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.

项目概要 这项以患者为导向的研究职业发展奖 (K23) 的总体目标是 为 Dawn Sugarman 博士提供成为独立专家所需的培训和研究活动 具有使用数字技术增加循证治疗机会的专业知识的研究者 患有阿片类药物使用障碍 (OUD) 的女性该申请概述了一项综合培训和研究计划， 将在专家的指导下为舒格曼博士提供实现其职业目标所需的技能。 物质使用障碍、OUD 和数字健康，Sugarman 博士的培训将重点关注以下关键内容 领域：(1) 数字健康设计和研究（Lisa Marsch 博士和 Kathleen Carroll 博士）；(2) 病因学和 OUD 患者的治疗（Shelly Greenfield 博士和 Roger Weiss 博士）；以及 (3) 统计方法 纵向数据分析（Garrett Fitzmaurice 博士）将通过这三个领域的培训来实现。 教学和应用活动、参加国家会议和机构以及指导会议。 Sugarman 将把培训活动中获得的技能应用到一个研究项目中，该项目的重点是 制定创新策略以增加阿片类药物使用障碍的药物治疗起始时间 (MOUD) 对患有 OUD 的女性来说，MOUD 是有效的，但其利用率却不断上升。 由于阿片类药物过量导致女性死亡，制定可持续战略以吸引和留住女性至关重要 MOUD。患有 OUD 的女性有更多的医疗问题、更严重的功能障碍和更严重的精神问题。 针对药物滥用的女性，已开发出比男性更严重的 OUD 治疗方法。 然而，与药物使用减少和护理连续性增加有关； 由于面对面的交付模式，广泛的使用受到了限制，而且还没有具体说明 此外，还缺乏证明有效的研究。 为解决这一差距，提出了 K23 提案。 研究项目将利用以用户为中心的设计流程来开发一个数字平台，以提供性别平等 满足混合性别环境中患有 OUD 的女性的个性化需求的特殊护理。 中心假设是，针对性别的数字干预将克服面对面交付的障碍 并将增加女性参与 MOUD 的机会。这项研究将解决女性患有这种疾病的治疗方面的关键差距。 OUD 通过以下方式：(1) 为具有 OUD 的女性制定针对性别的数字干预措施 (GSDI)；以及 (2) 开展 一项试点随机对照试验，旨在检验在治疗期间向患有 OUD 的女性提供 GSDI 的可行性 以及 OUD 稳定后立即对 GSDI 对 MOUD 启动的影响进行初步估计。 还将检查这些数据将为未来 R01 进行更大规模的 II 期疗效试验的设计提供信息。 Sugarman 博士的培训和拟议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