Reducing Opioid and Other Drug Use in Justice-Involved Emerging Adults using Paraprofessional Coaches (with and without Lived Experience) to Deliver Effective Services in a Non-Treatment Setting

使用辅助专业教练（有或没有生活经验）减少涉及司法的新兴成年人的阿片类药物和其他药物使用，以在非治疗环境中提供有效的服务

• 批准号: 10846139
• 负责人: Tess K. Drazdowski
• 金额: $ 16.92万
• 依托单位: CHESTNUT HEALTH SYSTEMS, INC.
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10846139
• 关键词: Acceleration; Address; Adherence; American; Applied Skills; Belief; Bioethics; Cessation of life; Client; Clinical Psychology; Communities; Complex; Consolidated Framework for Implementation Research; Development; Drops; Drug usage; Education; Educational workshop; Elements; Employment; Epidemic; Ethics; Evidence based practice; Future; Goals; Grant; Health; Health Services; Health Services Research; Improve Access; Individual; Injury; Intervention; Justice; Knowledge; Lead; Measurement; Medical; Mentored Patient-Oriented Research Career Development Award; Mentorship; Methodology; Methods; Monitor; Opiate Addiction; Opioid; Outcome; Performance; Population; Public Health; Qualitative Methods; Qualitative Research; Randomized; Recovery; Reporting; Research; Research Methodology; Research Personnel; Risk Factors; Role; Sampling; Scientific Advances and Accomplishments; Services; Societies; Source; Statistical Methods; Symptoms; System; Testing; Time; Training; Training Activity; Vertebral column; Vocation; Vulnerable Populations; Work; Writing; age group; aged; career; career development; contingency management; cost; criminal behavior; design; developmental psychology; emerging adult; evidence base; experience; high risk; high risk population; human subject protection; implementation science; improved; innovation; intervention delivery; lectures; novel; opioid epidemic; opioid overdose; opioid use; outpatient programs; parole; peer; peer support; premature; probation; programs; randomized, clinical trials; recidivism; reduced substance use; relapse risk; research and development; service programs; service providers; skills; societal costs; statistics; substance use; substance use treatment; success; symposium; unintended pregnancy

PROJECT SUMMARY/ABSTRACT The ultimate goal of this Mentored Patient-Oriented Research Career Development Award (K23) is to develop the applicant into an independent investigator prepared to lead ethical, large-scale, and rigorously designed health services research focused on high-risk emerging adults (EAs; aged 18-25). Specifically, the applicant will focus on improving access to and engagement in evidence-based practices (EBPs) for EAs with opioid and other substance use (SU) and co-occurring justice system (JS) involvement, via use of paraprofessional coaches. The proposed career development and research plan builds on the applicant's prior training in clinical and developmental psychology, EBPs, and SU. Through the proposed training plan, the applicant will: (1) gain direct experience conducting ethical health services research with vulnerable populations; (2) attain knowledge and skills for measurement, methodologies, and the interplay of key developmental outcomes in EAs with opioid and other SU problems; (3) advance expertise in the complex statistical methods required for health services research, including mixed methods research, and (4) facilitate professional development as an independent health services researcher focused on EAs with opioid and other SU problems via extensive training in grant writing, grants management, and development of a health services program of research. Training activities will include formal training and mentorship from a team of experts in the fields of SU, randomized clinical trials, EA peer support, bioethics, justice, implementation, and advanced health services statistical methods; intensive training in conducting ethical research with high-risk populations; coursework and lectures on implementation science, qualitative research methods, statistics, and protection of human subjects; and participation in scientific workshops and conferences. The applicant will apply these skills to pilot research aimed at using paraprofessional coaches to increase engagement and access to EBPs (i.e., contingency management for SU and vocational/educational coaching) for EAs with SU and JS involvement. In partnership with parole and probation, EAs with SU will be randomized to work with paraprofessional coaches either with or without lived experience (i.e., successful SU recovery). Although using peer paraprofessional coaches (those with lived experience) is becoming more popular and supported at the federal level, the outcome of this work on the paraprofessional coaches themselves, especially for EAs, is largely unexplored. The proposed study will use both quantitative and qualitative methods to gain a better understanding of the impacts on both the coaches and their EA clients using the Consolidated Framework for Implementation Research (CFIR). Given the high rates and particularly detrimental effects of SU for EAs with JS involvement, the goals of this project have the potential to address an important and costly public health problem. As SU and poor vocational/educational attainment greatly increases the likelihood of recidivism, innovative strategies to reduce opioid and other SU for EAs is critical, along with understanding the effects on the service providers (i.e., paraprofessional coaches).

项目概要/摘要 这个以患者为导向的研究职业发展奖（K23）的最终目标是发展 申请人成为一名准备领导道德、大规模和严格设计的独立调查员 卫生服务研究重点关注高风险新兴成年人（EA；18-25 岁）。具体而言，申请人将 重点关注改善阿片类药物和其他药物的 EA 获得和参与循证实践 (EBP) 通过使用辅助专业教练，防止药物滥用 (SU) 和同时发生的司法系统 (JS) 的参与。这 拟议的职业发展和研究计划建立在申请人之前的临床和研究培训的基础上 发展心理学、EBP 和 SU。通过拟议的培训计划，申请人将：（1）获得直接 对弱势群体进行道德卫生服务研究的经验； (2) 获得知识并 评估技能、方法以及 EA 与阿片类药物和药物的关键发展成果之间的相互作用 其他 SU 问题； (3) 提高卫生服务所需的复杂统计方法的专业知识 研究，包括混合方法研究，以及（4）促进作为独立的专业发展 卫生服务研究人员通过广泛的拨款培训专注于阿片类药物和其他 SU 问题的 EA 写作、拨款管理和卫生服务研究计划的制定。培训活动将 包括 SU、随机临床试验、EA 领域专家团队的正式培训和指导 同行支持、生物伦理、正义、实施和先进的卫生服务统计方法；密集的 对高危人群进行伦理研究的培训；有关实施的课程作业和讲座 科学、定性研究方法、统计和人类受试者的保护；和参与科学 研讨会和会议。申请人将把这些技能应用于试点研究，旨在利用 辅助专业教练，以提高参与度和获得 EBP（即 SU 的应急管理） 和职业/教育辅导），针对有 SU 和 JS 参与的 EA。与假释和 试用期内，SU 的 EA 将被随机分配到与有或没有生活的辅助专业教练一起工作 经验（即成功的 SU 恢复）。尽管使用同行辅助专业教练（那些在生活中 经验）在联邦层面变得越来越受欢迎和支持，这项工作的成果 辅助职业教练本身，尤其是 EA 的教练，在很大程度上还没有被探索过。拟议的研究将使用 定量和定性方法，以更好地了解对教练和教练的影响 他们的 EA 客户使用实施研究综合框架 (CFIR)。鉴于高利率 特别是 SU 对 JS 参与的 EA 的不利影响，该项目的目标有潜力 解决一个重要且代价高昂的公共卫生问题。由于 SU 和职业/教育程度较差 大大增加了累犯的可能性，减少阿片类药物和其他 EA 的 SU 的创新策略是 至关重要，同时了解对服务提供者（即辅助教练）的影响。