Transitions Clinic Network: Post Incarceration Addiction Treatment, Healthcare, and Social Support (TCN PATHS) study

摘要 自我羞辱是影响OUD治疗和治疗中参与和保留的许多障碍之一 可能是导致惩教机构出院后服药过量的高风险的原因。识别 缓和和改变释放后阿片类药物相关过量死亡风险的因素可能会造成 提供新的干预措施和方案的机会。在患有以下疾病的人中进行的研究 物质使用障碍(SUD)已将对既定耻辱的恐惧以及对自我耻辱的恐惧识别为 阻碍治疗进入和参与的诱因。自我污名如何影响 还没有人研究过在出狱后参与治疗的问题。鲜为人知的是 以患者为中心的初级保健模式是否可以改善自我污名，以及这是否在 反过来，提高了OUD治疗的参与度和固位力。这项研究有助于 我们小组正在进行新一代药物滥用健康服务研究，以解决 自我污名对新的以病人为中心的初级保健的有效性和中心的影响 改善涉及司法的OUD患者健康的方法。整体研究 这项家长津贴补充(1UG1DA050072)的目的是检验自我的影响 对OUD治疗的耻辱在刚刚出狱的人中层出不穷，并评估 TCN干预与释放后治疗期间自我污名的减少有关 句号。我们的目标是：(1)确定哪些社会人口学特征和心理社会、健康、 治疗因素与自我污名有关。(2)确定自我污名是否 缓和参与TCN和参与OUD治疗之间的关联 在发布之后。结果将为后续的R34测试和 改善自我污名及其对治疗结果的影响的干预。专业人士 发展计划将有助于申请人获得独立的研究生涯 重点测试初级保健中可获得的干预方式，以减少自我羞辱和 在这一弱势群体中，加强对有价值的人生目标的追求。

ABSTRACT Self-stigma is one of many barriers that affect engagement and retention in OUD treatment and may be driving the high risk of overdose following release from correctional facilities. Identifying factors that moderates and modify post-release opioid related overdose mortality risk can create opportunities for novel interventions and programs. Studies conducted among individuals with a substance use disorder (SUD) have identified fear of enacted stigma, as well as self-stigma, as predisposing factors that hinder treatment entry and engagement. How self-stigma impacts the engagement in OUD treatment following release from jail has not been studied. Less is known on whether a patient-centered primary care model can ameliorate self-stigma and whether this, in turn, enhances improved OUD treatment engagement and retention. This study contributes to a new generation of drug abuse health services research emerging in our group that addresses the effects of self-stigma on the effectiveness and patient-centeredness of a new primary care-based approach to improving the health of justice-involved individuals with OUD. The overall research objective of this supplement to parent grant (1UG1DA050072) is to examine the effects of self- stigma on the OUD treatment cascade among individuals just released from jail and assess if the TCN intervention is associated with self-stigma reductions during post release treatment period. We aim to: (1) Identify which sociodemographic characteristics and psychosocial, health, and treatment factors are associated with self-stigma. (2) Determine whether self-stigma moderates the association between TCN participation and engagement in OUD treatment following release. Results will provide preliminary data for a subsequent R34 testing an intervention to ameliorate self-stigma and its impact on treatment outcomes. The professional development plan will facilitate attainment of the applicant’s independent research career focused on testing intervention modalities accessible in primary care to reduce self-stigma and enhance pursuing valued life goals in this vulnerable population.