Neighborhoods, Mental Health, and the Prevention of Opioid Overdose: A Mixed Methods Approach

社区、心理健康和阿片类药物过量的预防：混合方法

基本信息

批准号：
10054543
负责人：
Elizabeth Nesoff
金额：
$ 6.27万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-15 至 2020-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10054543
关键词：
Acute Address Adult Affect Anxiety Anxiety Disorders Area Arousal Bayesian Modeling Behavior Characteristics Chicago Cities Communities Consumption Crack Cocaine Data Deterioration Development Diagnosis Diagnostic Disease Drug Use Disorder Drug abuse Drug usage Drug user Economics Educational workshop Effectiveness Environment Environmental Health Equation Ethics Exhibits Fentanyl Goals Health Status Home environment Injury Intervention Interview Intoxication Knowledge Lighting Link Location Major Depressive Disorder Major Mental Illness Marijuana Measures Mediating Mediator of activation protein Mental Depression Mental Health Mental disorders Mentors Methods Modeling Mood Disorders Neighborhoods New York City Opioid Overdose Pain management Pharmaceutical Preparations Policies Population Prevalence Prevention Psychiatric epidemiology Public Health Qualitative Methods Reporting Research Research Activity Research Methodology Research Training Risk Risk Factors Safety Scientist Social Interaction Social isolation Statistical Data Interpretation Stigmatization Structure Testing Training Translating Travel United States base built environment career comparative cost design experience hands on research heroin use implementation strategy injection drug use injury-related death multidisciplinary novel strategies opioid misuse opioid overdose opioid use opioid use disorder opioid user overdose prevention overdose risk prescription opioid prevent residence skills social social deficits social group stressor theories trend violence prevention

项目摘要

PROJECT SUMMARY/ABSTRACT Increasing opioid use in the U.S. has led to a dramatic increase in opioid-related fatal and non-fatal overdoses (OD), and adults with mental health disorders, including anxiety and mood disorders, are significantly more likely to use nonprescription opioids. Mental health and associated drug use are directly and significantly impacted by the neighborhood environment, but few studies have examined the impact of modifiable neighborhood features on OD risk. The broad objective of this study is to investigate modifiable neighborhood factors which impact mental health and which may contribute to opioid OD. The proposed research will achieve the following interconnected specific aims using mixed quantitative/qualitative approaches with fatal OD data from New York City, Chicago, and Seattle and original in-depth interviews with people who use drugs: (1) investigate the associations between modifiable physical and social neighborhood factors and opioid OD; (2) examine key mental health indicators as mediators of the relationship between modifiable neighborhood factors and opioid OD; (3) comparatively investigate the associations between modifiable neighborhood factors, mental health indicators, and opioid OD, comparing the locations where people who use opioids lived versus the locations where they overdosed. In-depth interviews with people who use drugs will provide context for quantitative results, identifying mechanisms by which neighborhood impacts drug using and associated OD risk and informing novel strategies for OD prevention. This K01 mentored research scientist development proposal will provide the training and expertise needed to transition to research independence in drug use research. Five specific training areas will be incorporated to carry out these research goals: (1) obtain advanced skills in structural equation modeling and Bayesian modeling methods, and causal inference theory and methods; (2) develop expertise in mixed quantitative and qualitative methods research theory, design, and analysis, and build capacity in collecting and analyzing qualitative data; (3) develop subject matter expertise in psychiatric epidemiology and associated drug use risk factors, in particular, major depression, general anxiety disorders, and diagnostic criteria for psychiatric disorders; (4) obtain additional training in the ethical conduct of research among marginalized and stigmatized populations; (5) build professional skills for a successful research career as an independent scientist leading multidisciplinary teams to build new knowledge and address major challenges in drug use and abuse. These training goals will be achieved through a combination of didactic courses, specialized workshops, hands-on research, and mentoring from an interdisciplinary team of experts. This research and training will lead to a subsequent R01 proposal that formally tests implementation strategies and effectiveness of neighborhood-level interventions for OD prevention.

项目摘要/摘要美国的阿片类药物使用量增加导致阿片类药物相关的致命和非致命性过量的急剧增加（OD）和患有精神健康障碍的成年人，包括焦虑和情绪障碍，都更加多可能使用非处方阿片类药物。心理健康和相关的药物使用直接而显着受社区环境的影响，但是很少有研究检查了可修改的影响 OD风险的邻里功能。这项研究的广泛目的是调查可修改的社区影响心理健康并可能导致阿片类药物的因素。拟议的研究将实现使用混合定量/定性方法与致命的OD数据相互联系的特定目标来自纽约市，芝加哥，西雅图以及使用毒品的人进行深入的访谈：（1）研究可修改的物理和社会邻里因素与阿片类药物OD之间的关联；（2）检查关键的心理健康指标，作为可修改邻里因素之间关系的介体和阿片类药物；（3）相对研究可修改的邻里因素，心理之间的关联健康指标和阿片类药物OD，比较了使用阿片类药物的人们与他们服药过量的位置。与使用毒品的人进行深入的访谈将为定量结果，确定邻里使用和相关的OD风险影响药物的机制并为预防OD的新策略提供信息。这项K01指导了研究科学家发展建议将提供过渡以研究药物使用研究独立性所需的培训和专业知识。五将合并特定的培训领域以实现这些研究目标：（1）获得高级技能结构方程建模和贝叶斯建模方法以及因果推断理论和方法；（2）在混合定量和定性方法研究理论，设计和分析方面发展专业知识，并建立收集和分析定性数据的能力；（3）发展精神病学主题专业知识流行病学和相关的药物使用危险因素，尤其是严重抑郁症，一般焦虑症，和精神疾病的诊断标准；（4）获得研究道德行为的额外培训在边缘化和受污名的人群中；（5）为成功的研究职业建立专业技能一个独立的科学家领导多学科团队建立新知识并应对主要挑战在吸毒和滥用方面。这些培训目标将通过结合教学课程来实现，专业的专业研讨会，动手研究和跨学科专家团队的指导。这研究和培训将导致随后的R01提案，以正式测试实施策略和邻里级别的干预措施用于预防OD。