Evaluating Social Connectedness to Support Recovery from Opioid Use Disorder during the Postpartum Period

评估社会联系以支持产后阿片类药物使用障碍的恢复

• 批准号: 10681764
• 负责人: Alicia M Allen
• 金额: $ 23.03万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10681764
• 关键词: Academic achievement; Anxiety; Behavioral; Birth; Buffers; Child; Childbirth; Control Groups; Data; Data Analytics; Development; Ecological momentary assessment; Elements; Emotional; Evidence based treatment; Family; General Population; Generations; Goals; Health; Individual; Infant; Intervention; Interview; Knowledge; Loneliness; Machine Learning; Maternal Mortality; Medical Records; Mental Depression; Mothers; Motivation; Opioid; Outcome; Overdose; Pain; Pain management; Participant; Pattern; Perinatal; Play; Population; Postpartum Depression; Postpartum Period; Pregnancy; Prevalence; Prevention; Recovery; Recovery Support; Relapse; Research Project Grants; Risk; Risk Factors; Role; Sampling; Signal Transduction; Sleep disturbances; Social isolation; Social outcome; Social support; Specialist; Stress; Substance Use Disorder; Target Populations; Testing; Theoretical model; Time; Woman; Work; care giving burden; caregiving; craving; foster care; fourth trimester; high risk; illicit opioid; improved; individualized medicine; infant outcome; informant; novel; opioid misuse; opioid overdose; opioid use; opioid use disorder; overdose death; peer support; perinatal period; prevent; relapse prevention; relapse risk; social; social attachment; statistics; stress management; stressor

PROJECT SUMMARY The prevalence of opioid use disorder (OUD) during pregnancy has increased by nearly 500% over the past 15 years. While motivation for and compliance with OUD treatment during pregnancy is heightened, up to 80% of postpartum individuals with OUD relapse to illicit opioid use within six months of childbirth. A growing body of evidence indicates that, in the general population, positive social connectedness and strong social bonds are associated with improved OUD recovery outcomes (e.g., reduced craving, lower risk of relapse). Conversely, loneliness and social isolation are significant predictors of opioid misuse and relapse, particularly for women. Loneliness increases during transitional periods including from pregnancy to postpartum, signaling increased risk for adverse recovery outcomes. Moreover, relapse risk during the fourth trimester (i.e., the time from delivery to postpartum week 12) may be compounded by unique postpartum stressors, including postpartum depression and anxiety, sleep disturbances, heightened need for pain management, and caregiving-specific stress. Our overall goal is to understand the role of social connectedness in OUD-related recovery outcomes, specifically during the postpartum fourth trimester, an ideal inflection point with untapped potential. To achieve this goal we will pursue three aims. The first two aims will utilize existing data (derived from DP2-HD105541; PI: Allen) from 50 participants with OUD and 25 control participants who were followed from pregnancy through five months postpartum. Using ecological momentary assessments (EMA) paired with medical record data, we will assess social connectedness and OUD-related recovery outcomes. We will evaluate differing theoretical models of social connectedness in this population by testing the main and stress-buffering effects of social connectedness on recovery outcomes up to one year postpartum (Aim 1). Additionally, we will characterize dynamic changes in social connectedness across the fourth trimester and how patterns/changes relate to mothers’ recovery outcomes (Aim 2). Lastly, we will complete key informant interviews with 30 participants from the target population to explore the feasibility, acceptability, and opportunities for intervention to enhance social connectedness to improve the treatment of OUD and prevent postpartum relapse (Aim 3). The results of this study, regardless of outcome, will directly contribute to scientific knowledge on the role of social connectedness in postpartum OUD recovery. Moreover, this work will allow for the identification of new intervention targets, which will contribute to the development of novel, high-impact relapse prevention treatments tailored to the fourth trimester, a unique inflection point with ample untapped opportunity. This will be directly impactful to the 80,000- 120,000 women, infants, and families suffer the consequences of perinatal OUD every year.

项目概要 过去 15 年，怀孕期间阿片类药物使用障碍 (OUD) 的患病率增加了近 500% 虽然妊娠期间 OUD 治疗的动机和依从性是哮喘，但高达 80% 的人在怀孕期间接受 OUD 治疗。 患有 OUD 的产后个体在分娩后六个月内再次非法使用阿片类药物。 有证据表明，在一般人群中，积极的社会联系和牢固的社会纽带是 与改善 OUD 恢复结果相关（例如，减少渴望、降低离线风险）。 孤独和社会孤立是阿片类药物滥用和复发的重要预测因素，特别是对于女性而言。 在过渡时期（包括从怀孕到产后）孤独感增加，信号增加 此外，妊娠第四个月（即分娩后的时间）复发风险。 到产后第 12 周）可能会因独特的产后压力因素而加剧，包括产后抑郁症 焦虑、睡眠障碍、哮喘疼痛管理需求以及护理特定的压力。 总体目标是了解社会联系在 OUD 相关恢复结果中的作用，特别是 在产后第四个月，这是一个具有未开发潜力的理想拐点，为了实现这一目标，我们。 将追求三个目标。前两个目标将利用现有数据（源自 DP2-HD105541；PI：Allen）。 对 50 名 OUD 参与者和 25 名对照参与者进行了从怀孕到五个月的跟踪 我们将使用生态瞬时评估 (EMA) 与医疗记录数据相结合进行评估。 我们将评估不同的理论模型。 通过测试社会联系的主要效应和压力缓冲效应来了解该人群的社会联系 此外，我们将描述产后一年内的恢复结果（目标 1）。 第四个月的社会联系以及模式/变化与母亲康复的关系 最后，我们将完成对目标中 30 名参与者的关键信息访谈。 探索干预措施的可行性、可接受性和机会，以增强社会 改善 OUD 治疗并预防产后复发（目标 3）。 研究，无论结果如何，都将直接有助于增进关于社会联系作用的科学知识 此外，这项工作将有助于确定新的干预目标， 这将有助于开发针对第四代疾病的新型、高影响力的复发预防治疗方法 三个月，一个独特的拐点，有大量未开发的机会，这将直接影响到 80,000 人。 每年有 120,000 名妇女、婴儿和家庭遭受围产期 OUD 的影响。