SCH: INT: Collaborative Research: An intelligent Pervasive Augmented reaLity therapy (iPAL) for Opioid Use Disorder and Recovery

阿片类药物使用障碍和成瘾现在被定性为全国性的“阿片类药物流行病”，过量服用现在是美国伤害死亡的主要原因。虽然与其他慢性疾病（如心脏病）相比，过去二十年来阿片类药物过量死亡人数大大增加，但针对阿片类药物渴望、恢复和复发的远程监测和管理工具和技术的发展却没有跟上。我们迫切需要设计出谨慎的、可获得的、相互联系的和个性化的治疗方案，以支持那些从阿片类药物使用障碍（OUD）中康复的人，而不是传统的治疗方法。该项目开发了智能普及增强现实疗法（iPAL），这是一种技术支持的OUD干预措施，旨在帮助OUD患者控制他们的渴望，以降低复发或过量服用的风险。iPAL将补充心理疗法（认知行为疗法和心率变异性生物反馈）与沉浸式技术（增强现实和混合现实）相结合，通过个性化策略提供便利、自由使用、即时/实时。这项工作将彻底改变个人学习、发现、创造和治愈的方式，在更广泛的背景下为OUD患者制定治疗策略。该开发系统的直接效益将是iPAL，这是一种帮助OUD患者体验更高质量生活的设备。拟议的框架具有超越OUD的转化潜力：可作为患有其他形式成瘾（例如吸烟和酒精）、自杀意念、创伤后应激障碍和/或严重抑郁症的人的心理健康支持援助。这项工作与农村地区尤其相关，因为那里的OUD患者往往难以获得服务。即使提供服务，污名也是获得这些传统成瘾服务的重大障碍。该项目的新颖和潜在变革性质在于超越了对关键技术（例如增强现实、混合现实和虚拟现实）、神经生理学（例如功能性大脑活动、心率变异性、皮电活动）和沉浸式情感决定因素（例如正或负效价和唤醒）的基础理论理解和识别，这些因素可以预测OUD患者的体验和随后的意图（例如，管理渴望）。该团队专注于不引人注目的手段（例如，移动和可穿戴技术），以收集实时生理参数，利用人工智能（AI）算法和沉浸式技术格式，谨慎地提供个性化和交互式的基于证据的补充OUD心理疗法。开展了一系列综合研究工作，以推进空间和情感计算科学（技术成果）和行为科学（健康成果），这将有助于以下智力优势：(1)开发一个智能系统，提供个性化和交互式的基于证据的心理治疗；(2)从根本上测量、建模和比较用户参与，使用神经特征、生理和主观反应，跨越现实-虚拟连续体；(3)使用智能和连接的沉浸式现实技术，为增强传统的OUD干预做出贡献；(4)确定最适合作为移动和实时个性化治疗干预的沉浸水平；(5)推进对普及和个性化沉浸技术在高危人群中所起作用的理解。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

Opioid use disorder and addiction are now characterized as a nationwide “opioid epidemic,” with overdoses now the leading cause of injury deaths in the United States. While opioid overdose deaths have increased greatly over the past two decades as compared to other chronic diseases (e.g., heart disease) the development of remote monitoring and management tools and techniques for opioid cravings, recovery, and relapse have not kept pace. There is a critical need to design therapy programs that are discreet, accessible, connected, and personalized by supporting those recovering from Opioid Use Disorder (OUD), beyond conventional therapies. This project develops intelligent Pervasive Augmented reaLity therapies (iPAL) - a technology-enabled OUD intervention that aims to help OUD sufferers manage their cravings to reduce their risk for relapse or overdose. iPAL integrates complementary psychotherapies (cognitive behavioral therapy and heart rate variability biofeedback) with immersive technologies (augmented and mixed reality) to offer convenience, discretion in use, in the moment/real-time through personalized strategies. This work is poised to revolutionize how individuals learn, discover, create, and heal in the broader context of developing treatment strategies for those with OUD. The immediate benefit of the developed system will be iPAL, an appliance for helping those with OUD to experience a better quality of life. The proposed framework has translational potential beyond OUD: serving as a mental health support aid for those suffering from other forms of addiction (e.g., smoking and alcohol), suicidal ideation, post-traumatic stress disorder, and/or severe depression. This work is especially relevant to rural areas where people with OUD often have poor access to services. Even when services are available, stigma is a significant barrier to accessing these traditional addiction services.The novel and potentially transformative nature of this project lies in transcending the foundational theoretical understanding and identification of key technological (e.g., augmented, mixed, and virtual reality), neurophysiological (e.g., functional brain activity, heart rate variability, electrodermal activity), and affective determinants (e.g., positive or negative valence and arousal) of immersion that predict OUD patient experience and subsequently intent (e.g., manage cravings). The team focuses on unobtrusive means (e.g., mobile and wearable technology) to collect real-time physiological parameters to discreetly deliver personalized and interactive evidence-based complementary OUD psychotherapies utilizing Artificial Intelligence (AI) algorithms and immersive technology formats. A series of integrated research efforts is undertaken to advance spatial and affective computing science (technology outcomes) and behavioral science (health outcomes) that will contribute to the following intellectual merits: (1) developing an intelligent system to deliver personalized and interactive evidence-based psychotherapies, (2) fundamentally measuring, modeling, and comparing user engagement using neural signatures and physiological and subjective responses across the reality-virtuality continuum, (3) contributing to augmenting traditional OUD interventions using smart and connected immersive reality technologies, (4) determining the level of immersion most suitable as a mobile and real-time personalized therapeutic intervention, and (5) advancing understanding regarding the role that pervasive and personalized immersive technology plays in at-risk populations.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.