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.

项目总结 美国正处于阿片类药物流行之中。每年给社会带来的总成本超过1万亿美元。这个 新冠肺炎疫情似乎加速了这个问题，已有超过81,000人死于 在截至2020年5月的一年中服药过量。令人惊讶的是，尽管有200多万人使用阿片类药物 在这些成年人中，只有不到35%的人在2019年接受了治疗。耻辱是导致 这一治疗差距。对于有OUD的人来说，内化的负面信念可能会限制他们与 医疗保健系统。此外，临床医生中的耻辱可能会限制挽救生命的治疗的实施。 对于所有试图应对阿片类药物流行的策略，一个极未得到充分利用的因素是当代的 教与学的方法。尽管新冠肺炎极大地颠覆了教育系统，但 大流行病突出了通过技术进行创新的重要性和机会。 C4创新(C4)及其在耶鲁大学(耶鲁)和西黑文退伍军人医学中心的合作伙伴 (WHVA)提议开发和测试OASIS(克服和解决物质使用中的污名 紊乱)。OASIS是一个基于网络的教育平台，面向初级保健临床医生和有OUD的个人。 我们相信，OASIS将减少护理障碍，提高OUD治疗结果。我们队 包括教育、神经科学和OUD治疗、污名的影响和管理等方面的专家， 以及产品开发和测试。该平台将帮助患者和临床医生与不同的 根据他们的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非同步机会。我们设计这个平台是为了帮助个人 在沉思前或沉思的上瘾阶段，瞄准限制与之接触的污名 护理，并帮助启动循证治疗。我们的第一阶段试点研究以两个具体目标为指导： 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：试点绿洲与一小部分未经治疗的OUD患者及其临床医生确定 第二阶段有效性试验的可行性、可接受性和初步产品有效性。 C4-Yale-WHVA团队将在患者(N=30)和临床医生(N=5)中使用VALIDATED 测量和定性访谈。该团队将评估可用性、满意度、知识、赋权、 和耻辱。未来的第二阶段项目将包括对最终产品进行对照试验，以证明其 使患者能够与其初级保健临床医生进行对话并发起OUD的效果 治疗，有能力将该工具扩展到未来解决更广泛物质的产品中。 我们的团队相信，医疗保健系统将有兴趣为患者和 临床医生减少耻辱，改善结果，并降低与未经治疗的OUD相关的高昂成本。