Improving social connectedness through digital health to enhance recovery from OUD among the justice involved population.

通过数字健康改善社会联系，以促进司法相关人群从 OUD 中恢复。

• 批准号: 10675916
• 负责人: Kirsten Johnson Langdon
• 金额: $ 21.51万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-15 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10675916
• 关键词: Address; Adult; Ambulatory Care; Back; Cellular Phone; Communities; Criminal Justice; Dedications; Dropout; Education; Ethics; Evidence based treatment; Face; Facebook; Feeling; General Population; Geography; Goals; HIV; Health; Hybrids; Imprisonment; Income; Individual; Interview; Jail; Justice; Knowledge; Loneliness; Manuals; Natural Language Processing; Outcome; Outpatients; Participant; Persons; Pharmaceutical Preparations; Population; Prisons; Public Health; Randomized, Controlled Trials; Recording of previous events; Recovery; Recovery Support; Research; Resources; Risk; Risk Factors; Secure; Security; Self Efficacy; Self-Injurious Behavior; Social support; Structure; Target Populations; Testing; Text; Time; Vulnerable Populations; Work; acceptability and feasibility; addiction; community reentry; coronavirus disease; digital health; effectiveness/implementation study; evidence base; experience; follow up assessment; formative assessment; future implementation; high risk; illicit opioid; implementation barriers; implementation evaluation; implementation facilitators; improved; improved outcome; medication for opioid use disorder; mobile application; mortality; novel; opioid mortality; opioid use; opioid use disorder; overdose death; peer; peer recovery; peer support; primary outcome; programs; prospective; recruit; secondary outcome; social; social group; social stigma; standard of care; substance use; transmission process; treatment as usual; uptake; violent crime

ABSTRACT Individuals with criminal justice involvement experience elevated rates of Opioid Use Disorder (OUD) and are at significantly higher risk of death from opioid overdose in the first year following release from jail/prison. Medications for OUD (MOUD) are an evidence-based approach to treating OUD and offer extensive benefits including lowering rates of mortality, illicit opioid use, HIV transmission, violent crime, and arrest. While many correctional settings have started to implement MOUD, there are significant challenges to continuing medication/treatment while transitioning back to the community. Intersectional stigma related to addiction and history of incarceration is associated with greater difficulties with reintegration, increased isolation, and heightened feelings of loneliness. Lack of social connectedness further serves as a risk factor for decreased retention in treatment, discontinuation of MOUD, and a return to substance use. Peer support is a key component of many evidence-based OUD recovery programs. When used in conjunction with MOUD, it has the potential to improve perceived social support, self-efficacy, and treatment engagement. However, access to live peer support has been challenged by COVID restrictions, highlighting a critical need for digital health platforms to deliver peer support. The Marigold Mobile Peer Support (“MPS”) App is a dedicated, secure, mobile application that employs structured, live peer moderation to guide text-based conversations with groups of participants and behind-the-scenes natural language processing (NLP) to automatically identify “red flag” content within peer chats. While initial work demonstrates the utility of deploying the MPS App in outpatient treatment settings for OUD, it has yet to be tested in correctional settings or among justice-involved populations. The goal of the proposed application is to advance evidence-based and scalable treatments for OUD, by decreasing loneliness and enhancing perceived social support via novel application of an established mobile app among individuals with a history of engaging in MOUD while in jail/prison. The study will be accomplished through two primary aims: (1) develop an implementation manual to guide delivery of the MPS App for those with a recent (past year) history of engaging in MOUD while in jail/prison by conducting in-depth interviews with prospective app users and other key stakeholders; and (2) conduct a randomized controlled trial to assess feasibility, acceptability, and preliminary efficacy of the MPS App relative to enhanced treatment- as-usual among individuals with a recent (past year) history of engaging in MOUD while in jail/prison. Findings from this study will be used to develop a R01 application to conduct a fully-powered Hybrid Type 1 Effectiveness-Implementation study.

抽象的 涉及刑事司法的个人阿片类药物使用障碍 (OUD) 的发病率较高，并且 出狱后第一年因阿片类药物过量死亡的风险明显更高。 OUD 药物 (MOUD) 是一种治疗 OUD 的循证方法，具有广泛的益处 包括降低死亡率、非法阿片类药物使用、艾滋病毒传播、暴力犯罪和逮捕。 惩教机构已开始实施 MOUD，但继续实施仍面临重大挑战 药物/治疗，同时过渡回社区。与成瘾和相关的交叉耻辱。 监禁史与重返社会更加困难、孤立程度增加以及 缺乏社交联系进一步成为降低孤独感的风险因素。 坚持治疗、停止 MOUD 以及恢复药物使用是关键。 与 MOUD 结合使用时，它是许多基于证据的 OUD 恢复计划的组成部分。 改善感知社会支持、自我效能和治疗参与度的潜力。 现场同伴支持受到了新冠疫情限制的挑战，凸显了对数字健康的迫切需求 Marigold 移动同伴支持（“MPS”）应用程序是一款专用、安全、 移动应用程序，采用结构化的实时同行审核来指导与群组进行基于文本的对话 参与者和幕后自然语言处理 (NLP) 自动识别“危险信号” 最初的工作展示了在门诊部署 MPS 应用程序的实用性。 OUD 的治疗环境，尚未在惩教环境或涉及司法的环境中进行测试 拟议应用的目标是推进基于证据的、可扩展的治疗。 OUD，通过新颖地应用既定的方法来减少孤独感并增强感知的社会支持 该研究将在有 MOUD 历史的个人中进行。 通过两个主要目标来实现：(1) 制定实施手册来指导 MPS 的实施 该应用程序适合那些最近（过去一年）在监狱/监狱中通过深入开展 MOUD 活动的人 与潜在的应用程序用户和其他主要利益相关者进行访谈；(2) 进行随机对照调查； 评估 MPS 应用程序相对于强化治疗的可行性、可接受性和初步功效的试验 - 与最近（去年）在监狱中参与 MOUD 历史的个人一样。 这项研究的成果将用于开发 R01 应用程序，以进行全动力混合动力 1 型 有效性-实施研究。