Investigating Maternal Opioid Use, Neonatal Abstinence Syndrome and Response in NW Tribal Communities

调查西北部落社区母亲阿片类药物的使用、新生儿戒断综合症和反应

• 批准号: 9980845
• 负责人: JODI A LAPIDUS
• 金额: $ 19.63万
• 依托单位: NORTHWEST PORTLAND AREA INDIAN HLTH BD
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9980845
• 关键词: Address; Adverse effects; Affect; Age; Age of Onset; Alcohol or Other Drugs use; American Indians; Area; Behavioral; Birth; Breast Feeding; Caring; Communities; Complement; Congresses; Data; Development; Distress; Ensure; Epidemiology; Evidence based treatment; Exposure to; Fatality rate; Fever; Funding; Future; General Population; Goals; Health; Health Service Area; Health Services; Healthcare Systems; Heroin Users; Hospitals; Idaho; Incidence; Indian reservation; Individual; Infant; Infant Health; Infrastructure; Intervention; Intervention Studies; Interview; Investigation; Maternal Health; Medical; Mental Health; Mothers; National Health Services; Native Americans; Neonatal Abstinence Syndrome; Newborn Infant; Northwest Tribe; Not Hispanic or Latino; Opiate Addiction; Opioid; Oregon; Outcome; Overdose; Phase; Policies; Policy Research; Pregnancy; Pregnant Women; Procedures; Process; Race; Recording of previous events; Reporting; Research; Research Project Grants; Resolution; Risk; Severities; Social Work; Statistical Methods; Stress; Structure; Substance Withdrawal Syndrome; Time; Trauma; Tremor; Tribes; United States Indian Health Service; Washington; Woman; Work; base; behavior influence; child bearing; collaborative approach; data warehouse; design; drug withdrawal; fetal drug exposure; gastrointestinal; geographic difference; improved; maternal opioid use; medication-assisted treatment; member; next generation; opioid epidemic; opioid overdose; opioid use; organizational structure; postnatal; prenatal exposure; prescription opioid misuse; reduced substance abuse; response; rural area; rurality; social; social structure; sucking; treatment program; treatment services; treatment strategy; trend; tribal community; tribal health; tribal member; tribal organization; usability

Abstract (30 lines max) Medical and nonmedical use of prescription opioids has rocketed in the US over the past two decades. The rise in opioid use during pregnancy marked disparities among AI/AN women and newborns. While there are evidence-based treatment strategies recommended for use during pregnancy and in the postnatal use period, use of these strategies is substantially lower in AI/AN across the US. As sovereign nations, tribes are often responsible for policies, practices, and infrastructure improvements to address these problems. The Northwest Tribal Epidemiology Center (The EpiCenter) is tasked with responding to the data needs of the 43 NW Tribes, including Opioid use, Neonatal Abstinence Syndrome (NAS) and access and utilization of treatment related information. We initiate this proposal in response to these requests and needs of the tribes. We plan to perform an epidemiologic assessment to determine the magnitude and impact of maternal substance use during pregnancy and NAS among American Indians in the Northwest. We will leverage ongoing and planned work in the Tribal Epidemiology Center to estimate race- corrected rates and trends of maternal substance use during pregnancy and NAS in hospital discharge data. We will also investigate opioid use and treatment in the NW as reported in Indian Health Service’s national data repository. We will complement these quantitative data with qualitative data to help us understand the environmental, social and organizational structures, processes, and policies, as well as individual behaviors that influence access to, or use of, treatment in Northwest Tribes This proposal will bring together epidemiologic and content experts, as advisory board members to respond to the data and ensure that analyses and reports are useful to decision-makers in various capacities. Upon successful completion of these study aims proposed, we will be poised to implement and evaluate future tribal interventions and policies, which in the long term could reduce the effect of the opioid crisis in Northwest American Indian communities.

摘要（最多 30 行） 过去两年美国处方阿片类药物的医疗和非医疗使用激增 几十年来，怀孕期间阿片类药物使用的增加标志着 AI/AN 妇女和妇女之间的差异。 虽然有基于证据的治疗策略建议在新生儿期间使用。 在妊娠期和产后使用期间，这些策略的使用率要低得多 作为美国的主权国家，部落通常对政策、实践、 以及改善基础设施来解决这些问题。 中心 (EpiCenter) 的任务是响应 43 个西北部落的数据需求， 包括阿片类药物的使用、新生儿戒断综合症 (NAS) 以及药物的获取和利用 我们针对这些请求和需求发起此提案。 部落的。 我们计划进行流行病学评估，以确定疫情的严重程度和影响 西北美洲印第安人怀孕期间母体物质使用和 NAS。 我们将利用部落流行病学中心正在进行和计划中的工作来估计种族- 孕期母亲物质使用和住院 NAS 的纠正率和趋势 我们还将调查西北地区阿片类药物的使用和治疗情况，如报告中所述。 我们将补充这些定量数据。 通过定性数据帮助我们了解环境、社会和组织 结构、流程和政策，以及影响访问的个人行为，或 西北部落的使用和治疗 该提案将汇集流行病学和内容专家作为顾问委员会成员 对数据做出回应并确保分析和报告对决策者有用 成功完成所提出的这些研究目标后，我们将 准备实施和评估未来的部落干预措施和政策，从长远来看 可以减少阿片类药物危机对西北美洲印第安人社区的影响。

项目成果

Racial Misclassification and Disparities in Neonatal Abstinence Syndrome Among American Indians and Alaska Natives.

美洲印第安人和阿拉斯加原住民的种族错误分类和新生儿禁欲综合症的差异。

• 发表时间: 2022-10
• 作者: Lan, Chiao;Joshi, Sujata;Dankovchik, Jenine;Jimenez, Candice;Needham Waddell, Elizabeth;Lutz, Tam;Lapidus, Jodi
• 通讯作者: Lapidus, Jodi