Capturing Rural Risk Network Structures from Continuous-time Interaction Data (RISC)

从连续时间交互数据 (RISC) 中捕获农村风险网络结构

• 批准号: 10117091
• 负责人: Jeffrey Smith
• 金额: $ 24.95万
• 依托单位: UNIVERSITY OF NEBRASKA LINCOLN
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-05 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10117091
• 关键词: Address; Admission activity; Affect; Behavioral; Communicable Diseases; Communities; Computer Models; Country; Coupled; Data; Disease; Disease Outbreaks; Drug usage; Drug user; Economics; Epidemic; Epidemiology; Excision; Gender; Geography; Goals; HIV; HIV Infections; HIV/HCV; Health; Hepatitis C; Hepatitis C Transmission; Hepatitis C co-infection; Hepatitis C virus; Hospitalization; Illicit Drugs; Indiana; Individual; Intervention; Iowa; Knowledge; Laws; Life Cycle Stages; Measures; Mentors; Methamphetamine; Methodology; Mission; Missouri; Modeling; Monitor; National Institute of Drug Abuse; Nebraska; Needle Sharing; Needle-Exchange Programs; Needles; Opioid; Outcome; Pattern; Pharmaceutical Preparations; Pharmacotherapy; Play; Population; Populations at Risk; Positioning Attribute; Prevention strategy; Process; Public Health; Public Policy; Research; Risk; Risk Behaviors; Risk Factors; Rural; Rural Population; Rural drug addiction; Social Mobility; Social Network; Strategic Planning; Stress; Structure; Substance abuse problem; Surveys; Syringes; Time; Vulnerable Populations; Work; addiction; combat; comorbidity; contextual factors; drug structure; epidemiological model; experience; high risk behavior; high risk population; illicit drug use; improved; infection rate; infection risk; innovation; models and simulation; network models; novel; physical conditioning; resilience; rural area; rural drug use; rural setting; simulation; social; substance abuse treatment; substance use; therapy development; urban setting

PROJECT ABSTRACT Rural drug use in the Central Plains is a large and growing public health problem. Recent substance abuse data show that Nebraska, Iowa, and Missouri are all in the top 10 states for methamphetamine-related hospital admissions. The high level of substance abuse is coupled with a severe lack of treatment facilities in these rural areas, as well as restrictive syringe access laws. These conditions (high substance use, few treatment facilities, and lack of access to clean needles) combine to create a vulnerable population, one particularly at risk for the spread of infectious diseases, like HIV and hepatitis C virus (HCV). For example, a well-publicized HIV outbreak in southern Indiana occurred in 2015, revealing widespread rural drug use. Outbreaks like this demonstrate that even populations with low rates of HIV (for example) may be structurally at risk for an epidemic. Despite the urgency of the rural drug use problem, relatively little is known about the network and behavioral risk factors of rural drug users. Most of the data on illicit drugs come from urban settings, even while rural drug use and related health outcomes have increased over the last few decades. The lessons learned from urban drug users are unlikely to hold in rural areas, where conditions and experiences can be quite different; for example, rural drug users tend to have small social circles, limited chances for social or economic mobility, high availability of drugs, and few drug treatment venues. This project, as part of the larger Rural Drug Addiction Research Center, will fill in crucial gaps in the knowledge of rural drug use and associated health risks while investigating the potential efficacy of different interventions. In particular, the social network dynamics and behavioral contexts that contribute to the risk of HCV and HIV infection will be investigated in three rural areas surrounding communities in Nebraska, Iowa, and Missouri. Behavioral risks associated with HIV and HCV spread, as well as the structure of the drug use network, will be measured as important risk factors for disease spread (Aim 1). Using these data, an empirically-grounded, epidemiological simulation will be developed. The simulation approach makes it possible to pinpoint the conditions under which an epidemic is possible and describe the possible efficacy of different interventions in limiting a potential outbreak. Previous network models will be extended by combining traditional survey data with innovative, continuous-time interaction data, resulting in an epidemiological framework that measures factors like relationship timing, context, and geography (Aim 2), factors that are known to affect disease spread but have previously been difficult to quantify. This simulation will then be used to characterize the risk of HIV/HCV spread in this drug user population (Aim 3). Overall, the project will offer timely, crucial information about a rural, at-risk population. The broad, long-term objective is to establish an empirically- validated, epidemiological model with clear public policy applications, such as the monitoring of disease spread in rural, at-risk populations and the development of interventions to combat addiction related harms.

项目摘要 中原农村吸毒是一个巨大且日益严重的公共卫生问题。最近的药物滥用数据 显示内布拉斯加州、爱荷华州和密苏里州均位列甲基苯丙胺相关医院排名前十的州 招生。这些农村地区药物滥用率很高，而且严重缺乏治疗设施。 地区，以及限制性注射器使用法律。这些条件（物质使用量高、处理设施少、 和缺乏清洁针头）结合起来形成了一个弱势群体，这一群体尤其面临着被感染的风险。 传染病的传播，如艾滋病毒和丙型肝炎病毒（HCV）。例如，广为人知的艾滋病毒爆发 2015 年印第安纳州南部发生的一起事件揭示了农村地区毒品的广泛使用。像这样的疫情爆发表明 即使是艾滋病毒感染率较低的人群（例如）也可能在结构上面临流行病的风险。尽管 农村吸毒问题的紧迫性，人们对农村吸毒问题的网络和行为危险因素知之甚少。 农村吸毒者。大多数关于非法药物的数据来自城市环境，尽管农村药物使用和相关数据也来自城市环境。 过去几十年来，健康状况有所改善。从城市吸毒者身上吸取的教训是 在农村地区不太可能成立，那里的条件和经验可能有很大不同；例如农村药品 使用者的社交圈子往往较小，社会或经济流动性有限，毒品的可获得性较高， 且药物治疗场所很少。该项目作为更大的农村毒瘾研究中心的一部分，将填补 在调查潜在的农村毒品使用和相关健康风险的知识方面存在重大差距 不同干预措施的效果。特别是，社交网络动态和行为背景 将在社区周围的三个农村地区调查丙型肝炎病毒和艾滋病毒感染的风险 在内布拉斯加州、爱荷华州和密苏里州。与 HIV 和 HCV 传播及其结构相关的行为风险 药物使用网络的影响将被作为疾病传播的重要风险因素进行衡量（目标 1）。使用这些数据， 将开发以经验为基础的流行病学模拟。模拟方法使得 可以查明可能发生流行病的条件并描述可能的功效 限制潜在爆发的不同干预措施。以前的网络模型将通过组合来扩展 传统调查数据与创新的、连续时间的交互数据，从而产生流行病学数据 衡量关系时间、背景和地理位置（目标 2）等已知因素的框架 影响疾病传播，但以前很难量化。然后，该模拟将用于 描述该吸毒人群中 HIV/HCV 传播的风险特征（目标 3）。总体而言，该项目将及时提供 有关农村高危人群的重要信息。广泛的、长期的目标是建立一个基于经验的 经过验证的流行病学模型，具有明确的公共政策应用，例如疾病传播的监测 在农村、高危人群中，制定干预措施以对抗成瘾相关的危害。