Increasing Referrals to Medications for Opioid Use Disorders from Drug Treatment Courts using Organizational Linkage Intervention

使用组织联系干预增加戒毒法庭对阿片类药物使用障碍药物的转诊

• 批准号: 10513740
• 负责人: Ekaterina Pivovarova
• 金额: $ 5.4万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-11-15 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10513740
• 关键词: Address; Administrative Supplement; Adoption; Cause of Death; Characteristics; Collaborations; Communication; Communities; Consolidated Framework for Implementation Research; Data; Data Analyses; Data Collection; Development; Drug Courts; Drug abuse; Drug usage; Enrollment; Environment; Evaluation; Evidence based practice; Focus Groups; Funding; Goals; Gold; Grant; Health Services; Health Services Accessibility; Imprisonment; Individual; Intention; Intervention; Interview; Justice; Knowledge; Lead; Legal; Manuals; Massachusetts; Maternity leave; Mentored Patient-Oriented Research Career Development Award; Mentorship; Methods; Monitor; National Institute of Drug Abuse; Opioid; Overdose; Overdose reduction; Participant; Perception; Persons; Pharmaceutical Preparations; Pharmacotherapy; Pilot Projects; Population; Populations at Risk; Practice Guidelines; Preparation; Procedures; Process; Provider; Public Health; Randomized Clinical Trials; Randomized Controlled Trials; Readiness; Recovery; Research; Research Personnel; Research Training; Resources; Scientist; Services; Site; Structure; Substance Use Disorder; Supervision; Surveys; System; Time; Training; Work; acceptability and feasibility; addiction; archive data; archived data; base; court; design; drug standard; efficacy evaluation; evidence based guidelines; experience; high risk; high risk population; implementation barriers; implementation evaluation; implementation science; implementation strategy; improved; medication-assisted treatment; offender; opioid epidemic; opioid overdose; opioid use; opioid use disorder; parole; post implementation; preference; probation; probationer; programs; skills; standard care; theories

PROJECT SUMMARY/ABSTRACT This supplement is intended to offset delays in Dr. Pivovarova’s K23 (DA049953) pilot study and training associated with her maternity leave from 09/01/2020 to 12/01/2020. The supplemental funds will be used towards hiring a .6 FTE research coordinator to assist Dr. Pivovarova with data collection, analysis, dissemination of findings, and preparation for R01 grant submission in Year 3 of her K23. Dr. Pivovarova’s K23 award is designed to obtain training and pilot data necessary to conduct independent research in applying implementation science to increase access to empirically based substance use disorder (SUD) treatments for justice involved individuals. Opioid-related drug overdose is a leading cause of death for individuals with justice involvement. Yet, most individuals in the justice system fail to receive the gold standard treatment for opioid use disorder – medications for opioid use disorder (MOUDs). Drug treatment courts (DTC) are diversionary programs that leverage legal sanctions in exchange for mandatory and court-monitored engagement in SUD treatment. There are over 3,100 DTC programs nationwide that manage thousands of offenders in the community with SUDs. Despite their focus on addiction treatment, DTCs have been slow to incorporate MOUDs. Systemic barriers to use of MOUD in DTCs have been well documented and include poor communication and lack of collaboration with MOUD providers in the community. The proposed study directly addresses barriers in communication and referral practices between DTC and community MOUD providers by adapting an implementation strategy, which has been previously shown as effective in community corrections programs. The Medication for Opioid Use Disorders Implementation – in Drug Treatment Courts (MOUDI-DTC) is an implementation strategy that aims to improve interagency relationships and increase access to MOUDs for high-risk individuals. Using the Consolidated Framework for Implementation Research (CFIR), a mixed-methods study is being conducted to achieve these specific aims: 1) evaluate current MOUD referral practices, barriers, facilitators, and readiness for change 2) develop MOUDI- DTC implementation strategy and manual, 3) implement MOUDI-DTC for 12 months in three DTCs and evaluate efficacy, acceptance and feasibility of the implementation strategy. The findings will provide preliminary data about efficacy of MOUDI-DTC on increasing referrals and acceptability and feasibility of MOUDI-DTCs to ultimate expand and evaluate the strategy nationwide. The findings will also provide pilot data for developing an R01 randomized clinical trial to compare MOUDI-DTC to referral practices as usual in DTCs. More broadly, this research will lead to development of best-practice guidelines about how DTCs should work with MOUD community providers to increase access to care and referrals to MOUDs. Completing this study will serve as one component of a rigorous training plan for Dr. Pivovarova to receive directed training in 1) implementation science, 2) MOUD, and 3) organizational theory and systems level intervention. Alongside this, Dr. Pivovarova is receiving mentorship from leading addictions, health services, and implementation science researchers.

