ELEVATE Center: Reduction of Maternal Morbidity from Substance Use Disorder in Utah

ELEVATE 中心：降低犹他州药物使用障碍导致的孕产妇发病率

• 批准号: 10748243
• 负责人: Torri D Metz
• 金额: $ 194.97万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-17 至 2030-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10748243
• 关键词: Accidents; Accounting; Active Learning; Address; Adverse effects; Affect; Alaska Native; American Indians; Caring; Cessation of life; Clinic; Collaborations; Communities; Dependence; Discipline of obstetrics; Discrimination; Disparity; Drug usage; Educational Curriculum; Elements; Equity; Family; Glean; Goals; Healthcare; Individual; Infrastructure; Inpatients; Intervention; Interview; Leadership; Learning; Link; Location; Maternal Health; Maternal Mortality; Medical Care Team; Medicine; Mental disorders; Methods; Mission; Morbidity - disease rate; Mothers; Names; Native Americans; Outpatients; Overdose; Patient-Focused Outcomes; Perinatal; Perinatal Care; Persons; Pharmaceutical Preparations; Population; Populations at Risk; Postpartum Period; Pregnancy; Provider; Recovery; Research; Research Infrastructure; Research Personnel; Research Project Grants; Research Training; Review Committee; Role; Rural; Rural Community; Scientist; Substance Use Disorder; Suicide; System; Testing; Time; Trainers Training; Training; Tribes; Universities; Utah; Work; addiction; community engagement; community partnership; community setting; disparity reduction; effectiveness/implementation trial; experience; future implementation; health training; implementation science; improved outcome; informant; maternal morbidity; member; multidisciplinary; next generation; pregnancy associated death; pregnant; programs; response; rural setting; scale up; simulation; substance use; success; tool

PROJECT SUMMARY ELEVATE CENTER Accidental drug overdose and suicide were the leading causes of pregnancy-associated death in Utah from 2015-2020, accounting for nearly 40% of all pregnancy-associated deaths over that time period. At-risk populations, including those in rural settings and those who identify as American Indian or Alaska Native are disproportionately affected by maternal morbidity. We bring together a transdisciplinary team with expertise in obstetrics, addiction medicine, simulation training, experiential learning, bias and disparity reduction, community engagement and implementation science. Together, this collaborative team will establish the ELEVATE Maternal Health Center of Excellence. ELEVATE is named to encompass our mission to Expand our reach across Utah and the Mountain West, LEVerage existing infrastructure, And Treat pregnant and postpartum people with substance use disorder (SUD) who experience disparities to achieve Equity. In response to our community partners and needs of disproportionately affected populations, we propose three projects in years 1-5, which will be scaled up and implemented statewide and disseminated nationally in years 6 and 7. Project 1 (CEREMONY) will implement a culturally appropriate and multidisciplinary perinatal care clinic for individuals with SUD at Sacred Circle Clinic, which is a clinic serving Native mothers. Project 2 (INSPIRE) will develop, implement and test a modular learning intervention, anchored in simulation training, for interprofessional members of the healthcare team to reduce bias related to SUD in pregnancy. A robust train- the-trainer curriculum will allow us to implement the program across the state and reach rural communities. Project 3 (MEMORIES) will refine and test an expanded informant interview tool to ascertain community and systems contributions to maternal deaths, and the role of discrimination in deaths from SUD. The tool will then be disseminated nationally to Maternal Mortality Review Committees. Our ELEVATE Center aims are to: (1) provide integrated and efficient leadership of the three proposed projects, maximizing coordination with community partners and incorporating research training across all elements of the ELEVATE Center; (2) mature our existing community partnerships and statewide networks in order to facilitate future implementation science and effectiveness trials to reduce maternal morbidity and mortality in Utah, and (3) reduce maternal morbidity in Utah and nationally through implementation of community-driven interventions and training of health care practitioners. The ELEVATE Center will rigorously investigate and identify contributors to maternal morbidity and mortality from SUD with a focus on rural and Native populations. The multipronged approach of the ELEVATE Center will reduce maternal morbidity from substance use in Utah while training the next generation of scientists focused on morbidity reduction. Our efforts can ultimately be expanded nationally to address a leading cause of pregnancy-associated death in the U.S.

项目摘要高架中心 意外药物过量和自杀是犹他州与妊娠相关死亡的主要原因 2015 - 2020年，该时间段占所有与怀孕相关的死亡的近40％。处于危险中 人口，包括农村环境中的人群以及那些被识别为美洲印第安人或阿拉斯加本地人的人口 受母亲发病率的影响不成比例。我们将一个具有专业知识的跨学科团队汇集在一起 产科，成瘾医学，仿真培训，经验学习，偏见和差异， 社区参与和实施科学。这个合作团队将共同建立 提升孕产妇健康卓越中心。抬高的命名是涵盖我们扩展的使命 我们穿越犹他州和山区西部，利用现有的基础设施，治疗怀孕和 产后患有药物使用障碍（SUD）的人经历差异以实现公平。 为了回应我们的社区合作伙伴和受影响不成比例的人群的需求，我们提出了三个 1 - 5年内的项目将在全国范围内进行规模扩大和实施，并在全国范围内进行分散 6和7。项目1（仪式）将实施适当和多学科的围产期护理 神圣圈子诊所的SUD患者的诊所，该诊所是一家为本地母亲服务的诊所。项目2 （INSPIRE）将开发，实施和测试模块化学习干预措施，以模拟培训为基础 医疗保健团队的跨专业成员减少与妊娠中SUD相关的偏见。强大的火车 - 培训者课程将使我们能够在全州实施该计划并到达农村社区。 项目3（记忆）将完善并测试扩展的信息面试工具，以确定社区和 系统对孕产妇死亡的贡献以及歧视在SUD死亡中的作用。然后该工具将 在全国范围内传播给孕产妇死亡审查委员会。 我们的高架中心的目标是：（1）提供三个提议的综合有效领导 项目，最大化与社区合作伙伴的协调并纳入所有人的研究培训 高架中心的元素； （2）成熟我们现有的社区伙伴关系和全州范围内的网络 为了促进未来的实施科学和有效性试验，以降低母亲的发病率和 犹他州的死亡率以及（3）通过实施降低犹他州的产妇发病率 社区驱动的干预措施和培训医疗保健从业人员。 高架中心将严格调查并确定孕产妇发病率和死亡率的贡献者 来自SUD，重点是农村和本地人口。高架中心的多重方法 在训练下一代科学家时，将减少犹他州物质使用的产妇发病率 专注于发病率降低。我们的努力最终可以在全国范围内扩展，以解决主要原因 美国与怀孕相关的死亡