Development of a novel community-based high-performance surveillance network for drug use

开发基于社区的新型高性能毒品使用监测网络

• 批准号: 10512220
• 负责人: Joshua Adam Barocas
• 金额: $ 226.37万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10512220
• 关键词: Development; novel; community; based; performance

PROJECT SUMMARY Surveillance efforts for substance use are failing us. They rely on outdated risk prediction tools yet risk factors for HIV and overdose are context-specific and are impacted by the interplay between patient-, provider-, and system-level factors as well as epidemiologic realities in a community. They rely on direct estimation methods for measuring prevalence yet barriers such as lack of access to medications for opioid use disorder (MOUD) and harm reduction services, stigma, criminalization of drug use, and unaffordable housing prevent people who use drugs (PWUD) from being counted. Additionally, they rarely involve community engagement and surveillance data are not disseminated effectively to communities to achieve maximum benefit. In the context of the ongoing overdose crisis and recent outbreaks of HIV among PWUD in Indiana, Massachusetts, Kentucky, and West Virginia, the failures of this basic tool of public health take on a new urgency. The number of efficacious programs and interventions to prevent and treat substance use and HIV continues to grow, but without accurate estimates of the size of the pool of people at risk of overdose and for acquiring HIV and knowledge of their specific risk factors, these interventions cannot reach their full potential. We cannot reach people who we do not know exist and are at risk. We, therefore, need to immediately modernize and upgrade our surveillance capacity to understand the size and composition of drug-using populations. I am proposing an innovative, interdisciplinary research program that integrates epidemiology, community engagement, biostatistics, econometrics, and information dissemination to create a novel community-based, high- performance surveillance network for PWUD. I will do this by (1) creating a community engaged research (CEnR) process around big data for PWUD; (2) building community-specific risk prediction algorithms for HIV acquisition, disease progression, and loss to follow up among PWUD; (3) using enhanced indirect estimation methods to determine the size of populations of PWUD and to evaluate the impact of interventions; and (4) disseminating findings and translating research into action. The data centerpiece of this program will be the Public Health Data Warehouse, an individually-linked database from more than 15 Massachusetts government agencies, which includes more than 97% of the Massachusetts population. Preliminary analyses with this database are underway and will be made accessible to communities in real-time. This project represents an approach that is entirely divergent from traditional surveillance techniques by using a combination of complex methodologies with the community always at the center of the process—from initiation to final output. This novel Massachusetts cOMmunity-bAsed Drug use surveillANCE (“Moma Dance”) Network will begin in Massachusetts, but will serve as a model for other states and jurisdictions as they contend with the failures of their own surveillance systems for PWUD. These efforts will translate research into action at the community level and have an immediate and sustained public health impact on the drug use and HIV epidemics.

项目概要 对药物使用的监测工作正在失败。他们依赖过时的风险预测工具，但艾滋病毒和服药过量的风险因素是特定于具体情况的，并受到患者、提供者和系统层面因素之间相互作用以及社区流行病学现实的影响。他们依靠直接估计方法来衡量流行率，但缺乏治疗阿片类药物使用障碍 (MOUD) 的药物和减少伤害服务、耻辱感、吸毒犯罪化以及负担不起的住房等障碍阻碍了吸毒者 (PWUD) 的统计。此外，它们很少涉及社区参与，监测数据也没有有效地传播给社区以实现最大利益。在印第安纳州、马萨诸塞州、肯塔基州和西弗吉尼亚州持续存在的用药过量危机和最近在残疾人士中爆发艾滋病毒的背景下，这一基本公共卫生工具的失败变得更加紧迫。预防和治疗药物滥用和艾滋病毒的有效计划和干预措施的数量持续增加，但如果不能准确估计有过量用药风险和感染艾滋病毒的人群规模以及对其具体风险因素的了解，这些干预措施就无法充分发挥其潜力。我们无法接触到那些我们不知道存在且处于危险之中的人。因此，我们需要立即现代化和升级我们的监测能力，以了解吸毒人群的规模和构成。我提议一项创新的跨学科研究计划，该计划整合了流行病学、社区参与、生物统计学、计量经济学和信息传播，为 PWUD 创建一个新颖的基于社区的高性能监测网络。我将通过 (1) 围绕 PWUD 大数据创建社区参与研究 (CEnR) 流程来实现这一目标； (2) 建立针对艾滋病毒感染、疾病进展和残疾人士失访的社区特定风险预测算法； (3) 使用增强的间接估计方法确定残疾人士人口规模并评估干预措施的影响； (4) 传播研究结果并将研究转化为行动。该计划的数据核心将是公共卫生数据仓库，这是一个来自超过 15 个马萨诸塞州政府机构的单独链接的数据库，其中包括超过 97% 的马萨诸塞州人口。该数据库的初步分析正在进行中，并将可供社区实时访问。该项目代表了一种与传统监控技术完全不同的方法，它结合了复杂的方法，并始终以社区为中心——从启动到最终输出。这个新颖的马萨诸塞州社区毒品使用监测（“Moma Dance”）网络将在马萨诸塞州启动，但也将成为其他州和司法管辖区的典范，因为它们正在应对自己的 PWUD 监测系统的失败。这些努力将把研究转化为社区一级的行动，并对吸毒和艾滋病毒流行产生直接和持续的公共卫生影响。

项目成果

Opioid Use Disorder Among Ohio's Medicaid Population: Prevalence Estimates From 19 Counties Using a Multiplier Method.

俄亥俄州医疗补助人群中的阿片类药物使用障碍：使用乘数法对 19 个县的患病率进行估计。

• DOI: 10.1093/aje/kwac154
• 发表时间: 2022
• 期刊: American journal of epidemiology
• 影响因子: 5
• 作者: Doogan,NathanJ;Mack,Aimee;Wang,Jianing;Crane,Dushka;Jackson,Rebecca;Applegate,Mary;Villani,Jennifer;Chandler,Redonna;Barocas,JoshuaA
• 通讯作者: Barocas,JoshuaA

Analysis of Smartphone Text Data Related to mpox from a U.S. Sample of Gay, Bisexual, and Other Men Who Have Sex with Men During the 2022 Outbreak.

• DOI: 10.1089/lgbt.2022.0307
• 发表时间: 2023-10
• 期刊: LGBT health
• 影响因子: 4.8
• 作者: Cascalheira CJ;Hong C;Beltran RM;Karkkainen K;Beikzadeh M;Sarrafzadeh M;Holloway IW
• 通讯作者: Holloway IW

Identifying structural risk factors for overdose following incarceration: a concept mapping study.

确定监禁后服药过量的结构性风险因素：概念图研究。

• DOI: 10.1186/s40352-024-00265-w
• 发表时间: 2024
• 期刊: Health & justice
• 影响因子: 3.5
• 作者: Nall,SamanthaK;Jurecka,Cole;AmmonsJr,Anthony;Rodriguez,Avel;Craft,Betsy;Waleed,Craig;Dias,Daniel;Henderson,Jessie;Boyer,Joshua;Yamkovoy,Kristina;Swathi,PallaviAytha;Patil,Prasad;Behne,Forrest;LeMasters,Katherine;Brinkley-Rub
• 通讯作者: Brinkley-Rub