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.

项目概要/摘要美国阿片类药物使用量的增加导致与阿片类药物相关的致命和非致命过量用药急剧增加（OD），患有精神健康障碍（包括焦虑和情绪障碍）的成年人明显更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且显着受邻近环境的影响，但很少有研究探讨可修改的影响 OD 风险的邻域特征。这项研究的主要目标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消耗的因素。拟议的研究将实现使用混合定量/定性方法和致命 OD 数据实现以下相互关联的具体目标来自纽约、芝加哥和西雅图的原创深度访谈吸毒者：(1) 研究可改变的身体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改变的邻里因素之间关系的中介和阿片类药物 OD； (3)比较研究可改变的邻里因素、心理因素之间的关联健康指标和阿片类药物 OD，比较使用阿片类药物的人与使用阿片类药物的人居住的地点他们服药过量的地点。对吸毒者的深入访谈将为定量结果，确定社区影响吸毒和相关 OD 风险的机制并提供预防 OD 的新策略。 K01 指导研究科学家发展提案将提供药物使用研究过渡到研究独立性所需的培训和专业知识。五将纳入具体的培训领域来实现这些研究目标：（1）获得以下领域的高级技能：结构方程建模和贝叶斯建模方法、因果推理理论和方法； (2) 发展混合定量和定性方法研究理论、设计和分析方面的专业知识，并建立收集和分析定性数据的能力； (3) 培养精神病学方面的专业知识流行病学和相关吸毒危险因素，特别是重度抑郁症、一般性焦虑症、以及精神疾病的诊断标准； (4) 获得研究道德行为方面的额外培训被边缘化和被污名化的人群； (5) 为成功的研究生涯培养专业技能独立科学家领导多学科团队建立新知识并应对重大挑战在吸毒和滥用方面。这些培训目标将通过教学课程的结合来实现，专业研讨会、实践研究以及跨学科专家团队的指导。这研究和培训将导致随后的 R01 提案正式测试实施策略和社区层面预防 OD 干预措施的有效性。