Overcoming Stigma and Improving Outcomes for Substance Use Disorders Through Education, Engagement, and Empowerment

通过教育、参与和赋权克服药物滥用障碍的耻辱并改善结果

• 批准号: 10360831
• 负责人: ELLEN L EDENS
• 金额: $ 22.01万
• 依托单位: C4 INNOVATIONS, LLC
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2023-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10360831
• 关键词: Achievement; Address; Adult; Affect; American; Appointment; Area; Attitude; Basic Science; Belief; COVID-19; COVID-19 pandemic; Caring; Clinical; Collaborations; Cost Savings; Development; Education; Educational Intervention; Educational Materials; Educational process of instructing; Effectiveness; Elements; Ensure; Evidence based treatment; Faculty; Family; Funding; Future; Genetic Counseling; Healthcare; Healthcare Systems; Home; Individual; Intervention; Interview; Joints; Knowledge; Learning; Measures; Medical center; Modeling; Modernization; Morals; National Institute of Mental Health; Neurosciences; Online Systems; Overdose; Patient-Focused Outcomes; Patients; Phase; Physician Assistants; Pilot Projects; Plant Roots; Policies; Prejudice; Primary Care Physician; Primary Health Care; Public Health; Recovery; Reporting; Research; Resources; Risk; Role; Sampling; Side; Small Business Innovation Research Grant; Social support; Societies; Subconscious; Substance Use Disorder; System; Technology; Testing; Time; Training; Treatment outcome; United States; United States Dept. of Health and Human Services; Universities; addiction; barrier to care; clinical encounter; combat; community based service; cost; design; education resources; effectiveness trial; empowered; empowerment; evidence base; experience; improved; improved outcome; innovation; innovative technologies; instrument; interest; medical schools; medical specialties; opioid abuse; opioid epidemic; opioid use; opioid use disorder; overdose death; pandemic disease; peer; prevent; product development; prototype; psychoeducation; research study; satisfaction; skills; social; social stigma; societal costs; tool; usability; web app

PROJECT SUMMARY The United States is amid an opioid epidemic. The overall annual cost to society is more than $1 trillion. The COVID-19 pandemic appears to have accelerated the problem, with more than 81,000 individuals dying from overdose in the year ending May 2020. Astonishingly, while more than 2 million individuals have opioid use disorder (OUD), fewer than 35% of these adults received treatment in 2019. Stigma is one major reason for this treatment gap. For individuals with OUD, internalized negative beliefs may limit their engagement with healthcare systems. Furthermore, stigma among clinicians may limit implementation of lifesaving treatment. For all the tactics tried to deal with the opioid epidemic, one greatly underused element is contemporary approaches to teaching and learning. Although COVID-19 massively disrupted educational systems, the pandemic has highlighted the importance of and opportunity for innovation through technology. C4 Innovations (C4) and partners at Yale University (Yale) and the West Haven VA Medical Center (WHVA) propose to develop and test OASIS (Overcoming and Addressing Stigma in Substance Use Disorders). OASIS is a web-based educational platform for primary care clinicians and individuals with OUD. We believe that OASIS will decrease barriers to care and enhance OUD treatment outcomes. Our team includes experts in education, the neuroscience and treatment of OUD, the effect and management of stigma, and product development and testing. The platform will help patients and clinicians to engage with a diverse set of high-quality educational materials according to their personal needs, including synchronous and asynchronous opportunities to interact with experts and peers. We designed the platform to assist individuals in the pre-contemplative or contemplative stages of addiction, targeting the stigma that limits engagement with care, and helping initiate evidence-based treatment. Two specific aims guide our Phase I pilot study: AIM 1: Develop a prototype of OASIS for patients with OUD and primary care clinicians; conduct usability testing. AIM 2: Pilot OASIS with a small sample of individuals with untreated OUD and their clinicians to determine feasibility, acceptability, and preliminary product effectiveness for a Phase II effectiveness trial. The C4–Yale–WHVA team will test OASIS with patients (N = 30) and clinicians (N = 5) using validated measures and qualitative interviews. The team will assess usability, satisfaction, knowledge, empowerment, and stigma. A future Phase II project would include a controlled trial of the final product demonstrating its efficacy for empowering patients to engage in dialogues with their primary care clinicians and initiate OUD treatment, with the ability to expand the tool for future products addressing a broader array of substances. Our team is confident that healthcare systems will be interested in purchasing a tool for patients and clinicians that reduces stigma, improves outcomes, and reduces high costs associated with untreated OUD.

项目概要 美国正处于阿片类药物流行之中。每年给社会造成的总成本超过 1 万亿美元。这 COVID-19 大流行似乎加剧了这一问题，已有超过 81,000 人死于该病 截至 2020 年 5 月的一年中，阿片类药物过量。令人惊讶的是，超过 200 万人使用阿片类药物 障碍（OUD），这些成年人中只有不到 35% 在 2019 年接受了治疗。耻辱是其主要原因之一 这个治疗差距。对于患有 OUD 的人来说，内在的负面信念可能会限制他们参与 医疗保健系统。此外，临床医生的耻辱感可能会限制挽救生命的治疗的实施。 对于试图应对阿片类药物流行病的所有策略来说，其中一个未被充分利用的因素是当代的 教学方法。尽管 COVID-19 严重扰乱了教育系统， 大流行凸显了技术创新的重要性和机遇。 C4 Innovations (C4) 与耶鲁大学 (Yale) 和 West Haven VA 医疗中心的合作伙伴 (WHVA) 建议开发和测试 OASIS（克服和解决药物使用中的耻辱） 障碍）。 OASIS 是一个基于网络的教育平台，面向初级保健临床医生和 OUD 患者。 我们相信 OASIS 将减少护理障碍并提高 OUD 治疗效果。我们的团队 包括教育、神经科学和 OUD 治疗、耻辱的影响和管理方面的专家， 以及产品开发和测试。该平台将帮助患者和临床医生与多元化的人互动 根据个人需求提供一套高质量的教育材料，包括同步和 与专家和同行互动的异步机会。我们设计该平台是为了帮助个人 在成瘾的前沉思或沉思阶段，针对限制参与的耻辱 护理，并帮助启动循证治疗。我们的第一阶段试点研究有两个具体目标： 目标 1：为 OUD 患者和初级保健临床医生开发 OASIS 原型；进行可用性测试。 目标 2：对未经治疗的 OUD 个体及其临床医生进行小样本试点 OASIS，以确定 II 期有效性试验的可行性、可接受性和初步产品有效性。 C4-耶鲁-WHVA 团队将使用经过验证的患者 (N = 30) 和临床医生 (N = 5) 来测试 OASIS 措施和定性访谈。该团队将评估可用性、满意度、知识、授权、 和耻辱。未来的第二阶段项目将包括对最终产品进行受控试验，证明其 使患者能够与初级保健临床医生进行对话并启动 OUD 的功效 治疗，能够扩展未来产品处理更广泛物质的工具。 我们的团队相信医疗保健系统将有兴趣为患者购买工具并 减少耻辱感、改善结果并降低与未经治疗的 OUD 相关的高成本。