A Brief Values Intervention to Support Veterans in Early Buprenorphine Treatment

支持退伍军人早期丁丙诺啡治疗的简短价值观干预

• 批准号: 10419896
• 负责人: Victoria Ameral
• 金额: --
• 依托单位: EDITH NOURSE ROGERS MEMORIAL VETERANS HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10419896
• 关键词: Address; Adherence; Area; Award; Behavior Therapy; Behavioral Model; Buprenorphine; Career Choice; Caring; Clinical; Clinical Research; Communities; Community Integration; Conduct Clinical Trials; Control Groups; Data; Development; Diagnosis; Early treatment; Education; Employment; Evidence based intervention; Exercise; Expectancy; Face; Family Relationship; Feedback; Fellowship; Foundations; Goals; Gold; Impairment; Interpersonal Relations; Intervention; Intervention Studies; Interview; K-Series Research Career Programs; Knowledge; Leadership; Link; Manuals; Measures; Medication Management; Mental disorders; Mentors; Mentorship; Methodology; Modeling; New England; Outcome; Overdose; Overdose reduction; Patients; Pharmaceutical Preparations; Phase; Pilot Projects; Population; Positioning Attribute; Procedures; Process; Protocols documentation; Provider; Psychologist; Psychotherapy; Qualitative Methods; Quality of life; Randomized; Randomized Controlled Trials; Recommendation; Recovery; Recovery of Function; Relapse; Research; Research Personnel; Research Training; Role; Sampling; Savings; Self Efficacy; Series; Site; Statistical Data Interpretation; Substance Use Disorder; Sum; Symptoms; System; Therapeutic Intervention; Time; Training; Training Activity; Unemployment; United States National Institutes of Health; Veterans; Work; acceptability and feasibility; addiction; alcohol use disorder; base; behavior change; buprenorphine treatment; career; clinical center; clinical trial analysis; community reintegration; comparison intervention; craving; design; evidence base; experience; experimental study; falls; field study; high risk; housing instability; improved; innovation; intervention effect; methadone clinic/center; model development; mortality; motivated behavior; non-opioid analgesic; novel; novel strategies; opioid use disorder; overdose risk; person centered; prevent; primary outcome; programs; psychosocial; recruit; research and development; satisfaction; secondary outcome; skills; standard care; standard of care; substance use treatment; therapy design; therapy development; treatment adherence; treatment as usual

The proposed Career Development Award (CDA-2) would support Dr. Victoria Ameral, Clinical Research Psychologist with the VISN 1 New England Mental Illness Research, Education, and Clinical Center (MIRECC) and recent graduate of the VA Interprofessional Advanced Addiction Fellowship, in her goal of becoming an expert in recovery-oriented behavioral interventions for Veterans with Opioid Use Disorder (OUD). Medications for OUD save lives by preventing relapse and overdose, but they do not actively directly address the significant functional challenges for Veterans in early recovery. Adjunctive behavioral interventions hold promise for this area, but existing approaches rarely outperform standard buprenorphine medication management. This may be due to a tendency for early sessions to focus on symptoms (i.e., cravings and urges) that are already addressed by medication treatment. The proposed research seeks to develop a brief, values-based intervention which instead focuses on helping to improve Veterans’ interpersonal functioning and community integration during early treatment. These two recovery-oriented concepts are closely linked to the known functional consequences of OUD and are key predictors of recovery outcomes. The three phases and respective aims for the current proposal cover the activities outlined in Stages 1a and 1b of Rounsaville’s Behavioral Therapy Development Model. Specifically, manual development (Stage 1a) will include stakeholder interviews with Veterans and VA Providers (Aim 1) and an open pilot with a small sample of Veterans to field test the intervention (Aim 2). The final phase of the proposed research will be a pilot randomized controlled trial (RCT) of the intervention compared to standard medication management, the standard of care and most common comparison condition for research with this population (Aim 3), which will provide feasibility and acceptability data for the intervention. These aims will directly support a subsequent RR&D MERIT proposal to conduct a full-scale RCT of the resulting intervention and will also provide invaluable experience for the candidate’s intended long-term career path. The current proposal’s training aims are designed to build on Dr. Ameral’s clinical background in Acceptance and Commitment Therapy (the theoretical foundation for the proposed intervention), experience in translational experimental research, and demonstrated commitment to a VA research career in recovery-oriented addiction. These training aims will be met through a series of formal training experiences together with support and guidance from a mentorship team of highly productive VA researchers with complementary expertise and skills sets. Specifically, the current proposal will address critical knowledge and skills gaps for the candidate in relevant content areas (recovery-oriented research, behavioral intervention development, medications for OUD) and methodological approaches (conducting clinical trials, qualitative methods, statistical analysis for clinical trials), and leadership and professional development to support the proposed research and career plan. In sum, the research and training outlined in the current proposal will position Dr. Ameral to become a leading researcher in the area of recovery-oriented interventions for Veterans with OUD.

拟议的职业发展奖 (CDA-2) 将支持维多利亚·阿梅拉尔 (Victoria Ameral) 博士（临床研究） VISN 1 新英格兰精神疾病研究、教育和临床中心 (MIRECC) 的心理学家 刚刚从 VA 跨专业高级成瘾奖学金毕业，她的目标是成为一名 患有阿片类药物使用障碍 (OUD) 的退伍军人以恢复为导向的行为干预专家。药物 OUD 通过防止复发和用药过量来拯救生命，但他们并没有积极直接解决重大问题 退伍军人在早期康复过程中面临的功能挑战。辅助行为干预有望实现这一目标 领域，但现有方法很少优于标准丁丙诺啡药物管理。这可能 是由于早期治疗倾向于关注已经存在的症状（即渴望和冲动） 通过药物治疗来解决。拟议的研究旨在制定一个简短的、基于价值观的 干预的重点是帮助改善退伍军人的人际功能和社区 早期治疗期间的整合。这两个以恢复为导向的概念与已知的密切相关 OUD 的功能后果，是恢复结果的关键预测因素。三个阶段和 当前提案的各自目标涵盖了 Ronsaville 阶段 1a 和 1b 中概述的活动 行为治疗发展模型。具体来说，手册开发（第 1a 阶段）将包括利益相关者 与退伍军人和退伍军人事务部提供者进行访谈（目标 1），并进行公开试点，并抽取一小部分退伍军人样本进行实地考察 测试干预措施（目标 2）。拟议研究的最后阶段将是试点随机对照试验 （RCT）干预措施与标准药物管理、护理标准和大多数 对该人群进行研究的共同比较条件（目标 3），这将提供可行性和 干预的可接受性数据。这些目标将直接支持后续的 RR&D MERIT 提案 对由此产生的干预措施进行全面的随机对照试验，也将为 候选人预期的长期职业道路。当前提案的培训目标旨在以博士为基础。 Ameral 在接受与承诺疗法方面的临床背景（该疗法的理论基础） 提议的干预措施），转化实验研究的经验，并表现出对 退伍军人管理局研究以康复为导向的成瘾。这些培训目标将通过一系列正式的培训来实现 培训经验以及来自高效 VA 导师团队的支持和指导 具有互补专业知识和技能的研究人员。具体来说，当前提案将解决关键问题 候选人在相关内容领域（面向康复的研究、行为学）的知识和技能差距 干预措施开发、OUD 药物）和方法论方法（进行临床试验、 定性方法、临床试验的统计分析）以及领导力和专业发展 支持拟议的研究和职业计划。总之，当前概述的研究和培训 该提案将使 Ameral 博士成为康复干预领域的领先研究员 适合使用 OUD 的退伍军人。