项目概要/摘要 本补充材料旨在弥补 Pivovarova 博士 K23 (DA049953) 试点研究和培训的延误 与她从 09/01/2020 到 12/01/2020 的产假相关的补充资金将用于 聘请 .6 FTE 研究协调员协助 Pivovarova 博士收集、分析和传播 Pivovarova 博士的 K23 奖项的第三年的 R01 拨款申请的准备工作。 获得应用实施科学进行独立研究所需的培训和试点数据 增加对涉及正义的个人获得基于经验的药物使用障碍（SUD）治疗的机会。 与阿片类药物相关的药物过量是导致司法参与的个人死亡的主要原因。 司法系统中的个人未能接受阿片类药物使用障碍的黄金标准治疗——药物治疗 阿片类药物使用障碍 (MOUD) 药物治疗法庭 (DTC) 是利用法律的转移计划。 制裁以换取强制性和法庭监督的 SUD 待遇。有 3,100 多个。 全国范围内的 DTC 计划尽管重点突出，但仍使用 SUD 管理社区中的数千名罪犯。 在成瘾治疗方面，DTC 将 MOUD 纳入 DTC 的系统性障碍。 已得到充分记录，包括与 MOUD 提供商的沟通不畅和缺乏合作 拟议的研究直接解决了社区之间沟通和转介实践中的障碍。 DTC 和社区 MOUD 提供商通过调整实施策略（之前已展示） 在社区惩戒计划中同样有效。阿片类药物使用障碍药物实施 - 中 戒毒法庭（MOUDI-DTC）是一项旨在改善机构间协作的实施战略 关系并增加高风险个体获得 MOUD 的机会。 实施研究 (CFIR) 是一项混合方法研究，旨在实现以下具体目标：1) 评估当前 MOUD 转介实践、障碍、促进因素和变革准备情况 2) 制定 MOUD- DTC实施策略和手册，3）在三个DTC中实施MOUDI-DTC 12个月并评估 实施战略的有效性、接受度和可行性。调查结果将提供初步数据。 关于 MOUDI-DTC 在增加转诊以及 MOUDI-DTC 最终的可接受性和可行性方面的功效 该研究结果还将为开发 R01 提供试点数据。 比较 MOUDI-DTC 与 DTC 中通常的转诊实践的随机临床试验。 研究将导致制定关于 DTC 如何与 MOUD 合作的最佳实践指南 社区提供者增加获得护理和转介至 MOUD 的机会将作为一项研究。 Pivovarova 博士接受 1) 实施科学方面的定向培训的严格培训计划的一部分， 2) MOUD，以及 3) 组织理论和系统层面的干预，Pivovarova 博士正在接受。 来自领先的成瘾、卫生服务和实施科学研究人员的指导。

项目成果

Massachusetts Justice Community Opioid Innovation Network (MassJCOIN).

• DOI: 10.1016/j.jsat.2021.108275
• 发表时间: 2021-09
• 期刊: Journal of substance abuse treatment
• 影响因子: 3.9
• 作者: Evans EA;Stopka TJ;Pivovarova E;Murphy SM;Taxman FS;Ferguson WJ;Bernson D;Santelices C;McCollister KE;Hoskinson R Jr;Lincoln T;Friedmann PD;MassJCOIN Research Group
• 通讯作者: MassJCOIN Research Group

Experiences of Court Clinicians Who Perform Civil Commitment Evaluations for Substance Use Disorders.

• DOI: 10.29158/jaapl.200061-20
• 发表时间: 2021-06
• 期刊: JOURNAL OF THE AMERICAN ACADEMY OF PSYCHIATRY AND THE LAW
• 影响因子: 2.7
• 作者: Christopher, Paul P.;Pridgen, Bailey E.;Pivovarova, Ekaterina
• 通讯作者: Pivovarova, Ekaterina

Impact of extended release naltrexone on health-related quality of life in individuals with legal involvement and opioid use disorders.

• DOI: 10.1080/08897077.2020.1809603
• 发表时间: 2021
• 期刊: SUBSTANCE ABUSE
• 影响因子: 3.5
• 作者: Pivovarova, Ekaterina;Min, Hye Sung;Friedmann, Peter D.
• 通讯作者: Friedmann, Peter D.

Uncommon and preventable: Perceptions of diversion of medication for opioid use disorder in jail.

• DOI: 10.1016/j.jsat.2022.108746
• 发表时间: 2022-07
• 期刊: JOURNAL OF SUBSTANCE ABUSE TREATMENT
• 影响因子: 3.9
• 作者: Evans, Elizabeth A.;Pivovarova, Ekaterina;Stopka, Thomas J.;Santelices, Claudia;Ferguson, Warren J.;Friedmann, Peter D.
• 通讯作者: Friedmann, Peter D.

Medication for opioid use disorder treatment continuity post-release from jail: A qualitative study with community-based treatment providers.

• DOI: 10.1016/j.drugpo.2022.103803
• 发表时间: 2022-12
• 期刊: INTERNATIONAL JOURNAL OF DRUG POLICY
• 影响因子: 4.4
• 作者: Stopka, Thomas J;Rottapel, Rebecca E;Ferguson, Warren J;Pivovarova, Ekaterina;Toro-Mejias, Lizbeth Del;Friedmann, Peter D;Evans, Elizabeth A
• 通讯作者: Evans, Elizabeth A