A Brief Values Intervention to Support Veterans in Early Buprenorphine Treatment

支持退伍军人早期丁丙诺啡治疗的简短价值观干预

• 批准号: 10419896
• 负责人: Victoria Ameral
• 金额: --
• 依托单位: EDITH NOURSE ROGERS MEMORIAL VETERANS HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10419896
• 关键词: Address; Adherence; Area; Award; Behavior Therapy; Behavioral Model; Buprenorphine; Career Choice; Caring; Clinical; Clinical Research; Communities; Community Integration; Conduct Clinical Trials; Control Groups; Data; Development; Diagnosis; Early treatment; Education; Employment; Evidence based intervention; Exercise; Expectancy; Face; Family Relationship; Feedback; Fellowship; Foundations; Goals; Gold; Impairment; Interpersonal Relations; Intervention; Intervention Studies; Interview; K-Series Research Career Programs; Knowledge; Leadership; Link; Manuals; Measures; Medication Management; Mental disorders; Mentors; Mentorship; Methodology; Modeling; New England; Outcome; Overdose; Overdose reduction; Patients; Pharmaceutical Preparations; Phase; Pilot Projects; Population; Positioning Attribute; Procedures; Process; Protocols documentation; Provider; Psychologist; Psychotherapy; Qualitative Methods; Quality of life; Randomized; Randomized Controlled Trials; Recommendation; Recovery; Recovery of Function; Relapse; Research; Research Personnel; Research Training; Role; Sampling; Savings; Self Efficacy; Series; Site; Statistical Data Interpretation; Substance Use Disorder; Sum; Symptoms; System; Therapeutic Intervention; Time; Training; Training Activity; Unemployment; United States National Institutes of Health; Veterans; Work; acceptability and feasibility; addiction; alcohol use disorder; base; behavior change; buprenorphine treatment; career; clinical center; clinical trial analysis; community reintegration; comparison intervention; craving; design; evidence base; experience; experimental study; falls; field study; high risk; housing instability; improved; innovation; intervention effect; methadone clinic/center; model development; mortality; motivated behavior; non-opioid analgesic; novel; novel strategies; opioid use disorder; overdose risk; person centered; prevent; primary outcome; programs; psychosocial; recruit; research and development; satisfaction; secondary outcome; skills; standard care; standard of care; substance use treatment; therapy design; therapy development; treatment adherence; treatment as usual

The proposed Career Development Award (CDA-2) would support Dr. Victoria Ameral, Clinical Research Psychologist with the VISN 1 New England Mental Illness Research, Education, and Clinical Center (MIRECC) and recent graduate of the VA Interprofessional Advanced Addiction Fellowship, in her goal of becoming an expert in recovery-oriented behavioral interventions for Veterans with Opioid Use Disorder (OUD). Medications for OUD save lives by preventing relapse and overdose, but they do not actively directly address the significant functional challenges for Veterans in early recovery. Adjunctive behavioral interventions hold promise for this area, but existing approaches rarely outperform standard buprenorphine medication management. This may be due to a tendency for early sessions to focus on symptoms (i.e., cravings and urges) that are already addressed by medication treatment. The proposed research seeks to develop a brief, values-based intervention which instead focuses on helping to improve Veterans’ interpersonal functioning and community integration during early treatment. These two recovery-oriented concepts are closely linked to the known functional consequences of OUD and are key predictors of recovery outcomes. The three phases and respective aims for the current proposal cover the activities outlined in Stages 1a and 1b of Rounsaville’s Behavioral Therapy Development Model. Specifically, manual development (Stage 1a) will include stakeholder interviews with Veterans and VA Providers (Aim 1) and an open pilot with a small sample of Veterans to field test the intervention (Aim 2). The final phase of the proposed research will be a pilot randomized controlled trial (RCT) of the intervention compared to standard medication management, the standard of care and most common comparison condition for research with this population (Aim 3), which will provide feasibility and acceptability data for the intervention. These aims will directly support a subsequent RR&D MERIT proposal to conduct a full-scale RCT of the resulting intervention and will also provide invaluable experience for the candidate’s intended long-term career path. The current proposal’s training aims are designed to build on Dr. Ameral’s clinical background in Acceptance and Commitment Therapy (the theoretical foundation for the proposed intervention), experience in translational experimental research, and demonstrated commitment to a VA research career in recovery-oriented addiction. These training aims will be met through a series of formal training experiences together with support and guidance from a mentorship team of highly productive VA researchers with complementary expertise and skills sets. Specifically, the current proposal will address critical knowledge and skills gaps for the candidate in relevant content areas (recovery-oriented research, behavioral intervention development, medications for OUD) and methodological approaches (conducting clinical trials, qualitative methods, statistical analysis for clinical trials), and leadership and professional development to support the proposed research and career plan. In sum, the research and training outlined in the current proposal will position Dr. Ameral to become a leading researcher in the area of recovery-oriented interventions for Veterans with OUD.

拟议的职业发展奖（CDA-2）将支持临床研究的Victoria Ameral博士 VISN 1新英格兰精神疾病研究，教育和临床中心（MIRECC）的心理学家 以及最近毕业于VA跨职业成瘾奖学金的毕业生，她的目标是成为一个 阿片类药物使用障碍退伍军人（OUD）的老兵的行为干预措施（OUD）的专家。药物 因为Oud通过防止继电器和过量来挽救生命，但它们并没有积极直接解决重要的问题 在早期恢复中，退伍军人对退伍军人面临挑战。辅助行为干预对此有望 区域，但是现有方法少于标准的丁丙诺啡药物管理。这可能 由于早期会议倾向于专注于症状（即渴望和冲动） 通过药物治疗解决。拟议的研究试图开发一个简短的，基于价值的 干预措施致力于帮助改善退伍军人的人际关系和社区 早期治疗期间的整合。这两个面向恢复的概念与已知的 OUD的功能后果是恢复结果的关键预测指标。这三个阶段和 当前提案的各个目标涵盖了Rounsaville阶段和1B阶段概述的活动 行为疗法发展模型。具体而言，手动开发（第1A阶段）将包括利益相关者 对退伍军人和VA提供商的访谈（AIM 1）和一个开放的飞行员，并提供了一小部分退伍军人 测试干预措施（AIM 2）。拟议的研究的最后阶段将是一项试点随机对照试验 （RCT）与标准药物管理相比，护理标准和大多数 该人群的研究常见比较条件（AIM 3），这将提供可行性和 干预的可接受性数据。这些目标将直接支持随后的RR＆D优点提案 进行由此产生的干预措施的全面RCT，还将为 候选人的意图长期职业道路。当前的提案的培训目标旨在基于博士。 Ameral的接受和承诺疗法的临床背景（理论基础 拟议的干预措施），翻译实验研究的经验，并证明了对 VA研究职业在面向恢复的成瘾中。这些培训目标将通过一系列正式 培训经验以及高产VA的指导团队的支持和指导 具有完善专业知识和技能的研究人员。具体而言，当前的建议将解决关键 相关内容领域中候选人的知识和技能差距（面向恢复的研究，行为 干预开发，OUD的药物和方法论方法（进行临床试验， 定性方法，临床试验的统计分析）以及领导力和专业发展 支持拟议的研究和职业计划。总而言之，当前概述的研究和培训 提案将使琥珀博士成为以恢复为导向干预措施领域的领先研究人员 对于有Oud的退伍军人。