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.

项目摘要/摘要 美国越来越多的阿片类药物使用导致与阿片类药物相关的致命和非致命过量急剧增加 (OD)，有精神健康障碍的成年人，包括焦虑和情绪障碍，明显更多 可能会使用非处方类阿片类药物。心理健康和相关药物的使用直接和显著地 受社区环境的影响，但很少有研究考察可改变的影响 关于吸食过量风险的社区特征。这项研究的主要目标是调查可修改的邻里 影响心理健康并可能导致阿片类药物过量风险的因素。拟议的研究将 使用混合的定量/定性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创深度访谈：(1)调查 可改变的身体和社会邻近因素对阿片类药物过量风险的影响；(2)检查关键的心理健康 可改变的邻居因素与阿片类药物过量风险之间关系的中介指标；(3) 可调性邻里因素与心理健康指标对阿片类药物影响的对比研究 将阿片类药物使用者居住的地点与他们过量服药的地点进行比较的吸毒风险。深入探讨 对吸毒者的采访将为量化结果提供背景，通过以下方式确定机制 哪个社区影响吸毒和相关的吸毒风险，并为吸毒的新战略提供信息 预防。K01指导的研究科学家发展计划将提供培训和专业知识 需要在药物使用研究中过渡到研究独立。五个具体的培训领域将是 (1)掌握空间分析方法方面的高级技能，包括 利用空间数据和先进的空间回归分析方法建立结构方程模型；(2)发展 在定量和定性混合方法研究理论、设计和分析以及能力建设方面的专长 在收集和分析定性数据方面；(3)发展精神流行病学的专题专门知识和 与药物使用相关的危险因素，特别是严重的抑郁症、一般焦虑症和诊断 精神障碍的标准；(4)在以下方面获得关于研究道德行为的额外培训 被边缘化和被污名化的人群；(5)为成功的研究生涯培养专业技能 独立科学家领导多学科团队建立新知识并应对 吸毒和滥用。这些培训目标将通过教学课程、专业课程和 来自跨学科专家团队的研讨会、实践研究和指导。这项研究和 培训将导致随后的R01提案，该提案正式测试实施战略和有效性 社区一级预防吸毒的干预措施。