Increasing Women's Engagement in Medication Treatment for Opioid Use Disorder through Digital Intervention

通过数字干预提高妇女对阿片类药物使用障碍药物治疗的参与度

• 批准号: 10651748
• 负责人: Dawn E Sugarman
• 金额: $ 18.75万
• 依托单位: MCLEAN HOSPITAL
• 依托单位国家: 美国
• 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/10651748
• 关键词: Address; Affect; Applied Skills; Area; Caring; Child; Clinical; Continuity of Patient Care; Data; Data Analyses; Development; Dissemination and Implementation; Dropout; Etiology; Evidence based treatment; Fatality rate; Feedback; Future; Gender; Goals; Health Personnel; Hospitals; Individual; Inpatients; Measures; Medical; Mental disorders; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Modeling; Modification; Online Systems; Outcome; Participant; Persons; Pharmaceutical Preparations; Phase; Positioning Attribute; Process; Randomized, Controlled Trials; Recovery; Reporting; Research; Research Activity; Research Personnel; Research Project Grants; Resources; Services; Severities; Statistical Methods; Substance Use Disorder; Testing; Time; Training; Training Activity; Treatment outcome; United States Dept. of Health and Human Services; Vulnerable Populations; Woman; Women' s Health; barrier to care; career; design; digital; digital health; digital intervention; digital platform; digital technology; effective intervention; efficacy trial; evidence base; follow-up; functional disability; improved outcome; innovation; medical schools; meetings; men; mortality; opioid overdose; opioid use disorder; overdose death; physical conditioning; post intervention; programs; prototype; recruit; reduced substance use; satisfaction; skill acquisition; skills; symposium; therapy development; trauma exposure; treatment as usual; user centered design

Project Summary The overarching goal of this Mentored Patient-Oriented Research Career Development Award (K23) is to provide Dr. Dawn Sugarman with the training and research activities needed to become an independent investigator with expertise in using digital technology to increase access to evidence-based treatment for women with opioid use disorder (OUD). This application outlines an integrated training and research plan that will provide Dr. Sugarman with the skills needed to achieve her career goal. Under the mentorship of experts in substance use disorders, OUD, and digital health, Dr. Sugarman’s training will focus on the following key areas: (1) digital health design and research (Drs. Lisa Marsch and Kathleen Carroll); (2) etiology and treatment of individuals with OUD (Drs. Shelly Greenfield and Roger Weiss); and (3) statistical methods for longitudinal data analysis (Dr. Garrett Fitzmaurice). Training in these three areas will be achieved through didactic and applied activities, participation in national conferences and institutes, and mentoring meetings. Dr. Sugarman will apply the skills acquired during the training activities to a research project focused on developing an innovative strategy for increasing initiation in medication treatment for opioid use disorder (MOUD) in women with OUD. Research shows that MOUD is effective but underutilized. With rising rates of fatal opioid overdoses in women, it is critical to develop sustainable strategies to engage and retain women in MOUD. Women with OUD have more medical problems, greater functional impairment, and greater psychiatric severity than men with OUD. Gender-specific treatments have been developed for women with substance use disorders and are associated with reduced substance use and increased continuity of care; however, widespread use has been restricted due to in-person delivery models, and they have not been specifically adapted to target engagement in OUD treatment. Moreover, there is a lack of research demonstrating effective strategies to implement this care for women in mixed-gender settings. To address this gap, the proposed K23 research project will utilize a user-centered design process to develop a digital platform to deliver gender- specific care that addresses the individualized needs of women with OUD in mixed-gender settings. The central hypothesis is that a gender-specific digital intervention will overcome the barriers of in-person delivery and will increase women’s initiation in MOUD. This research will address key gaps in treatment for women with OUD by: (1) developing a gender-specific digital intervention (GSDI) for women with OUD; and (2) conducting a pilot randomized controlled trial to examine the feasibility of delivering the GSDI to women with OUD during and immediately after OUD stabilization. Preliminary estimates on the effect of the GSDI on MOUD initiation will also be examined. These data will inform the design of a larger Stage II efficacy trial for a future R01 application. Dr. Sugarman’s training and proposed research will be carried out at McLean Hospital and Harvard Medical School, which will provide her with a multitude of resources to meet her goals.

