Intergenerational effects of America's opioid crisis: Parental drug use and offspring health

美国阿片类药物危机的代际影响：父母吸毒与后代健康

基本信息

批准号：
10192692
负责人：
Angelica Meinhofer
金额：
$ 17.95万
依托单位：
WEILL MEDICAL COLL OF CORNELL UNIV
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-01 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10192692
关键词：
Address Adolescence Adolescent Behavior Adult Affect Age Algorithms Americas Angelica Behavioral Biostatistical Methods Birth Caring Case Management Cessation of life Characteristics Child Child Care Child Health Child Health Services Child Welfare Childhood Chronic Cohort Studies Communicable Diseases Country Data Data Linkages Data Set Development Domestic Violence Drug usage Early Intervention Economic Policy Educational workshop Elderly Epidemiologic Methods Epidemiology Evaluation Exhibits Exposure to Family Foundations Funding Goals Health Health system Imprisonment Injury Institutionalization Interdisciplinary Study Knowledge Lead Life Life Cycle Stages Light Link Literature Longitudinal Studies Medicaid Mental Health Mental disorders Mentored Research Scientist Development Award Mentors Mentorship Methods Morbidity - disease rate Mothers Nature Neonatal Abstinence Syndrome Newborn Infant Opioid Outcome Overdose Parents Pharmaceutical Preparations Poisoning Policies Population Study Pregnancy Pregnant Women Prevention Problem behavior Process Provider Research Research Design Research Personnel Residential Treatment Resources Sampling Scoring Method Services Survival Analysis System Time Training Training Activity Transportation Trauma United States Vulnerable Populations adverse childhood events algorithm training behavioral health care outcomes career child services clinical practice complex data data management design development policy early childhood early life adversity early life exposure early onset experience fetal foster care health care service utilization health economics heroin use illicit opioid improved in utero indexing intergenerational maltreatment middle childhood mortality multilevel analysis neonatal health offspring opioid epidemic opioid exposure opioid use opioid use disorder pediatric trauma perinatal period physical conditioning population based prenatal exposure prescription opioid prescription opioid misuse programs screening skills socioeconomics substance abuse treatment substance use theories traumatic event

项目摘要

PROJECT SUMMARY/ABSTRACT The burden of America's opioid crisis has heavily fallen on children, a vulnerable population increasingly exposed to opioids in utero or childhood through parental opioid use (POU). POU exposure in utero may lead to a newborn experiencing neonatal opioid withdrawal syndrome, while POU exposure in childhood may lead to a child experiencing maltreatment and family separation due to parental drug overdose mortality, parental institutionalization, or foster care placement. Life course theory postulates that early life adversity, especially in utero and early childhood, may lead to lifelong physical and mental health, substance use, behavioral, and socioeconomic problems. This K01 Mentored Research Scientist Development Award application proposes a training and research plan that will support Dr. Angélica Meinhofer on a path towards independence, focused on elucidating the impact of exposure to POU in early life (in utero up to age 8) on mental health disorders, chronic conditions, infectious diseases, injuries, and healthcare utilization in early and middle childhood. The training plan supplements Dr. Meinhofer's prior expertise in opioid use disorders, health economics, and policy evaluation with training in (1) child health with a life course perspective, (2) behavioral health systems and services for children and families, (3) epidemiology and biostatistics methods, and (4) complex data management and linkage algorithms. Dr. Meinhofer will achieve the proposed training objectives with a combination of formal coursework, workshops, and hands-on experience, as well as the mentorship of Dr. Bruce Schackman, Dr. Yuhua Bao, Dr. Katherine Keyes, and Dr. Rachel Dunifon. Drawing from the Medicaid Analytic eXtract (MAX) linked with other datasets and combining a longitudinal, population-based study design with difference-in-differences and propensity score methods, Dr. Meinhofer will use the knowledge and skills acquired through these training activities to achieve the following aims: (1) Estimate the association between exposure to opioids in utero and physical and mental health, and healthcare utilization in early childhood; (2) Estimate the association between exposure to parental drug overdose mortality in early childhood and physical and mental health, injuries, and healthcare utilization in early and middle childhood; and (3) Estimate the association between exposure to parental opioid use disorders medication treatment in early childhood and physical and mental health, injuries, and healthcare utilization in early and middle childhood. Understanding how early life exposure to POU may affect offspring outcomes over the life course provides a strong foundation upon which clinicians and policymakers can design a more proactive, coordinated, family-centered, and overall more effective agenda. The proposed K01 Award will provide Dr. Meinhofer with the resources, training, and mentoring needed to become an R01-funded independent investigator leading a multidisciplinary research program to inform policies for improving the wellbeing of children and families affected by parental substance use.

项目摘要/摘要美国阿片类药物危机的伯恩（Burnen）严重落在了儿童身上，这是一个脆弱的人口通过父母阿片类药物（POU）暴露于子宫或童年时期的阿片类药物。子宫内的POU暴露可能会导致对于新生儿，经历了新生儿阿片类药物戒断综合征，而童年时期的POU可能会导致由于父母药物过量死亡率而导致虐待和家庭分离的儿童，父母制度化或寄养护理位置。生活课程理论假定了早期的生命冒险，尤其是在子宫和幼儿时代可能会导致终身身心健康，物质使用，行为和社会经济问题。该K01指导研究科学家发展奖申请提案培训和研究计划将支持AngélicaMeinhofer博士迈向独立的道路，重点在阐明早期暴露于POU（8岁以下的子宫内）对心理健康障碍的影响时，早期和中期的慢性病，传染病，受伤和医疗保健利用。培训计划补充了Meinhofer博士在阿片类药物使用障碍，健康经济学和政策方面的先前专业知识通过（1）儿童健康培训的评估，具有生命课程的观点，（2）行为卫生系统和儿童和家庭的服务，（3）流行病学和生物统计学方法，以及（4）复杂数据管理和链接算法。 Meinhofer博士将实现拟议的培训目标正式课程，讲习班和动手经验以及博士的心态的结合布鲁斯·沙克曼（Bruce Schackman），尤胡·鲍（Yuhua Bao）博士，凯瑟琳·凯斯（Katherine Keyes）博士和雷切尔·邓菲恩（Rachel Dunifon）博士。从医疗补助分析提取物（MAX）与其他数据集链接并结合了基于人群的研究具有差异差异和可靠性得分方法的设计，Meinhofer博士将使用知识和通过这些培训活动获得的技能以实现以下目的：（1）估计协会在子宫内接触阿片类药物与身体和心理健康的暴露与早期的医疗保健利用之间童年; （2）估计早期暴露于父母药物过量死亡率之间的关联童年，身体健康，伤害以及早期和中期的医疗保健利用；（3）估计暴露于父母阿片类药物使用障碍药物治疗之间的关联幼儿期以及早期和中期的身体健康，伤害以及医疗保健利用童年。了解早期对POU的早期暴露会如何影响生活过程中的后代结果为临床医生和政策制定者可以设计更积极的基础，为此提供了坚实的基础以家庭为中心，总体上更有效的议程。拟议的K01奖将为博士提供。拥有资源，培训和心理的Meinhofer需要成为R01资助的独立领导多学科研究计划的研究人员为改善福祉的政策提供了信息受父母用途影响的儿童和家庭。