Project-007

项目-007

基本信息

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
项目类别：
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

项目摘要

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) 在美国已达到危机水平 OUD 和其他物质的风险最高。使用障碍 (SUD) 与 14 岁之前煽动的使用有关。报告称，2000 年至 2017 年间，德克萨斯州发生了 102,940 起阿片类药物相关暴露事件，其中 21,723 起归因于阿片类药物暴露 1999 年至 2015 年间，因阿片类药物导致的死亡人数为 16,843 人，其中该年龄段死亡人数为 2,200 人。范围为 15-24 年，在此期间稳步升级，而德克萨斯州位居各州之列。人均阿片类药物过量使用率最低，据报告 2015 年至 2016 年增加了 7.4%。翻译生态系统优化（EOT）可选功能将利用我们丰富的信息技术和临床和研究卓越，创建 ECHO 项目（社区医疗保健成果扩展） UTMB 在农村和服务欠缺社区的网络历来都很强大，这种经验是一次宝贵的经验。 EOT 目标的核心力量是解决 SUD/OUD 综合护理方面的现有差距。 teleECHO 网络建立在与 14 个家庭医学社区医生的现有关系的基础上德克萨斯州农村和服务欠缺县的诊所，以促进 OUD/SUD 与精神卫生服务的整合远程指导将在医疗保健工作者中建立一个实践社区。（医生、教师、住院医师、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，并建立开展研究所需的关系 EOT 将与德克萨斯州地区 CTSA 联盟 (TRCC) 合作，为农村和服务不足的社区提供服务。与由 31 个诊所组成的 UTMB 地区妇幼保健计划 (RMCHP) 网络合作，以加强 teleECHO 具有基于 OUD/ 当代知识的有针对性的、以妇女和怀孕为中心的主题 SUD 和心理健康障碍将捕获定量和分类的电子健康。阿片类药物、其他危险因素及其流行病学监测和临床研究记录数据库孕产妇-围产期死亡率和发病率之间的相互作用为了为当代知识的使用提供信息， teleECHO 网络将通过实践社区扩展以青少年为中心的主题我们将与学校的教师和医疗保健提供者一起翻译。我们通过影响力、有效性、采用、实施、维护将基于证据的发现付诸实践 (RE-AIM) 方法侧重于基于证据的药物使用和暴力预防计划。重点以我们的集体力量为基础，推动我们走向一个未来，在这个未来中， OUD/SUD 的医疗保健，以及基于证据的、文化敏感的教育和预防战略在德克萨斯州不同的城市和农村社区颁布，并最终在全国 CTSA 网络中颁布和他们的人民服务。