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 中部平原中的农村吸毒是一个越来越多的公共卫生问题。最近的药物滥用数据 证明内布拉斯加州，爱荷华州和密苏里州都位于与甲基苯丙胺相关的医院的前10个州 招生。高水平的药物滥用与这些农村的严重缺乏治疗设施相结合 区域以及限制性注射器访问法。这些条件（高吸毒，几乎没有治疗设施， 并且缺乏获得清洁针头）结合起来创造一个脆弱的人群，尤其是有风险 传染病的传播，例如HIV和丙型肝炎病毒（HCV）。例如，一个广为人知的艾滋病毒爆发 在印第安纳州南部发生，发生在2015年，揭示了广泛的农村毒品使用。这样的爆发表明 即使是艾滋病毒率低的人群（例如）也可能在结构上有流行病的风险。尽管有 农村药物使用问题的紧迫性，对网络和行为风险因素的了解相对较少 农村吸毒者。关于非法药物的大多数数据都来自城市环境，即使在农村毒品和相关的情况下 在过去的几十年中，健康成果有所提高。从城市吸毒者那里学到的教训是 在农村地区，条件和经验可能会大不相同；例如，农村药物 用户倾向于拥有少量的社交界，社会或经济流动性的机会有限，毒品可用性高， 很少有药物治疗场所。作为较大的农村吸毒研究中心的一部分，该项目将填补 在研究潜力的同时，了解农村药物使用和相关健康风险的关键差距 不同干预措施的功效。特别是，社交网络动态和行为环境 将在社区周围的三个农村地区进行调查，以促进HCV和HIV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传播相关的行为风险以及结构 在药物使用网络中，将衡量作为疾病蔓延的重要危险因素（AIM 1）。使用这些数据， 将开发一个经验基础的流行病学模拟。模拟方法使它 可以确定流行病的条件并描述可能的疗效 在限制潜在爆发方面的不同干预措施。以前的网络模型将通过组合扩展 传统的调查数据具有创新的，连续的时间交互数据，导致流行病学 衡量关系时机，上下文和地理等因素的框架（AIM 2），已知的因素 影响疾病蔓延，但以前很难量化。然后将使用此模拟 表征艾滋病毒/HCV在该药物用户人群中传播的风险（AIM 3）。总体而言，该项目将及时提供 有关农村，危险人口的关键信息。广泛的长期目标是建立一个经验 - 经过验证的流行病学模型，具有明确的公共政策应用，例如监测疾病的传播 在农村，处于危险中的人口以及打击与成瘾有关的危害的干预措施的发展。