性 预防OD的邻里水平干预措施。