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.

项目概要 阿片类药物的流行已导致广泛的、令人困扰的公共卫生后果，并且不成比例地 影响，高危人群包括孕妇和产后妇女（PPW）及其婴儿。 拥有 OUD 的人还面临着高度的自我耻辱——由于以下原因而对自己产生负面情绪的内化 药物滥用与包括康复在内的许多有害后果高度相关。 此外，自我耻辱阻碍了治疗。 PPW 与 OUD 之间的启动和参与，导致双方产生额外的不良健康后果 数字干预有可能支持 PPW 的健康行为。 OUD 也可能提供一种有前途的方法来减少他们的自我耻辱是一种数字化。 旨在促进对 OUD 药物治疗的依从性和治疗保留的干预 考虑到 PPW 的独​​特需求，但目前缺乏减少自我污名化的功能。 我们将通过以耻辱为中心的生态瞬时干预 (EMI) 来增强 Enhearten，旨在：1) 筛查耻辱感，2) 通过及时干预来消除这些漏洞。 在第一阶段，我们将调整 Enhearten 以包含新的 EMI 功能，并使用 Discover 完善该工具， 设计/构建和测试 (DDBT) 框架，以确保减少弱势群体的自我耻辱 在第二阶段开始时，我们将进行额外的 DDBT 周期，以 进一步提高我们的 EMI 的可用性和有效性 然后，我们将进行个人级别的多中心。 随机对照试验，测试 Enhearten 在减少自我伤害方面的可行性、可接受性和功效 耻辱和提高治疗依从性将从各个诊所进行招募。 专门使用 OUD 治疗 PPW 的 Midwest 将成为使用 OUD 治疗 PPW 的宝贵工具。 补充传统的面对面护理，减少自我耻辱，并支持持续的激励和 在康复过程中遵守治疗计划。