Leveraging Parents and Peer Recovery Supports to Increase Recovery Capital in Emerging Adults with Polysubstance Use: Feasibility, Acceptability, and Scaling Up of Launch

利用父母和同伴的康复支持来增加使用多物质的新兴成年人的康复资本：可行性、可接受性和扩大启动规模

• 批准号: 10590541
• 负责人: Tess K. Drazdowski
• 金额: $ 1.16万
• 依托单位: OREGON SOCIAL LEARNING CENTER, INC.
• 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 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10590541
• 关键词: Abbreviations; Abstinence; Address; Adherence; Adolescent; Adult; Affect; Back; Capital; Caring; Cessation of life; Clinic; Communities; County; Data; Development; Dropout; Drops; Educational process of instructing; Effectiveness; Elderly; Ensure; Family; Feedback; Felis catus; Funding; Future; Goals; Health Services; Helping to End Addiction Long-term; Injury; Intervention; Interview; Investigator-Initiated Research; Knowledge; Life; Medical; Mental Health Services; Methods; Modeling; Names; Online Systems; Opiate Addiction; Opioid; Outcomes Research; Outpatients; Parents; Performance at work; Pharmaceutical Preparations; Pilot Projects; Play; Population; Procedures; Protocols documentation; Provider; Public Health; Randomized; Recovery; Recovery Support; Reporting; Research; Resources; Risk; Role; Route; Rural Community; Rural Health; Schools; Service delivery model; Services; Site; Social Network; Social support; Specific qualifier value; Speed; Stimulant; Training; Training Support; Transportation; United States National Institutes of Health; Work; acceptability and feasibility; adverse outcome; age group; aged; behavioral health; community based participatory research; community engaged research; contingency management; cost; emerging adult; evidence base; experience; feasibility testing; future implementation; health equity; help-seeking behavior; heroin use; high risk population; improved; innovation; multiple drug use; opioid epidemic; opioid misuse; overdose death; peer; peer support; personalized approach; polysubstance use; prevent; programs; recruit; residence; rural area; scale up; service gap; skills; substance use; substance use treatment; tool; uptake; virtual; virtual coach

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. Emerging adults (EAs; aged 18-26) have the highest rates of poly-substance use compared to all other age groups. They have been hit particularly hard by the opioid crisis, estimated to cost the U.S. $1 trillion a year. In fact, nearly all EAs with a substance use problem report regular use of multiple drugs. Recovery capital, or the resources available to promote substance use recovery (e.g., vocational/educational skills, recovery-supportive community) is also much lower for EAs compared to older adults. This is not surprising given this developmental stage of instability and transition. Unfortunately, most EAs with poly-substance use are not receiving services, a problem that is exacerbated in rural communities, which often lack access to any behavioral health services. Further, EAs who do access substance use services are unlikely to receive evidence-based care and are more likely to drop out compared to older adults. Clearly, more developmentally appropriate and engaging services are needed for EAs with poly-substance use, regardless of residence, but particularly in rural communities. This R34, from an early stage investigator, initiates research to fill this service gap via an innovative adaptation of existing substance use services. It leverages (1) parents of EAs and (2) peer recovery supports (PRS), while ensuring services are equitable and scalable. Substance use services for EAs rarely involve parents, but their involvement could be the difference-maker for sustaining recovery. Beyond parents, the lack of recovery-focused peer social support is a major barrier to sustained recovery in EAs. Fortuitously, certified PRS are trained to help EAs find a recovery peer community and possibly build recovery capital. Thus, this R34 pilots a scalable service for EAs, named Launch, that involves both parents and PRS, thereby targeting poly-substance use from two crucial angles. After adapting and evaluating training protocols and adherence tools (Aim 1), 24 EAs with poly-substance use and their parents will be recruited. Parents will engage in web-based coaching to use Contingency Management for Emerging Adults (CM-EA), built on decades of work supporting CM as a leading intervention for poly-substance use. Concurrently, EAs will be randomized to one of two conditions to work with a PRS. In the first condition, PRS will provide typical services, including recovery social networking. In the second, PRS will provide typical services but will also further build the EAs' recovery capital via vocational/educational/ financial skills. The feasibility and acceptability of the study protocol and Launch services will be assessed (Aim 2). Notably, this project has been informed by Community-Based Participatory Research (CBPR) practices, which continue in the R34 by incorporating feedback from EAs with lived experience in recovery and the parent coach, PRS, and families. Further, to improve eventual uptake, payors/providers of substance use services will be interviewed. Sites for a future large-scale adaptive trial will also be recruited (Aim 3). If Launch is ultimately deemed effective, it would fill a major gap in the substance use services field by providing a highly specified and individualized service for reducing risk and promoting adaptive life functioning in EAs with poly-substance use.

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治疗倡议跨NIH的研究，以改善阿片类药物和成瘾的治疗方法。与所有其他年龄段相比，新兴的成年人（EAS；年龄18-26岁）的多余率使用率最高。阿片类药物危机受到了特别严重的打击，估计损失了美国每年1万亿美元的损失。实际上，几乎所有具有药物使用问题的EA都会定期使用多种药物。恢复资本或 与老年人相比，EA的可用于促进基材恢复恢复的资源（例如，出版/教育技能，恢复支持社区）也要低得多。考虑到不稳定和过渡的发展阶段，这并不奇怪。不幸的是，大多数带有多种用途的EA都没有接收服务，一个 在农村社区中加剧的问题通常无法获得任何行为健康服务。此外，使用访问药物使用服务的EA不太可能接受循证护理，与老年人相比，更有可能辍学。显然，开发较合适的服务 无论居住如何，尤其是在农村社区中，都需要使用多用途的使用。这款R34来自早期的研究人员，通过对现有药物使用服务的创新适应来填补这一服务差距。它利用（1）EAS和（2）同行恢复支持（PR）的父母，同时确保服务是公平且可扩展的。 EAS的药物使用服务很少参与父母，但他们的 参与可能是维持恢复的差异。除了父母之外，缺乏以恢复为重点的同伴社会支持是EA中持续康复的主要障碍。幸运的是，经过认证的PR经过培训，以帮助EAS找到一个恢复同伴社区并可能建立恢复资本。这是R34飞行员的一项可扩展的EAS服务，名为发射，涉及父母和PRS，从而针对两个关键角度的多态使用。在适应和评估培训方案和依从性工具（AIM 1）之后，将招募使用Poly-Subbestance及其父母的24 EAS。父母将参与基于网络的教练以使用意外事件 新兴成年人的管理（CM-EA）建立在数十年来支持CM的工作的基础上，作为用于多余的多余的主要干预措施。同时，EA将被随机分为两个条件之一，与PR一起使用。在第一个条件下，PR将提供典型的服务，包括恢复社交网络。在第二个中，PRS将提供典型的服务，但也将通过出版/教育/ 财务技能。将评估研究方案和启动服务的可行性和可接受性（AIM 2）。值得注意的是，基于社区的参与性研究（CBPR）实践为该项目提供了信息，该实践在R34中通过EAS的Recovery in Recovery in Recovery in Recovery进行了R34和家长教练，PRS和家庭。此外，为了改善最终的吸收，将采访付款人/提供者的付款人/提供者。未来大规模自适应试验的地点也将被招募（AIM 3）。如果最终认为发射有效，它将通过提供高度指定和个性化的服务来降低风险并促进EAS在EAS中使用Poly-Substance使用来减少自适应生活功能，从而填补物质使用服务领域的主要空白。