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: 10413057
• 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 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10413057
• 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; Overdose reduction; Participant; Perception; Persons; Pharmaceutical Preparations; Pharmacotherapy; Population; Populations at Risk; Practice Guidelines; Procedures; Process; Program Development; Provider; Public Health; 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; court; design; drug standard; efficacy evaluation; evidence based guidelines; experience; high risk; high risk population; implementation barriers; implementation evaluation; implementation measures; implementation science; implementation strategy; improved; interest; medication-assisted treatment; offender; opioid epidemic; opioid overdose; opioid use disorder; parole; post implementation; preference; 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.

项目摘要/摘要 拟议的K23职业发展计划将为Ekaterina Pivovarova博士提供培训和飞行员 进行独立研究以应用实施科学以增加访问访问所必需的数据 基于经验的药物使用障碍（SUD）治疗涉及个人。阿片类药物相关的药物 服用过量是有正义参与的人的主要死亡原因。但是，大多数正义中的人 系统无法接受阿片类药物使用障碍的黄金标准治疗 - 阿片类药物使用障碍的药物 （mouds）。药物治疗法院（DTC）是转移计划，利用法律制裁以换取 强制性和法院监控参与SUD治疗。全国有3,100多个DTC计划 这管理了社区中成千上万的犯罪者。尽管他们专注于成瘾治疗，但 DTC纳入标准练习的速度很慢。 DTC中使用MOUD的系统性障碍 已经有充分的文献记载，包括沟通不良，缺乏协作和与之的关系 社区中的穆德提供商。拟议的研究直接解决了交流的障碍和 通过调整实施策略，DTC和社区MOUD提供商之间的推荐实践 以前已显示在社区更正计划中有效。阿片类药物使用的药物 疾病实施 - 在药物治疗法院（Moudi-DTC）是一种实施策略，旨在 改善相互作用的关系并增加对高风险个体的MOUD访问权限。使用 合并实施研究框架（CFIR），将进行混合方法研究 实现这些具体目的：1）评估当前的MOUD推荐实践，障碍，促进者和准备就绪 更改2）制定Moudi-DTC实施策略和手册，3）实施Moudi-DTC 12个月 在三个DTC中，并评估了实施策略的效率，接受和可行性。调查结果会 提供有关Moudi-DTC效率增加推荐和可接受性和可行性的初步数据 Moudi-DTC的最终扩展和评估全国战略。这些发现还将提供飞行员 用于开发R01随机临床试验的数据，以将Moudi-DTC与往常的转诊实践进行比较 DTC。从更广泛的角度来看，这项研究将导致制定有关DTC应该如何应如何制定的最佳实践指南 与MOUD社区提供商合作，以增加获得护理的机会并转介莫德。完成这项研究 将作为Pivovarova博士在1中接受定向培训的严格培训计划的一个组成部分） 实施科学，2）MOUD和3）组织理论和系统级干预。在K23期间， Pivovarova博士将从该领域的领先研究人员那里获得个性化和团队的心态 司法机构的实施科学和SUD治疗：Drs。彼得·弗里德曼（Peter Friedmann）（小学），斯蒂芬妮 柠檬，大卫·史密森（David Smelson）和费伊纳税人（Faye Taxman）。