Optimized Interventions to Prevent Opioid Use Disorder among Adolescents and Young Adults in the Emergency Department

预防急诊科青少年和年轻人阿片类药物使用障碍的优化干预措施

基本信息

批准号：
10397259
负责人：
Erin E. Bonar
金额：
$ 58.49万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-15 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10397259
关键词：
Accident and Emergency department Administrative Supplement Adolescent and Young Adult Affect African African American Age Analgesics Behavior Therapy Behavioral Caring Clinical Trials Cognitive Data Analyses Development Drug usage Effectiveness Electronic Health Record Electronic Mail Emergency Department patient Enrollment Feeling suicidal Female Fentanyl Funding Future Health Care Visit Health Services Accessibility Health system Healthcare Systems Heroin Heterogeneity Hybrids Individual Infrastructure Integrated Health Care Systems Intervention Interview Life Mediation Mental Depression Modification Morbidity - disease rate Not Hispanic or Latino Opioid Outcome Overdose Participant Patients Periodicity Plant Roots Population Positioning Attribute Prevention Prevention Research Prevention approach Prevention strategy Process Public Health Qualitative Methods Randomized Controlled Trials Recommendation Recruitment Activity Risk Risk Factors Schedule Site Structure Suicide Surveys Technology Time Travel Underrepresented Populations United States National Institutes of Health Visit analog base binge drinking brief intervention coping cost effective diversity and inclusion experience follow-up healing health data illicit opioid implementation facilitation implementation intervention inclusion criteria innovation male meetings mortality motivational enhancement therapy opioid misuse opioid mortality opioid use opioid use disorder outreach patient portal prescription opioid prevent preventive intervention racial disparity recruit reduced substance use risk sharing screening social media telehealth treatment disparity

项目摘要

Project Summary National Survey on Drug Use and Health (NSDUH) data show that past-year prescription opioid use (i.e., pain relievers) in 2019 for older adolescents and young adults (AYAs) was: 19.7% (ages 16-17), 24.8% (ages 18-25), and 28.2% (ages 26-29), whereas past-year opioid misuse (prescription+illicit) rates were: 3.4% (ages 16-17), 5.3% (ages 18-25), and 5.8% (ages 26-29). Thus, use of opioids by AYAs (ages 16-30) is a public health concern requiring scalable and sustainable strategies to prevent opioid misuse and opioid use disorders (OUDs), and prevention approaches implemented in health systems have the potential to alter risk trajectories. In this supplement, “opioid” misuse includes prescription opioids (without a prescription, more than prescribed, or for reasons other than prescribed) and use of illicit opioids (e.g., heroin, fentanyl analogs). This supplement request is directly responsive to NS-21-025 by requesting support to increase participant diversity and inclusion in our ongoing HEAL Prevention Initiative-funded randomized controlled trial (RCT) to technology-driven prevention interventions. The NSDUH data show that past-year prescription opioid use and misuse rates are concerning among Black/African American AYAs. Further, Black/African Americans are historically under-represented in prevention research and clinical trials, but, given racial disparities in OUD treatment access, it is critical to fully engage these populations. Thus, we propose two aims related to our RCT: 1) Increase outreach to enhance inclusion of AYAs who identify as Black/African American, permitting meaningful analyses of moderators (enrolling ~N = 110 additional AYAs), and 2) Enhance inclusion in our implementation aim by conducting in-depth interviews (IDIs) with Black/African American participants after follow-up (N =20) to identify: a) barriers/facilitators to future implementation of interventions for this sub- population, and b) aspects of the recruitment/intervention delivery that were perceived by participants as engaging and/or helpful or recommendations for modifications to increase appeal and helpfulness. Thus, greater involvement of Black/African American AYAs in this RCT will enhance the generalizability and cultural relevance of the interventions for planned dissemination. Qualitative methods will inform vignettes of patient journeys that characterize their experiences (from the Emergency Department touchpoint through intervention delivery) and outcomes for dissemination at HEAL meetings and in our implementation toolkit. By supplementing current efforts, we are poised to have a greater impact on the problem of opioid misuse and OUD through enhanced inclusion of under-represented individuals. Our use of electronic health record- facilitated recruitment and IDIs to inform our implementation toolkit are key innovations that support future integration of our technology-driven prevention interventions in healthcare systems.

