The Daily Progress System - A Recovery Support Tool to Reduce Health Disparities in Outpatient Substance Use Treatment

每日进度系统 - 一种恢复支持工具，可减少门诊药物使用治疗中的健康差异

• 批准号: 9901091
• 负责人: Steven Bernard Carswell
• 金额: $ 22.5万
• 依托单位: COG ANALYTICS, LLC
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-24 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9901091
• 关键词: 12 year old; Abstinence; Adult; Affect; African American; Alcohol or Other Drugs use; Ambulatory Care; Appointment; Asians; Baltimore; Caring; Cessation of life; Client; Clinical; Clinical Services; Collaborations; Communities; Computer software; Counseling; Criminal Justice; Data; Development; Dropout; Drug usage; Economics; Face; Family; Federally Qualified Health Center; Feedback; Focus Groups; General Population; Health; Health Insurance Portability and Accountability Act; Health Personnel; Healthcare; High Prevalence; Hispanics; Individual; Low income; Mental Health; Modality; Moods; Motivation; Notification; Online Systems; Outcome; Outpatients; Pharmacotherapy; Phase; Population; Process; Professional counselor; Public Health; Quality of Care; Questionnaires; Recording of previous events; Recovery; Relapse; Reporting; Research; Risk; Risk Factors; Sampling; Secure; Small Business Technology Transfer Research; Structure; Substance Use Disorder; Summary Reports; Supervision; Surveys; System; Systems Development; Technology; Testing; Therapeutic; Time; Treatment outcome; addiction; base; care outcomes; craving; design; ethnic minority population; experience; feasibility trial; health disparity; improved; inner city; innovation; innovative technologies; novel; opioid use disorder; parole; physical conditioning; premature; probation; probationer; product development; protective factors; prototype; psychosocial; racial and ethnic; reduced substance use; relapse risk; service delivery; societal costs; support tools; treatment center; treatment services; usability; web app; week trial

ABSTRACT Substance use disorders (SUDs), including opioid use disorders, continue to be one of the most serious public health issues in the US,1 leading to negative physical and mental health problems, family disruption, and premature death.2-4 African Americans with drug use histories that are under criminal justice supervision are particularly vulnerable to experiencing the negative consequences associated with SUDs due to higher levels of economic hardship.4 Outpatient treatment delivered in community-based settings is the dominant modality for SUD treatment, typically involving weekly psychosocial counseling sessions in an individual and/or group format.5,6 Longer retention in treatment is associated with better outcomes including reductions in substance use, mental health problems, and societal costs.7-10 Unfortunately, less than half of those individuals who initiate treatment successfully complete it. 6,50-52 African Americans in particular have lower treatment retention and completion rates as compared to Whites,11,12 constituting an ongoing risk for relapse and escalating substance use.6,13,14 One potential way to improve engagement and retention in substance use treatment involves ongoing client and counselor feedback during treatment. The structure of outpatient treatment typically involves intermittent clinical contact between client and counselor, generally on a weekly basis, and often in a group- based format, leaving clinicians with a deficit of information regarding client progress between weekly treatment sessions. Recent addiction research suggests that obtaining information from clients between weekly treatment sessions could provide counselors with valuable and timely data regarding client treatment needs, potentially enhancing their ability to deliver quality care and client-centered treatment, and improving treatment engagement and retention, and perhaps abstinence outcomes.15,16 The Daily Progress System (DPS) is a mobile-friendly, web-based software application designed to improve treatment engagement and retention and reduce therapeutic information deficits. The DPS will provide appointment reminder notifications and collect risk and protective factor information from clients in addiction treatment on a daily basis. Prior to clients’ weekly counseling sessions, the DPS will generate a brief, one-page weekly summary report for counselors and clients that will summarize client daily report information, which can be used to improve the delivery of group- and individual-based treatment services. By improving client engagement and retention in treatment, this innovative technology has great potential to reduce health disparities regarding substance use treatment outcomes that affect one of the most vulnerable segments of the population (i.e., African Americans with drug use histories under criminal justice supervision). Given the continued public health crisis of SUDs, including opioid use disorders, technologies to enhance engagement and retention in treatment are urgently needed. If proven efficacious, the DPS could be deployed across the growing national network of outpatient substance use treatment providers, and health care centers that provide substance use treatment, to enhance quality care and improve client outcomes, potentially having high public health impact.

抽象的 药物使用障碍（SUD），包括阿片类药物使用障碍，仍然是最严重的一种 美国的公共卫生问题，1导致负面的身心健康问题，家庭中断以及 早死亡。2-4非洲裔美国人有毒品使用历史，在刑事司法监督下 特别容易受到较高水平引起的与SUD相关的负面后果 经济困难。4在社区环境中提供的门诊治疗是主要方式 用于SUD治疗，通常涉及个人和/或组中的每周社会心理咨询会议 格式。5,6治疗中的长期保留与更好的结果有关，包括降低底物 使用，心理健康问题和社会成本。不幸的是，不到一半的人 启动治疗成功完成。 6,50-52个非洲裔美国人的治疗保留率较低 与白人相比，有11,12个构成了持续的救济风险和升级的风险 物质使用。6,13,14 提高参与度和保留物质使用治疗的一种潜在方法是持续 客户和辅导员在治疗期间的反馈。门诊治疗的结构通常涉及 一般每周，通常在一个小组中，客户与辅导员之间的间歇性临床接触 基于格式，使临床医生为客户提供有关客户进度的信息的辩护 治疗课程。最近的成瘾研究表明，从客户之间获取信息 每周的治疗课程可以提供有关客户治疗的宝贵和及时数据 需求，有可能增强他们提供优质护理和以客户为中心的治疗的能力，并提高 治疗参与和保留率，并可能戒酒结果。15,16 每日进度系统（DPS）是一个旨在移动的，基于网络的软件应用程序 改善治疗参与和保留率，并减少治疗信息缺陷。 DPS将提供 预约提醒通知并从成瘾中的客户那里收集风险和保护因素信息 每天进行治疗。在客户每周咨询会议之前，DPS将产生简短的一页 计数和客户的每周摘要报告，这些报告将摘要客户每日报告信息，可以 用于改善基于组和个体的治疗服务的交付。通过改善客户 参与和保留治疗，这种创新技术具有降低健康的巨大潜力 有关药物使用治疗结果的差异，影响了最脆弱的部分之一 人口（即在刑事司法监督下使用毒品使用历史的非裔美国人）。鉴于 苏德邦的持续公共卫生危机，包括阿片类药物使用障碍，技术以增强参与度 迫切需要保留治疗。如果经过证实的有效效率，DP可以在 不断发展的国家门诊物质使用治疗提供者和提供的医疗保健中心的国家网络 药物使用治疗，以增强优质护理并改善客户的成果，有可能拥有高公众 健康影响。