项目摘要 这个受过指导的患者研究职业发展奖（K23）的总体目标是 向Dawn Sugarman博士提供成为独立的培训和研究活动 研究人员具有使用数字技术来增加获得基于证据的治疗的专业知识 阿片类药物使用障碍（OUD）的妇女。该应用程序概述了一个集成的培训和研究计划 将为Sugarman博士提供实现职业目标所需的技能。在专家 药物使用障碍，OUD和数字健康状况，Sugarman博士的培训将重点放在以下关键上 区域：（1）数字健康设计与研究（Lisa Marsch和Kathleen Carroll博士）； （2）病因和 对OUD的个人进行治疗（Shelly Greenfield博士和Roger Weiss）； （3）用于的统计方法 纵向数据分析（Garrett Fitzmaurice博士）。这三个领域的培训将通过 教学和应用活动，参加民族会议和机构以及心理会议。博士 Sugarman将把在培训活动期间获得的技能应用于一个专注于的研究项目 制定一种创新策略，以增加阿片类药物使用障碍的药物治疗倡议 （MOUD）在患有Oud的女性中。研究表明，Moud有效但未充分利用。利率上升 妇女致命的阿片类药物过量，制定可持续策略以使妇女参与和保留妇女 穆德。 OUD的女性有更多的医疗问题，更大的功能障碍和更大的精神病学 严重程度比有Oud的男人。为有药物使用的女性开发了特定性别的治疗 疾病，与减少药物使用和增加护理连续性有关；然而， 由于面对面的交付模型，宽度的使用受到限制，而且它们并非专门 适应目标参与OUD治疗。而且，缺乏研究表明有效的研究 在混合性别环境中为妇女实施这种护理的策略。为了解决这一差距，拟议的K23 研究项目将利用以用户为中心的设计过程来开发数字平台来提供性别 - 在混合性别环境中，可以解决妇女的个性化需求的具体护理。这 中心假设是，特定性别的数字干预将克服面对面交付的障碍 并将增加穆德的妇女倡议。这项研究将解决针对女性的关键差距 OUD：（1）为OUD女性开发针对性别的数字干预（GSDI）； （2）进行 一项飞行员随机对照试验，以检查将GSDI交付给患有OUD妇女的可行性 并在稳定后立即。对GSDI对MOUD启动的影响的初步估计 也将被检查。这些数据将为未来R01的更大阶段II阶段有效试验的设计提供信息 应用。 Sugarman博士的培训和拟议的研究将在麦克莱恩医院和哈佛大学进行 医学院将为她提供大量资源来实现她的目标。

项目成果

Alcohol and COVID-19: How Do We Respond to This Growing Public Health Crisis?

• DOI: 10.1007/s11606-020-06321-z
• 发表时间: 2021-01
• 期刊: Journal of general internal medicine
• 影响因子: 5.7
• 作者: Sugarman DE;Greenfield SF
• 通讯作者: Greenfield SF

Exploring Technology-Based Enhancements to Inpatient and Residential Treatment for Young Adult Women with Co-Occurring Substance Use.

• DOI: 10.1080/15504263.2021.1940412
• 发表时间: 2021-07
• 期刊: Journal of dual diagnosis
• 影响因子: 2.2
• 作者: Sugarman DE;Meyer LE;Reilly ME;Rauch SL;Greenfield SF
• 通讯作者: Greenfield SF

Gender differences in the prevalence of heroin and opioid analgesic misuse in the United States, 2015-2019.

• DOI: 10.1016/j.drugalcdep.2021.108978
• 发表时间: 2021-10-01
• 期刊: Drug and alcohol dependence
• 影响因子: 4.2
• 作者: McHugh RK;Nguyen MD;Chartoff EH;Sugarman DE;Greenfield SF
• 通讯作者: Greenfield SF

Telemedicine for treating mental health and substance use disorders: reflections since the pandemic.

• DOI: 10.1038/s41386-021-00960-4
• 发表时间: 2021-05
• 期刊: Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology
• 作者: Busch AB;Sugarman DE;Horvitz LE;Greenfield SF
• 通讯作者: Greenfield SF

Patients' perceptions of telehealth services for outpatient treatment of substance use disorders during the COVID-19 pandemic.

• DOI: 10.1111/ajad.13207
• 发表时间: 2021-09
• 期刊: The American journal on addictions
• 作者: Sugarman DE;Busch AB;McHugh RK;Bogunovic OJ;Trinh CD;Weiss RD;Greenfield SF
• 通讯作者: Greenfield SF