The Women-Centered Opioid Recovery Project: Advancing women's engagement in care for opioid use disorder through development of a novel recovery navigation system led by women in recovery

以妇女为中心的阿片类药物康复项目：通过开发由康复中的妇女主导的新型康复导航系统，促进妇女参与阿片类药物使用障碍的护理

• 批准号: 10598629
• 负责人: Melissa Kari Ward
• 金额: $ 17.87万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10598629
• 关键词: Accounting; Address; American; Award; Awareness; COVID-19; Caring; Child; Child Custody; Chronic; Clinical; Communities; Data; Development; Disparity; Evidence based intervention; Evidence based program; Face; Family member; Female; Focus Groups; Gender; Goals; HIV; Health; Health Personnel; Health Services Accessibility; Hybrids; Intervention; Interview; K-Series Research Career Programs; Life Cycle Stages; Mental Health; Mentorship; Methods; Navigation System; Neonatal Abstinence Syndrome; Neurobiology; Online Systems; Opiate Addiction; Opioid; Outcome; Participant; Persons; Population; Positioning Attribute; Pregnancy; Randomized; Recovery; Research; Research Personnel; Resources; Services; Shame; Structure; Surveys; Vulnerable Populations; Woman; addiction; barrier to care; care seeking; community engaged research; comorbidity; evidence base; experience; gender difference; improved; improved outcome; medical complication; meetings; men; novel; opioid epidemic; opioid overdose; opioid use; opioid use disorder; patient navigator; post pregnancy; programs; prototype; public health emergency; scale up; social stigma; theories; therapy design; therapy development; usability; virtual; web platform; web-based tool

PROJECT SUMMARY/ABSTRACT The opioid crisis has escalated dramatically among women: from 1999 to 2019, the rate of opioid-related overdoses among females increased from 1.4 to 9.3 per 100,000 population. Women face many unique challenges in obtaining treatment for opioid use disorder (OUD). These barriers include caretaking responsibilities and child custody concerns. Additionally, through a phenomenon known as “telescoping,” women have a shorter duration of opioid use before meeting the clinical criteria for OUD compared to men. Further complicating the treatment landscape for women with OUD is that they often present for treatment with more severe comorbidities than men do. These gendered differences highlight the importance of women- centered strategies for engagement in care, a critical step in the OUD Cascade of Care. To address these gendered needs and barriers to care, a novel women-centered recovery navigation system is proposed. Patient navigator programs are an evidence-based intervention that address disparities and destigmatize seeking care for vulnerable populations. While available for a range of chronic health issues, they have not been widely implemented or evaluated for women with OUD. Ultimately, the proposed recovery navigation system will combine a web-based platform with personalized, women-centered recovery navigator services, and will use a hybrid approach that connects women to both virtual and in-person services. This recovery navigation system will serve as a gateway to services that meet women’s unique needs through increasing awareness of service and resource availability, as well as normalizing and destigmatizing seeking treatment for OUD among women. Women in recovery from OUD will guide development through a structured community- engaged intervention development framework. The objectives of this project are to advance understanding of barriers to engagement in care for women with OUD and to create a women-centered recovery navigation system. These objectives will be achieved through the following specific aims: 1) identify key barriers to engagement in care for women with OUD, as well as potential solutions; 2) develop and evaluate a pilot women-centered recovery navigator program; and 3) develop and evaluate a web-based recovery platform to engage women with OUD in care. Analyses will be completed using both qualitative and quantitative methods. Upon completion of the proposed 5-year project and under the guidance of my mentorship team, I will advance my expertise in (1) community-engaged research strategies, (2) the theory and neurobiology of opioid dependence among women, and (3) intervention design. I will also have the data necessary to scale up and refine this women-centered recovery navigation system, and will submit an R01 application to do so by the beginning of year 5 of the award period. Taken together, I will be in a position to establish myself as an independent investigator focused on developing and adapting evidence-based, women-centered interventions that tangibly improve the health outcomes of women struggling with OUD and addiction across the life course.

项目摘要/摘要 阿片类药物危机在女性中急剧升级：从1999年到2019年，与阿片类药物有关 女性的过量服用从每100,000人口增加到9.3人。女人面临许多独特的 获得阿片类药物使用障碍治疗（OUD）的挑战。这些障碍包括CAETAKEN 责任和儿童监护权问题。另外，通过一种称为“望远镜”的现象， 与男性相比，妇女在满足OUD的临床标准之前的阿片类药物使用时间较短。 进一步使OUD女性的治疗景观复杂化的是，她们经常出席治疗 比男性更严重的合并症。这些性别差异强调了妇女的重要性 - 以护理参与为中心的策略，这是Oud Cascade Case的关键一步。解决这些 提出了一种以女性为中心的恢复导航系统的性别需求和护理障碍。 患者导航器计划是一种基于证据的干预措施，可以解决分布并贬低 寻求对脆弱人群的照顾。虽然可用于一系列慢性健康问题，但它们尚未 被广泛实施或评估了OUD妇女。最终，拟议的恢复导航 系统将将基于网络的平台与个性化的，以女性为中心的恢复导航器服务相结合， 并将使用将女性与虚拟和面对面服务联系起来的混合方法。这个恢复 导航系统将通过增加来满足妇女独特需求的服务通道 对服务和资源可用性的认识，以及使寻求治疗的正常化和命运 在女性中。从Oud恢复的妇女将通过一个结构化的社区指导发展 - 参与干预开发框架。该项目的目标是提高对 为患有OUD的妇女提供护理的障碍，并创建以女性为中心的康复导航 系统。这些目标将通过以下特定目的实现：1）确定关键障碍 从事OUD妇女以及潜在解决方案的照料； 2）开发和评估飞行员 以女性为中心的康复导航器计划； 3）开发和评估基于网络的恢复平台 让妇女和Oud一起照顾。分析将使用定性和定量方法完成。 在拟议的5年项目完成并在我的Mentalship团队的指导下完成后，我将进步 我在（1）社区参与研究策略中的专业知识，（2）阿片类药物的理论和神经生物学 妇女之间的依赖，以及（3）干预设计。我还将拥有规模扩展所必需的数据和 完善以女性为中心的恢复导航系统，并将提交R01申请 从奖励期开始的第5年开始。综上所述，我将有能力确立自己 独立研究者致力于开发和调整以循证为基础的以妇女为中心的干预措施 这种诱人的改善妇女的健康成果在整个生活过程中与Oud和成瘾斗争。