ASTERISK: Alcohol and Substance use Treatment and Engagement Research on Intervention Studies among Key populations

ASTERISK：重点人群中酒精和药物使用治疗和干预研究的参与研究

• 批准号: 10593145
• 负责人: Glenn-Milo Santos
• 金额: $ 18.76万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 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/10593145
• 关键词: AIDS prevention; Acceleration; Address; Advanced Development; Alcohol consumption; Area; Behavioral; Caring; Categories; Complex Analysis; Data; Data Analyses; Data Set; Ethnic Origin; Gender; Gender Identity; HIV; HIV risk; Health; Health Services Accessibility; Homelessness; Homophobia; Human Resources; Imprisonment; Individual; Intervention; Intervention Studies; Measures; Mentors; Methodology; Morbidity - disease rate; National Institute of Drug Abuse; National Institute on Alcohol Abuse and Alcoholism; Outcome; Participant; Persons; Pharmacotherapy; Population; Populations at Risk; Psychosocial Factor; Public Health; Race; Research; Research Personnel; Research Project Grants; Role; Sample Size; Sampling; Services; Sex Discrimination; Sexism; Social support; Source; Statistical Models; Structure; Subgroup; Substance Use Disorder; Surveys; Training; Treatment outcome; Treatment/Psychosocial Effects; Visit; Work; alcohol services; alcohol use disorder; burden of illness; career development; disability-adjusted life years; efficacious intervention; ethnic identity; experience; experimental study; medication compliance; mortality; novel; patient oriented research; polysubstance use; preference; programs; psychological distress; racial identity; racism; reduced alcohol use; resilience; scale up; sex; skill acquisition; social; social capital; social group; social stigma; structural determinants; substance use; substance use treatment; syndemic; transphobia; treatment strategy; uptake; years of life lost

PROJECT SUMMARY Alcohol and substance use disorders (ASUD) are associated with substantial morbidity and mortality. Globally alcohol use disorders (AUD) were attributed to 99.2 million disability-adjusted life years (DALYs) while illicit substance use disorders (SUD) were attributed to 31.8 million DALYs lost in 2016. Despite the urgent need to reduce the public health impacts of ASUD and scale up efficacious interventions, treatment uptake worldwide remains low. Psychosocial and structural factors are major barriers to ASUD treatment and engagement. For example, psychological distress, polysubstance use, homelessness, incarceration, and engagement in sex work have been associated with lower ASUD treatment coverage and completion. When these factors co-occur, they may also generate synergistic negative effects that contribute to less optimal health outcomes and greater disease burden (defined as syndemics). Less research has empirically examined the syndemic effects of psychosocial and structural barriers on ASUD treatment and treatment engagement. To optimize ASUD treatments and maximize engagement, there’s an urgent need to examine the syndemic relationship of these conditions, especially across multiple and diverse studies. To address these gaps, Dr. Santos proposes to expand his patient oriented research (POR) program, and expand his capacity to train early stage investigators (ESIs), particularly those from underrepresented backgrounds. Dr. Santos will provide experiential training for ESIs in three complementary POR projects (Projects A, B, and C) that will examine the barriers to ASUD treatment access and engagement, and explore treatment preferences of individuals with ASUD. Project A will examine the syndemic effects of psychosocial and structural conditions on the use of ASUD treatment (AIM 1), and the moderators of those effects (AIM 2), leveraging five National HIV Behavioral Survey cycles (cumulative n=3848) using an Integrative Data Analysis (IDA) approach. Project B will examine the syndemic effects of psychosocial and structural conditions on ASUD treatment outcomes (AIM 3), and the moderators of those effects (AIM 4), leveraging 10 ASUD pharmacotherapy trials (cumulative n=722), also using an IDA approach. Project C will examine the preferred treatment attributes of individuals with ASUD using Discrete Choice Experiments (DCE; AIM 5) and examine how preferences differ between groups (AIM 6) among 250 individuals with ASUD. Ultimately, the findings from this study will be fill critical gaps in ASUD treatment implementation, particularly for key populations disproportionately impacted by HIV. In parallel to these research projects, Dr. Santos will provide structured mentoring and training to ESIs in three key areas of support: instrumental, professional and social. Instrumental support will focus on building ESIs capacity to become independent researchers. Professional support will focus on career development skills to thrive in research. Finally, social support aims to increase their social capital and resilience through networking opportunities, group social activities, and individual coaching.

项目概要 酒精和物质使用障碍（ASUD）与全球范围内的高发病率和死亡率相关。 酒精使用障碍 (AUD) 导致 9,920 万伤残调整生命年 (DALY)，而非法饮酒 2016 年，物质使用障碍 (SUD) 导致 3180 万伤残调整生命年损失。尽管迫切需要 减少 ASUD 对公共卫生的影响并扩大有效的干预措施和全球治疗的采用 社会心理和结构性因素仍然较低，是 ASUD 治疗和参与的主要障碍。 例如，心理困扰、多物质使用、无家可归、监禁和从事性工作 当这些因素同时出现时，它们与较低的 ASUD 治疗覆盖率和完成率有关。 还可能产生协同负面影响，导致不太理想的健康结果和更大的影响 疾病负担（定义为综合征）较少有研究实证检验疾病负担的综合症效应。 ASUD 治疗和治疗参与的心理社会和结构性障碍。 治疗和最大限度地参与，迫切需要检查这些疾病的流行病关系 为了解决这些差距，桑托斯博士建议： 扩大他的以患者为导向的研究（POR）计划，并扩大他培训早期研究人员的能力 (ESI)，特别是那些来自代表性不足的背景的人，桑托斯博士将为他们提供体验式培训。 三个互补的 POR 项目（项目 A、B 和 C）中的 ESI 将审查 ASUD 的障碍 治疗的获取和参与，并探索 ASUD 患者的治疗偏好。 检查心理社会和结构状况对使用 ASUD 治疗的综合症影响（AIM 1）， 以及这些影响的调节因素（AIM 2），利用五个国家艾滋病毒行为调查周期（累计 n=3848) 使用综合数据分析 (IDA) 方法，项目 B 将检查流行病的影响。 ASUD 治疗结果 (AIM 3) 的心理社会和结构条件，以及这些条件的调节因素 效应（AIM 4），利用 10 项 ASUD 药物治疗试验（累计 n=722），也使用 IDA 方法。 项目 C 将使用离散选择检查 ASUD 患者的首选治疗属性 实验（DCE；AIM 5）并检查 250 名个体之间的偏好差异（AIM 6） 最终，这项研究的结果将填补 ASUD 治疗实施中的关键空白， 在开展这些研究项目的同时，特别是针对受艾滋病毒影响尤为严重的重点人群。 Santos 将在三个关键支持领域为 ESI 提供结构化指导和培训：工具、 专业和社会方面的支持将侧重于培养 ESI 的独立能力。 研究人员的专业支持将侧重于在研究中蓬勃发展的职业发展技能。 支持旨在通过社交机会、团体社交机会增加他们的社会资本和适应能力 活动和个人辅导。