项目概要全国药物使用与健康调查 (NSDUH) 数据显示，去年处方阿片类药物的使用 2019 年，老年青少年和年轻人 (AYA) 的药物（即止痛药）比例为：19.7%（16-17 岁）、24.8% （18-25 岁）和 28.2%（26-29 岁），而去年阿片类药物滥用（处方+非法）率为：3.4% （16-17 岁）、5.3%（18-25 岁）和 5.8%（26-29 岁）因此，AYA（16-30 岁）使用阿片类药物的比例较高。公共卫生问题需要可扩展和可持续的战略来防止阿片类药物滥用和使用疾病（OUD）和卫生系统实施的预防方法有可能改变风险在本补充品中，“阿片类药物”滥用包括处方阿片类药物（未经处方，超过处方或非处方原因）以及使用非法阿片类药物（例如海洛因、芬太尼类似物）。补充请求通过请求支持以增加参与者多样性来直接响应 NS-21-025 并纳入我们正在进行的 HEAL Prevention Initiative 资助的随机对照试验 (RCT)，以 NSDUH 数据显示，过去一年处方阿片类药物的使用和黑人/非裔美国人 AYA 的误用率也令人担忧。此外，黑人/非裔美国人的误用率也令人担忧。历史上在预防研究和临床试验中代表性不足，但是考虑到 OUD 中的种族差异因此，我们提出了与我们相关的两个目标。 RCT：1) 扩大外展范围，以增强对黑人/非裔美国人的 AYA 的包容性，并允许对主持人进行有意义的分析（注册 ~N = 110 个额外的 AYA），以及 2) 增强我们的包容性通过对黑人/非裔美国人参与者进行深度访谈 (IDI) 来实现实施目标后续行动（N = 20）以确定： a）未来实施该子干预措施的障碍/促进因素人口，以及 b) 被认为是招募/干预实施的各个方面有吸引力和/或有帮助的或建议修改以增加吸引力和帮助。黑人/非裔美国人 AYA 更多地参与这项 RCT 将增强普遍性和文化性干预措施与计划传播的相关性。定性方法将告知患者的情况。描述他们经历的旅程（从急诊科接触点到干预交付）以及在 HEAL 会议和我们的实施工具包中传播的成果。作为当前努力的补充，我们对阿片类药物滥用问题产生了更大的影响， OUD 通过加强对代表性不足的个人的包容性来实现我们对电子健康记录的使用。促进招聘和 IDI 为我们的实施工具包提供信息是支持未来的关键创新将我们技术驱动的预防干预措施整合到医疗保健系统中。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Including Community Partners in the Development and Adaptation of Intervention Strategies to Prevent Initiation or Escalation of Opioid Misuse.

让社区合作伙伴参与制定和调整干预策略，以防止阿片类药物滥用的发生或升级。

DOI：
发表时间：
2023-10
期刊：
影响因子：
0
作者：
Perry, Rebecca;Elek, Elvira;D'Amico, Elizabeth;Dickerson, Daniel;Komro, Kelli;Walton, Maureen;Razuri, Erin Becker;Yule, Amy M;Skinner, Juli;Pendergrass, Tyra;Larkin, Kaitlyn;Johnson, Carrie;Bonar, Erin E;Oudekerk, Barbara A;Hairgrove, Sara
通讯作者：
Hairgrove, Sara

Optimizing scalable, technology-supported behavioral interventions to prevent opioid misuse among adolescents and young adults in the emergency department: A randomized controlled trial protocol.

优化可扩展的、技术支持的行为干预措施，以防止急诊科青少年和年轻人滥用阿片类药物：随机对照试验方案。

DOI：
发表时间：
2021-09
期刊：
影响因子：
2.2
作者：
Bonar, Erin E;Kidwell, Kelley M;Bohnert, Amy S B;Bourque, Carrie A;Carter, Patrick M;Clark, Sarah J;Glantz, Meyer D;King, Cheryl A;Losman, Eve D;McCabe, Sean Esteban;Philyaw;Prosser, Lisa A;Voepel;Zheng, Kai;Wa
通讯作者：
Wa

Multidisciplinary Strategies for Preventing Opioid Misuse and Escalation by Targeting Mental Health Symptoms and Conditions.

针对心理健康症状和状况，防止阿片类药物滥用和升级的多学科策略。

DOI：
发表时间：
2023-10
期刊：
影响因子：
0
作者：
Yule, Amy M;Fernandes, Claudia;Stormshak, Elizabeth A;Yang, Yang;Shelley, Lillyan;Fiellin, Lynn E;Larkin, Kaitlin;Ridenour, Ty A;Saavedra, Lissette M;Kelleher, Kelly;Feng, Xin;Walton, Maureen A;Bonar, Erin E
通讯作者：
Bonar, Erin E

Leveraging the Full Continuum of Care to Prevent Opioid Use Disorder.

利用全面的连续护理来预防阿片类药物使用障碍。

DOI：
发表时间：
2023-10
期刊：
影响因子：
0
作者：
Cance, J D;Adams, E T;D'Amico, E J;Palimaru, A;Fernandes, C S F;Fiellin, L E;Bonar, E E;Walton, M A;Komro, K A;Knight, D;Knight, K;Rao, V;Youn, S;Saavedra, L;Ridenour, T A;Deeds, B
通讯作者：
Deeds, B

Methodological Strategies for Prospective Harmonization of Studies: Application to 10 Distinct Outcomes Studies of Preventive Interventions Targeting Opioid Misuse.

前瞻性研究协调的方法策略：应用于针对阿片类药物滥用的预防性干预措施的 10 项不同结果研究。

DOI：
发表时间：
2023-10
期刊：
影响因子：
0
作者：
Ridenour, Ty A;Cruden, Gracelyn;Yang, Yang;Bonar, Erin E;Rodriguez, Anthony;Saavedra, Lissette M;Hussong, Andrea M;Walton, Maureen A;Deeds, Bethany;Ford, Jodi L;Knight, Danica K;Haggerty, Kevin P;Stormshak, Elizabeth;Kominsky, Terrence K;Ahr
通讯作者：
Ahr