The Women-Centered Opioid Recovery Project: Advancing women's engagement in care for opioid use disorder through development of a novel recovery navigation system led by women in recovery

以妇女为中心的阿片类药物康复项目：通过开发由康复中的妇女主导的新型康复导航系统，促进妇女参与阿片类药物使用障碍的护理

• 批准号: 10428775
• 负责人: Melissa Kari Ward
• 金额: $ 17.87万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 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/10428775
• 关键词: Accounting; Address; American; Award; Awareness; COVID-19; Caring; Child; Child Custody; Chronic; Clinical; Communities; Data; Development; Evidence based intervention; Evidence based program; Face; Family member; Female; Focus Groups; Gender; Goals; HIV; Health; Health Personnel; Health Services Accessibility; Hybrids; Intervention; Interview; K-Series Research Career Programs; Life Cycle Stages; Mental Health; Mentorship; Methods; Navigation System; Neonatal Abstinence Syndrome; Neurobiology; Online Systems; Opiate Addiction; Opioid; Outcome; Participant; Patients; Persons; Population; Positioning Attribute; Pregnancy; Randomized; Recovery; Research; Research Personnel; Resources; Services; Shame; Structure; Surveys; Vulnerable Populations; Woman; addiction; barrier to care; care seeking; community engaged research; comorbidity; evidence base; experience; gender difference; improved; improved outcome; medical complication; meetings; men; novel; opioid epidemic; opioid overdose; opioid use; opioid use disorder; programs; prototype; public health emergency; scale up; social stigma; theories; therapy design; therapy development; treatment services; usability; virtual; web-based tool

PROJECT SUMMARY/ABSTRACT The opioid crisis has escalated dramatically among women: from 1999 to 2019, the rate of opioid-related overdoses among females increased from 1.4 to 9.3 per 100,000 population. Women face many unique challenges in obtaining treatment for opioid use disorder (OUD). These barriers include caretaking responsibilities and child custody concerns. Additionally, through a phenomenon known as “telescoping,” women have a shorter duration of opioid use before meeting the clinical criteria for OUD compared to men. Further complicating the treatment landscape for women with OUD is that they often present for treatment with more severe comorbidities than men do. These gendered differences highlight the importance of women- centered strategies for engagement in care, a critical step in the OUD Cascade of Care. To address these gendered needs and barriers to care, a novel women-centered recovery navigation system is proposed. Patient navigator programs are an evidence-based intervention that address disparities and destigmatize seeking care for vulnerable populations. While available for a range of chronic health issues, they have not been widely implemented or evaluated for women with OUD. Ultimately, the proposed recovery navigation system will combine a web-based platform with personalized, women-centered recovery navigator services, and will use a hybrid approach that connects women to both virtual and in-person services. This recovery navigation system will serve as a gateway to services that meet women’s unique needs through increasing awareness of service and resource availability, as well as normalizing and destigmatizing seeking treatment for OUD among women. Women in recovery from OUD will guide development through a structured community- engaged intervention development framework. The objectives of this project are to advance understanding of barriers to engagement in care for women with OUD and to create a women-centered recovery navigation system. These objectives will be achieved through the following specific aims: 1) identify key barriers to engagement in care for women with OUD, as well as potential solutions; 2) develop and evaluate a pilot women-centered recovery navigator program; and 3) develop and evaluate a web-based recovery platform to engage women with OUD in care. Analyses will be completed using both qualitative and quantitative methods. Upon completion of the proposed 5-year project and under the guidance of my mentorship team, I will advance my expertise in (1) community-engaged research strategies, (2) the theory and neurobiology of opioid dependence among women, and (3) intervention design. I will also have the data necessary to scale up and refine this women-centered recovery navigation system, and will submit an R01 application to do so by the beginning of year 5 of the award period. Taken together, I will be in a position to establish myself as an independent investigator focused on developing and adapting evidence-based, women-centered interventions that tangibly improve the health outcomes of women struggling with OUD and addiction across the life course.

项目总结/摘要 阿片类药物危机在女性中急剧升级：从1999年到2019年， 女性吸毒过量人数从每10万人1.4人增加到9.3人。女性面对许多独特的 在获得阿片类药物使用障碍（OUD）治疗的挑战。这些障碍包括照顾 责任和子女监护权问题。此外，通过一种被称为“伸缩”的现象， 与男性相比，女性在达到OUD临床标准之前使用阿片类药物的持续时间较短。 使OUD女性的治疗前景进一步复杂化的是， 比男性更严重的合并症这些性别差异凸显了女性的重要性- 参与护理的中心战略，这是OUD护理级联的关键步骤。解决这些 性别需求和障碍的照顾，一个新的女性为中心的恢复导航系统的建议。 患者导航程序是一种基于证据的干预措施，可以解决差异和消除污名 寻求对弱势群体的照顾。虽然可用于一系列慢性健康问题，但它们没有 对患有OUD的妇女进行广泛实施或评估。最终，建议的恢复导航 该系统将联合收割机与个性化的、以妇女为中心的康复导航服务相结合， 并将使用混合方法，将女性与虚拟和面对面的服务联系起来。这个恢复 导航系统将作为一个服务的门户，通过增加妇女的独特需求， 服务和资源可用性的认识，以及正常化和去污名化寻求治疗， 在女人中。从开放式发展中恢复的妇女将通过一个结构化的社区指导发展， 参与式干预发展框架。该项目的目标是促进对 参与OUD女性护理的障碍，并创建以女性为中心的康复导航 系统这些目标将通过以下具体目标实现：1）确定主要障碍， 参与照顾患有OUD的妇女，以及潜在的解决方案; 2）开发和评估试点项目 以妇女为中心的康复导航方案;以及3）开发和评估一个基于网络的康复平台， 让患有OUD的女性参与护理。将使用定性和定量方法完成分析。 在完成拟议的5年项目后，在我的导师团队的指导下，我将晋升为 我的专长是（1）社区参与的研究策略，（2）阿片类药物的理论和神经生物学 妇女的依赖性;（3）干预设计。我也将有必要的数据来扩大规模， 完善这个以女性为中心的恢复导航系统，并将提交R 01申请， 奖励期的第五年开始。综合起来，我将能够确立自己作为一个 一名独立调查员，专注于制定和调整以证据为基础、以妇女为中心的干预措施 切实改善在整个生命过程中与OUD和成瘾作斗争的妇女的健康状况。