Project-007

项目-007

• 批准号: 10376316
• 负责人: Randall J Urban
• 金额: $ 50.69万
• 依托单位: UNIVERSITY OF TEXAS MED BR GALVESTON
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-18 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10376316
• 关键词: 14 year old; Address; Adolescent; Age; Caring; Case Based Learning; Cessation of life; Clinic; Clinical Research; Clinical and Translational Science Awards; Communities; Community Healthcare; Community Physician; Community of Practice; County; Databases; Development; Ecosystem; Education; Electronic Health Record; Epidemiologic Monitoring; Faculty; Family Practice; Future; Goals; Health Personnel; Healthcare; Information Technology; Knowledge; Maternal and Child Health; Mental Health Services; Mental disorders; Opioid; Patient Care; Pattern; Perinatal mortality demographics; Physicians; Poison; Population; Pregnancy; Prevention program; Prevention strategy; Quality of Care; Reach Effectiveness Adoption Implementation and Maintenance; Reporting; Research; Risk Factors; Rural Community; Schools; Students; Substance Use Disorder; Texas; Translating; Translations; United States; Urban Community; Woman; Work; base; care outcomes; evidence base; experience; high risk; improved; opioid mortality; opioid overdose; opioid use; opioid use disorder; perinatal morbidity; programs; rural underserved; substance use; teacher; underserved community; violence prevention

Opioid overdose deaths and the rise in problematic opioid use patterns that indicate the development of opioid use disorder (OUD) have reached crisis levels in the United States. The highest risk for OUD and other substance use disorders (SUDs) associates with use instigated before 14 years of age. The Poison Center Network reported 102,940 opioid-related exposures in Texas from 2000-2017, including 21,723 exposures attributed to adolescents. Deaths attributed to opioids numbered 16,843 from 1999-2015, with 2,200 deaths in the age range of 15-24 years, tracking with a steady escalation over this period. While Texas ranks among the states with the lowest rate of opioid overdoses per capita, a 7.4% increase was reported between 2015 and 2016. The Ecosystem Optimization for Translation (EOT) optional function will harness our rich information technology and clinical and research excellence to create a Project ECHO (Extension for Community Healthcare Outcomes) network. UTMB’s networking in rural and underserved communities is historically strong and this experience is a central strength of the goal of the EOT to address existing gaps in integrated care in SUDs/OUD. The initial focus for the teleECHO network builds on the existing relationship with community physicians in 14 family medicine clinics in rural and underserved Texas counties to promote integration of OUD/SUD and mental health services into family medicine practices. Telementoring will create a community of practice across healthcare workers (physicians, faculty, residents, students) to facilitate case-based learning and disseminate best practices in OUD/SUD care, improve quality of care of patients, and build the relationships required to conduct research in rural and underserved communities. Partnering with the Texas Regional CTSA Consortium (TRCC), the EOT will work with the UTMB Regional Maternal and Child Health Program (RMCHP) network of 31 clinics to enhance teleECHO with targeted, women- and pregnancy-centered topics based upon contemporary knowledge of OUD/ SUDs and mental health disorders. This partnership will capture a quantitative and categorized electronic health record database for epidemiological surveillance and clinical research in opioids, other risk factors and their interactions in maternal-perinatal mortality and morbidity. To inform the use of contemporary knowledge, the teleECHO network will be expanded with adolescent-centered topics, delivered through a community of practice with teachers and healthcare providers in schools. Working with these schools and communities, we will translate our evidence-based findings into practice via a Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) approach focused on evidence-based substance use and violence prevention programs. The EOT is a pivot in emphasis grounded in our collective strengths to move us to a future in which the best practices of health care for OUD/SUDs, and evidence-based, culturally sensitive education and prevention strategies are promulgated across diverse urban and rural communities in Texas, and ultimately the national network of CTSAs and their populations served.

阿片类药物过量死亡和有问题的阿片类药物使用模式的增加，表明阿片类药物的发展 使用障碍（OUD）在美国达到了危机水平。 OUD和其他物质的最高风险 使用疾病（SUD）同事，并在14岁之前提出了使用。毒中心网络 2000 - 2017年从德克萨斯州报告了102,940次阿片类药物相关的暴露，其中包括21,723次暴露 给青少年。归因于1999 - 2015年的阿片类药物的死亡人数为16,843，年龄为2,200人 范围为15 - 24年，在此期间以稳定的升级跟踪。德克萨斯州在各州中排名 随着人均阿片类药物过量的速度最低，2015年至2016年之间增加了7.4％。 翻译的生态系统优化（EOT）可选功能将利用我们的丰富信息技术和 临床和研究卓越，创建一个项目回声（社区医疗保健成果的扩展） 网络。 UTMB在粗糙和服务不足的社区中的网络历史上很强，这种经历是一次 EOT的目标是解决SUDS/OUD综合护理中现有差距。最初的焦点 对于Telecho网络，基于与14个家庭医学中社区医生的现有关系 在德克萨斯州粗糙和服务不足的县诊所，以促进OUD/SUD和心理健康服务的整合 进入家庭医学实践。远程设备将在医护人员中创建一个实践社区 （医师，教师，居民，学生）促进基于案例的学习并传播最佳实践 OUD/SUD护理，提高患者护理质量，并建立进行研究所需的关系 粗糙和服务不足的社区。与德克萨斯州地区CTSA财团（TRCC）合作，EOT将 与31个诊所的UTMB区域孕产妇和儿童健康计划（RMCHP）网络合作以增强 基于当代对Oud/的知识，有针对性的，以妇女和怀孕为中心的主题 泡沫和心理健康障碍。该合作伙伴关系将捕获定量和分类的电子健康 记录阿片类药物，其他风险因素及其流行病学监测和临床研究的数据库 孕产妇死亡率和发病率的相互作用。为了告知当代知识的使用 Telecho网络将通过以青春期为中心的主题扩展，并通过一个实践社区提供 与学校的老师和医疗保健提供者一起。与这些学校和社区合作，我们将翻译 我们通过涉及，有效性，采用，实施，维护来实践的循证发现 （RE-AIM）的方法专注于基于证据的药物使用和预防暴力计划。 Eot是 强调我们集体优势的枢纽，将我们转移到了一个未来 OUD/SUD的医疗保健以及基于证据的文化敏感教育和预防策略是 在德克萨斯州的潜水城市和农村社区中颁布，最终是CTSAS的国家网络 他们的人口服务。