Adapting and Implementing a Chronic Disease Self-Management Program for Primary Care Patients with Opioid Use Disorder and Serious Mental Illness

针对患有阿片类药物使用障碍和严重精神疾病的初级保健患者调整和实施慢性病自我管理计划

• 批准号: 10785110
• 负责人: Elizabeth Siantz
• 金额: $ 18.66万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10785110
• 关键词: Address; Adoption; Adult; Area; Behavior; Buprenorphine; Caring; Chronic Disease; Clinic; Clinical; Clinical Investigator; Clinical Trials; Clinical Trials Design; Communities; Complex; Disease; Disease Management; Dissemination and Implementation; Doctor of Philosophy; Education; Educational Intervention; Environment; Ethnography; Evidence based treatment; Feasibility Studies; Formulation; Foundations; Future; Goals; Health; Health education; Helping to End Addiction Long-term; Hybrids; Improve Access; Intervention; Interview; Leadership; Mental Health Associations; Mental Health Services; Mentored Research Scientist Development Award; Mentors; Methods; Naltrexone; Outcome; Participant; Patient Education; Patients; Persons; Pharmaceutical Preparations; Pilot Projects; Population; Positioning Attribute; Primary Care; Procedures; Process; Provider; Qualitative Evaluations; Quality of Care; Randomized; Reporting; Research; Research Personnel; Resources; Science; Scientist; Self Management; Services; Site; Social Workers; Statistical Data Interpretation; Symptoms; Testing; Time; Training; Training Activity; United States National Institutes of Health; acceptability and feasibility; addiction; career; career development; contextual factors; design; education resources; effectiveness study; ethnographic method; evidence base; experience; feasibility testing; gaps in access; gender diversity; gender equity; health related quality of life; high risk; implementation barriers; implementation context; implementation evaluation; implementation facilitators; implementation intervention; implementation process; implementation research; implementation science; improved; innovation; medication for opioid use disorder; mortality; novel; opioid epidemic; opioid overdose; opioid use disorder; patient population; peer; physical conditioning; primary care clinic; primary care patient; primary care provider; primary care services; primary care setting; programs; randomized trial; satisfaction; self-management program; severe mental illness; skill acquisition; skills; social health determinants; social vulnerability; systematic review; tool; treatment as usual

This K01 award application is for Dr. Elizabeth Siantz, a PhD-trained social worker whose overarching career goal is to become an independent clinical investigator who uses implementation science to promote the adoption and integration of evidence-based Chronic Disease Self-Management programs for persons with chronic disease, primarily opioid use disorder (OUD) and serious mental illness (SMI). This K01 will support four key areas of career development: 1) intervention adaptation as it relates to the mental health and primary care needs of persons with OUD; 2) training in clinical trial design and management in real-world settings; 3) advanced skills for qualitatively evaluating intervention implementation; and 4) strengthening research leadership with a focus on gender equity and diversity in science. Dr. Siantz has assembled an interdisciplinary mentoring team comprised of Adam Gordon, MD (Primary Mentor), who is an expert dissemination and implementation (D&I) researcher focused on improving quality of care to vulnerable patient populations with OUD; and Leopoldo Cabassa, PhD, MSW (co-mentor), an expert mixed-methods D&I researcher focused on promoting the physical health of persons with SMI. Additional advisors include: Gerald Cochran, PhD, MSW, a clinical trialist with OUD expertise; Lawrence Palinkas, PhD, an expert in mixed-method designs for D&I research; Angela Presson, PhD, an expert in clinical trials statistical analyses; and Angela Fagerlin, PhD, an expert in patient decision support interventions and in gender equity and diversity in research leadership. People with OUD have a high co-occurrence of serious mental illness (SMI) and other chronic diseases, and are often challenged by their clinical symptoms and social vulnerabilities. While primary care settings frequently treat patients with OUD and SMI, primary care providers have few tools to support this population in self-managing these complex health conditions. Chronic Disease Self-Management programs (CDSMPs) can improve disease management skills and behaviors, but have not been adapted for primary care patients with OUD and SMI. Un-adapted versions might lack relevance to this population and setting. Dr. Siantz will address this implementation gap. This research will support a future hybrid-effectiveness study to test the adapted CDSMP for primary care patients with OUD and SMI. This study’s Specific Aims include: 1) Adapt the CDSMP for adults with OUD and SMI for implementation in a primary care setting using the Collaborative Intervention Planning Framework; 2) Test the feasibility, acceptability, and initial impact of the adapted CDSMP for persons with SMI and OUD in a primary care setting; and 3) Evaluate implementation process and context of the adapted CDSMP using Rapid Assessment Method Informed Clinical Ethnography. This proposed research is significant because it will develop a health education resource for a population at high risk for early mortality. The proposed research is innovative because it will extend an existing CDSMP to a new patient population (persons with OUD and SMI) and novel setting (primary care).

本 K01 奖申请对象为 Elizabeth Siantz 博士，她是一名受过博士学位培训的社会工作者，其总体工作包括： 职业目标是成为一名独立的临床研究者，利用实施科学来促进 为患有慢性病的人采用和整合基于证据的慢性病自我管理计划 慢性疾病，主要是阿片类药物使用障碍 (OUD) 和严重精神疾病 (SMI) 此 K01 将支持。 职业发展的四个关键领域：1）干预适应，因为它与心理健康和初级教育有关 OUD 患者的护理需求；2) 现实环境中的临床试验设计和管理培训； 定性评估干预实施情况的高级技能；4) 加强研究 Siantz 博士组建了一个跨学科的领导团队，专注于科学领域的性别平等和多样性。 指导团队由医学博士 Adam Gordon（首席导师）组成，他是一位传播和传播专家 实施（D＆I）研究人员致力于提高弱势患者群体的护理质量 OUD；以及 Leopoldo Cabassa，博士，MSW（共同导师），一位专注于 D&I 的混合方法专家研究员 促进 SMI 患者的身体健康 其他顾问包括：Gerald Cochran，博士，MSW，a 具有 OUD 专业知识的临床试验师 Lawrence Palinkas 博士，D&I 混合方法设计专家； 研究；Angela Presson 博士，临床试验统计分析专家；Angela Fagerlin 博士，临床试验统计分析专家； 患者公平决策支持干预措施以及研究领导力的性别和多样性方面的专家。 OUD 患者同时患有严重精神疾病 (SMI) 和其他慢性疾病的几率很高 疾病，并经常受到其临床症状和社会脆弱性的挑战。 虽然医疗机构经常治疗 OUD 和 SMI 患者，但初级保健提供者几乎没有工具来支持这一点 人口自我管理这些复杂的健康状况。 （CDSMP）可以提高疾病管理技能和行为，但尚未适用于初级保健 患有 OUD 和 SMI 的患者可能与该人群和环境缺乏相关性。 Siantz 将解决这一差距实施问题，该研究将支持未来的混合有效性研究。 测试针对 OUD 和 SMI 初级保健患者的改编后的 CDSMP 本研究的具体目标包括：1) 使用 OUD 和 SMI 成人的 CDSMP 进行调整，以便在初级保健机构中实施 协作干预规划框架；2）测试可行性、可接受性和初步影响 为初级保健机构中的 SMI 和 OUD 患者调整 CDSMP；以及 3) 评估实施情况； 使用快速评估方法知情临床民族志改编的 CDSMP 的过程和背景。 这项拟议的研究意义重大，因为它将为以下地区的人口开发健康教育资源： 拟议的研究具有创新性，因为它将现有的 CDSMP 扩展到 新的患者群体（OUD 和 SMI 患者）和新的环境（初级保健）。