A digital intervention to decrease self-stigma among pregnant and postpartum women with opioid use disorder

数字干预可减少患有阿片类药物使用障碍的孕妇和产后妇女的自我耻辱

• 批准号: 10360365
• 负责人: Patricia A Cavazos-Rehg
• 金额: $ 25.34万
• 依托单位: RISSANA, LLC
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10360365
• 关键词: Address; Adherence; Anxiety; Attitude; Behavior; Behavior Control; Behavioral; Benchmarking; Caring; Cessation of life; Clinic; Clinical; Control Groups; Discover, Design, Build, and Test Framework; Ensure; Exposure to; Face; Feedback; Feeling; Fostering; Funding; Goals; Grant; Guidelines; Health; Hospital Charges; Illinois; Impact evaluation; Individual; Intervention; Maternal Mortality; Measures; Mediating; Medical; Mental Depression; Mental Health; Methods; Midwestern United States; Missouri; Modeling; Mothers; Motivation; Opioid; Outcome; Participant; Perception; Persons; Pharmaceutical Preparations; Phase; Postpartum Period; Postpartum Women; Pregnant Women; Process; Provider; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Recovery; Recovery Support; Signal Transduction; Small Business Technology Transfer Research; Substance Use Disorder; Technology; Testing; Time; Treatment outcome; United States; United States National Institutes of Health; United States Substance Abuse and Mental Health Services Administration; Universities; Vulnerable Populations; Waiting Lists; Washington; Woman; Work; clinical care; clinically significant; cost; design; digital intervention; digital treatment; drug misuse; evidence base; experience; feasibility testing; high risk population; improved; indexing; innovation; interest; internalized stigma; medical schools; opioid abuse; opioid epidemic; opioid misuse; opioid mortality; opioid use disorder; overdose death; patient oriented; prevent; primary outcome; professor; prospective; psychological distress; recruit; relapse risk; response; secondary outcome; sobriety; social stigma; software development; substance use treatment; therapy design; tool; treatment adherence; treatment planning; usability; user centered design

Project Summary The opioid epidemic has resulted in widespread, detrimental public health consequences and disproportionally impacts vulnerable, high-risk groups including pregnant and postpartum women (PPW) and their babies. PPW with OUD also face high levels of self-stigma – the internalization of negative feelings about oneself because of drug misuse. Self-stigma is highly correlated with numerous detrimental consequences including recovery outcomes and reduced engagement with substance use treatment. Furthermore, self-stigma prevents treatment initiation and engagement among PPW with OUD, leading to additional adverse health outcomes for both mother and baby. Digital interventions have the potential to support healthier behaviors among PPW with OUD and may also provide a promising method for reducing their self-stigma. Enhearten is a digital intervention that is designed to foster adherence to medication for OUD and treatment retention while considering the unique needs of PPW, but it currently lacks features to decrease self-stigma. In this proposal, we will augment Enhearten with a stigma-focused ecological momentary intervention (EMI) designed to: 1) screen for feelings of stigma and 2) counteract these vulnerabilities via just-in-time interventions. Specifically, in Phase I, we will adapt Enhearten to include a new EMI feature and refine this tool using the Discover, Design/Build, and Test (DDBT) Framework to ensure that it will reduce self-stigma among this vulnerable population during critical moments. At the start of Phase II we will conduct an additional DDBT cycle to further increase the usability and efficacy of our EMI. Then, we will conduct an individual-level multicenter randomized controlled trial to test the feasibility, acceptability, and efficacy of Enhearten on reducing self- stigma and improving treatment adherence. Recruitment will occur from various clinics throughout the Midwest that specialize in treating PPW with OUD. Enhearten will be an invaluable tool for PPW with OUD by supplementing traditional in-person care, reducing self-stigma, and supporting continued motivation and adherence to their treatment plan during their recovery journey.

项目摘要 阿片类药物流行导致宽度，有害的公共卫生后果和不成比例 影响脆弱的高风险群体，包括怀孕和产后妇女（PPW）及其婴儿。 ppw 与Oud还面临高水平的自我污名 - 由于 滥用毒品。自我污名与许多有害后果高度相关，包括恢复 结果和减少与药物使用治疗的参与度。此外，自我污名可以阻止治疗 PPW与OUD之间的启动和参与，导致两者的其他不良健康结果 母亲和婴儿。数字干预措施有可能支持PPW之间更健康的行为 Oud并可能提供一种有望减少自我污名的承诺方法。 Enhearten是数字 旨在促进对OUD和治疗保留药物的依从性的干预措施 考虑到PPW的独特需求，但目前缺乏减少自我污名的功能。在此提案中， 我们将通过以污名为中心的生态瞬时干预（EMI）来增强：1） 筛选污名的感觉和2）通过即时干预来抵消这些漏洞。具体来说， 在第一阶段，我们将调整EnhareArten，以包含一个新的EMI功能，并使用Discover，“完善此工具” 设计/构建和测试（DDBT）框架，以确保它将减少这种脆弱的自我污名 在关键时刻的人口。在第二阶段开始时，我们将进行额外的DDBT周期 进一步提高我们的EMI的可用性和效率。然后，我们将进行个人级别的多中心 随机对照试验，以测试可行性，可接受性和易于降低自我的增强性 污名和改善治疗依从性。招聘将从整个诊所进行 中西部专门用Oud处理PPW。 EnhareArten将是PPW的宝贵工具。 补充传统的面对面护理，减少自我污名，并支持持续的动力和 在康复过程中遵守他们的治疗计划。