Fatal Overdose Review Teams - Research to Enhance Surveillance Systems (FORTRESS)

致命过量用药审查小组 - 加强监测系统的研究 (FORTRESS)

• 批准号: 10590303
• 负责人: Matthew Aalsma
• 金额: $ 157.1万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2024-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10590303
• 关键词: Address; Adherence; Affect; Attitude; Centers for Disease Control and Prevention (U.S.); Cessation of life; Charge; Child; Childhood; Collection; Communities; County; Data; Data Aggregation; Decision Making; Development; Drug usage; Ensure; Epidemic; Event; Evidence based treatment; Goals; Guidelines; Harm Reduction; Health; Helping to End Addiction Long-term; Imprisonment; Indiana; Individual; Intervention; Interview; Lead; Legal; Link; Modeling; Opiate Addiction; Opioid; Outcome; Overdose; Overdose reduction; Performance; Pharmaceutical Preparations; Pharmacotherapy; Phase; Philosophy; Pilot Projects; Policy Making; Population; Practice Guidelines; Prevention strategy; Public Health; Public Health Practice; Randomized; Recommendation; Recording of previous events; Research; Research Design; Resources; Risk Factors; Rural; Services; Social Work; Source; Speed; Sum; Surveys; System; Testing; Time; Training; Translating; United States National Institutes of Health; base; comorbidity; contextual factors; dashboard; data infrastructure; data repository; design; effectiveness outcome; emotional trauma; evidence base; implementation outcomes; implementation process; improved; member; mortality; multidisciplinary; multiple data sources; neglect; opioid misuse; overdose death; overdose prevention; overdose risk; programs; service gap; social; success; systems research; time use; tool; trial comparing; uptake; usability; user centered design

This study is part of the NIH’s Helping to End Addiction Long-term (HEAL) initiative to speed scientific solutions to the national opioid public health crisis. The NIH HEAL Initiative bolsters research across NIH to improve treatment for opioid misuse and addiction and to develop concrete strategies capable of providing rapid and durable solutions to the opioid crisis. This project seeks to address the overdose epidemic by working with overdose fatality review (OFR) teams. Current OFR practices rely on the case review model to make policy and programmatic recommendations. However, the continued rise in overdose rates and sheer number of preventable overdose deaths suggest a need to shift OFR teams away from case review and toward using timely population-level data to better inform their recommendations and actions. The goal of our proposed project, Fatal Overdose Review Teams – Research to Enhance Surveillance Systems (FORTRESS), is to improve standard OFR practices by equipping OFRs with a data dashboard built on real-time aggregate data, record-linked across multiple sources and presented in a way that helps identify and visualize common “overdose touchpoints,” or opportunities to deliver harm-reduction services or engage individuals at risk for overdose in evidence-based treatment. Aligning with the goals of the HEAL Data2Action Program, the FORTRESS research team will leverage available resources and expertise to help OFRs translate data to action. During the R61 Phase, the research team will strengthen established cross-sector partnerships with two state agencies, the Indiana Department of Health and the Indiana Management Performance Hub (MPH), which provide the necessary statewide data infrastructure to record-link population-level administrative data from multiple sources. MPH has also successfully developed publicly accessible data dashboards. The FORTRESS team will build on the early successes of MPH to ensure more timely collection of overdose event data and design the “Overdose Touchpoints Dashboard” (Aim 1). Our team will train OFR team members in Data-Driven Decision Making (DDDM) to effectively use the dashboard. The FORTRESS team also includes individuals involved in developing the CDC’s OFR best practice guidelines and a pilot study of OFR adherence to these guidelines, which will inform our team’s development of an “OFR Fidelity Tool” (Aim 2). This tool will be the first of its kind. For the R33 phase, we will conduct a cluster-randomized stepped-wedge trial comparing the impact of our intervention (dashboard + DDDM training) versus standard OFR practices on both implementation (Aim 3) and effectiveness outcomes (Aim 4). Implementation outcomes include implementation process fidelity (Stages of Implementation Completion), staff acceptance of harm reduction philosophies (qualitative interviews), OFR fidelity to CDC best practices (FORTRESS OFR Fidelity Tool), and usability of the Overdose Touchpoint Dashboard, (Systems Usability Scale). A statewide OFR data repository serves as a rich source of data on effectiveness outcomes, including OFR team recommendation quality and local actions to implement recommended overdose prevention strategies. We will also survey OFR team members to assess changes in their attitudes toward evidence-based overdose prevention strategies. In sum, the FORTRESS team is uniquely qualified to help OFRs use more comprehensive, available data to inform quality, action-oriented recommendations to reduce overdose.

这项研究是NIH的一部分，有助于长期（HEL）倡议结束成瘾，以加快对国家阿片类药物公共卫生危机的科学解决方案。 NIH Heal Heal倡议Bolsters在NIH跨NIH的研究，以改善阿片类药物滥用和成瘾的治疗方法，并制定能够为阿片类药物危机提供快速耐用的解决方案的具体策略。 该项目旨在通过使用过量死亡审查（OFR）团队来解决过量的流行病。当前的OFR实践依靠案例审查模型来提出政策和程序性建议。但是，用药率的持续上升和可预防的过量死亡人数的持续上升表明 需要将团队从案例审查转移到使用及时的人群级数据，以更好地告知他们的建议和行动。我们拟议的项目的目标是致命的过量审查团队 - 增强监视系统（堡垒）的研究是通过将OFRS配备与RRS配备的标准OFR实践 一个数据仪表板建立在实时汇总数据的基础上，并以多种来源进行记录链接，并以一种有助于识别和可视化常见的“过量接触点”或提供减少危害服务的机会或使有可能过量治疗的人与个人互动的机会。与目标的目标保持一致 HEAL DATA2ACTION计划，要塞研究团队将利用可用的资源和专业知识来帮助RRS将数据转化为行动。在R61阶段，研究团队将加强与两个州机构，印第安纳州卫生部和印第安纳州管理部的建立跨部门合作伙伴关系 Performance Hub（MPH），它提供了必要的全州数据基础架构，以记录来自多个来源的链接人群级管理数据。 MPH还成功开发了公开访问的数据仪表板。堡垒团队将基于MPH的早期成功，以确保更及时收集过量的事件数据并设计“过量接触点仪表板”（AIM 1）。我们的团队将培训OFR团队成员进行数据驱动的决策（DDDM），以有效地使用仪表板。要塞团队还包括参与制定CDC的OFR最佳实践指南的个人以及对这些指南的OFR遵守的试点研究，这将为我们团队开发“ OFR Fidelity工具”（AIM 2）。该工具将是同类工具。对于R33阶段，我们将进行一项集群式的阶梯式 - 边缘试验，以比较我们的干预措施（仪表板 + DDDM培训）与标准OFR实践对实施（AIM 3）和有效性结果（AIM 4）的影响。实施结果包括实施 流程保真度（实施完成阶段），员工减少危害哲学（定性访谈），对CDC最佳实践（Fortress ofr Fidelity工具）的保真度以及过量接触点仪表板的可用性（系统可用性量表）。全州数据存储库作为富人 有效性结果的数据来源，包括OFR团队建议质量和当地行动，以实施建议的预防策略。我们还将调查团队成员的成员，以评估他们参加基于证据的预防策略的出勤变化。总而言之，堡垒团队具有独特的资格，可以帮助RR使用更全面的可用数据来为质量，以动作为导向的建议提供减少用药过量的建议。