Neighborhoods, Mental Health, and the Prevention of Opioid Overdose: A Mixed Methods Approach

社区、心理健康和阿片类药物过量的预防：混合方法

• 批准号: 10369171
• 负责人: Elizabeth Nesoff
• 金额: $ 11.61万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-15 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10369171
• 关键词: Neighborhoods; Mental; Health; Prevention; Opioid

PROJECT SUMMARY/ABSTRACT Increasing opioid use in the U.S. has led to a dramatic increase in opioid-related fatal and non-fatal overdoses (OD), and adults with mental health disorders, including anxiety and mood disorders, are significantly more likely to use nonprescription opioids. Mental health and associated drug use are directly and significantly impacted by the neighborhood environment, but few studies have examined the impact of modifiable neighborhood features on OD risk. The broad objective of this study is to investigate modifiable neighborhood factors which impact mental health and which may contribute to opioid OD risk. The proposed research will achieve the following interconnected specific aims using mixed quantitative/qualitative approaches with fatal OD data from New York City and original in-depth interviews with people who use drugs: (1) investigate the impact of modifiable physical and social neighborhood factors on opioid OD risk; (2) examine key mental health indicators as mediators of the relationship between modifiable neighborhood factors and opioid OD risk; (3) comparatively investigate the impact of modifiable neighborhood factors and mental health indicators on opioid OD risk comparing the locations where opioid users lived versus the locations where they overdosed. In-depth interviews with people who use drugs will provide context for quantitative results, identifying mechanisms by which neighborhood impacts drug using and associated OD risk and informing novel strategies for OD prevention. This K01 mentored research scientist development proposal will provide the training and expertise needed to transition to research independence in drug use research. Five specific training areas will be incorporated to carry out these research goals: (1) obtain advanced skills in spatial analysis methods, including structural equation modeling with spatial data and advanced spatial regression analyses methods; (2) develop expertise in mixed quantitative and qualitative methods research theory, design, and analysis, and build capacity in collecting and analyzing qualitative data; (3) develop subject matter expertise in psychiatric epidemiology and associated drug use risk factors, in particular, major depression, general anxiety disorders, and diagnostic criteria for psychiatric disorders; (4) obtain additional training in the ethical conduct of research among marginalized and stigmatized populations; (5) build professional skills for a successful research career as an independent scientist leading multidisciplinary teams to build new knowledge and address major challenges in drug use and abuse. These training goals will be achieved through a combination of didactic courses, specialized workshops, hands-on research, and mentoring from an interdisciplinary team of experts. This research and training will lead to a subsequent R01 proposal that formally tests implementation strategies and effectiveness of neighborhood-level interventions for OD prevention.

项目总结/摘要 美国阿片类药物使用的增加导致阿片类药物相关的致命和非致命过量急剧增加 (OD)，而患有精神健康障碍（包括焦虑和情绪障碍）的成年人， 可能使用非处方阿片类药物。精神健康和相关的药物使用是直接和显著的 受邻里环境的影响，但很少有研究探讨了可修改的影响， 邻里特征对OD风险的影响本研究的主要目的是研究可修改邻域 影响心理健康和可能导致阿片类药物OD风险的因素。拟议的研究将 使用定量/定性混合方法，实现以下相互关联的具体目标， 来自纽约市的OD数据和对吸毒者的原始深入访谈：（1）调查 可改变的身体和社会邻里因素对阿片类药物OD风险的影响;（2）检查关键的心理健康 作为可改变的邻里因素与阿片类药物OD风险之间关系的中介指标;（3） 比较研究可改变的邻里因素和心理健康指标对阿片类药物的影响 OD风险比较阿片类药物使用者居住的地点与他们过量使用的地点。深入 与吸毒者的访谈将为定量结果提供背景，通过以下方式确定机制： 哪个社区影响药物使用和相关的OD风险，并为OD提供新的策略 预防该K 01指导研究科学家发展提案将提供培训和专业知识， 需要过渡到研究独立的药物使用研究。五个具体的培训领域将 纳入执行这些研究目标：（1）获得先进的技能，在空间分析方法，包括 空间数据结构方程建模和先进的空间回归分析方法;（2）开发 在混合定量和定性方法研究理论，设计和分析，并建立能力的专业知识 收集和分析定性数据;（3）发展精神病学方面的专业知识， 相关的药物使用风险因素，特别是重度抑郁症、广泛性焦虑症和诊断性焦虑症。 （4）获得关于研究道德行为的额外培训， 边缘化和污名化的人群;（5）建立专业技能，作为一个成功的研究生涯， 独立科学家领导多学科团队，以建立新的知识和应对重大挑战， 药物使用和滥用。这些培训目标将通过结合教学课程、专业课程、 研讨会，动手研究，并从一个跨学科的专家团队指导。这项研究和 培训将导致随后的R 01提案，正式测试实施策略和有效性 社区一级的干预措施来预防吸毒过量。