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

项目摘要/摘要 阿片类药物危机在女性中急剧升级：从1999年到2019年，与阿片类药物相关的比率 女性吸毒过量从每10万人1.4人增加到9.3人。女性面对许多独特的 在获得阿片使用障碍(OUD)治疗方面的挑战。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时间较短。 对患有尿毒症的女性来说，更复杂的是她们经常出现在治疗中 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级联护理的关键一步。要解决这些问题 根据性别需求和护理障碍，提出了一个新的以女性为中心的康复导航系统。 患者导航器计划是一种以证据为基础的干预措施，旨在解决差异和歧视 寻求对弱势群体的关怀。虽然它们可用于一系列慢性健康问题，但它们并没有 已被广泛实施或评估为患有OUD的妇女。最终，拟议的恢复导航 该系统将把一个基于网络的平台与个性化的、以妇女为中心的康复导航服务结合起来， 并将使用一种混合方法，将女性与虚拟和面对面的服务连接起来。这一次复苏 导航系统将成为满足妇女独特需求的服务的门户，通过增加 对服务和资源可获得性的认识，以及使寻求治疗的正常化和非法律化 在女性中的声音。康复中的妇女将通过一个有组织的社区指导发展- 参与式干预发展框架。这个项目的目标是增进对 阻碍参与照顾患有妇产科疾病的妇女，并创建以妇女为中心的康复导航 系统。这些目标将通过以下具体目标来实现：1)确定关键障碍 参与照顾患有妇产科疾病的妇女，以及潜在的解决方案；2)制定和评估试点项目 以妇女为中心的康复导航员计划；以及3)开发和评估基于网络的康复平台，以 让女性参与到关怀中来。分析将使用定性和定量两种方法完成。 在完成拟议的五年项目后，在我的指导团队的指导下，我将继续 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 女性依从性；(3)干预设计。我还将拥有必要的数据来扩展和 完善这一以妇女为中心的康复导航系统，并将提交R01申请，由 奖励期的第5年开始。总而言之，我将能够确立自己作为一名 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 这明显改善了在整个生命过程中与肥胖和成瘾作斗争的女性的健康状况。

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.