Substance Use and Gender-Affirming Care in Oregon's Medicaid Program

俄勒冈州医疗补助计划中的药物使用和性别肯定护理

• 批准号: 10432100
• 负责人: Jae Downing
• 金额: $ 7.22万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2023-01-05
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10432100
• 关键词: Affect; Alcohol consumption; Area; Behavioral; Caring; Cause of Death; Communities; Conservatism; Data; Demographic Factors; Discrimination; District of Columbia; Drug Addiction; Drug usage; Enrollment; Epidemiology; Face; Failure; Focus Groups; Gender; Goals; Health Policy; Health Sciences; Health Services Accessibility; Healthcare; Hormones; Insurance Coverage; Intervention; Interview; Knowledge; Link; Low income; Medicaid; Mental Health; Mentored Research Scientist Development Award; Mentors; Methods; National Institute of Drug Abuse; Operative Surgical Procedures; Oregon; Overdose; Patients; Persons; Play; Police; Population; Prevention; Primary Health Care; Provider; Public Health Schools; Quasi-experiment; Reading; Recording of previous events; Research; Research Activity; Research Methodology; Research Personnel; Risk; Risk Factors; Role; Rural; Sampling; Self-Injurious Behavior; Services; Sexual and Gender Minorities; Structure; Substance Use Disorder; System; Testing; Tobacco use; Training; Treatment Factor; Trust; Universities; Victimization; base; behavioral health; care delivery; care providers; career; career development; disorder prevention; drug abuse prevention; experience; gender minority group; gender nonconforming; health care availability; hormone therapy; illicit drug use; improved; innovation; insight; medically necessary care; meetings; mortality; patient population; patient-level barriers; population health; professor; programs; provider-level barriers; reduced substance use; response; screening; sexual minority group; skills; social; social structure; substance use; substance use treatment; transgender

PROJECT SUMMARY/ABSTRACT The proposed K01 award provides Dr. Downing, a new Assistant Professor in the Oregon Health & Science University/Portland State University School of Public Health, with the training and skills needed to achieve their long-term goal of becoming an independent investigator focused on the prevention and treatment of substance use disorders (SUD) among transgender and gender non-conforming (trans) people. Trans people face unique challenges related to SUD prevention and treatment, including lower healthcare access resulting from the failure of healthcare payers to cover medically necessary, trans-specific care. Dr. Downing’s background in health policy, gender and sexual minority population health, and quantitative methods in addition to their lived experience as a gender minority person makes them uniquely qualified to make significant contributions to this field. There are three areas where additional training will improve their ability to achieve their long-term career goals: 1) the financing and care delivery of state Medicaid programs, 2) the epidemiology and treatment of SUD, and 4) qualitative and mixed methods research. Dr. Downing’s training goals will be achieved through coursework, directed readings, one-on-one meetings with mentors, and mentored research activities. The K01 mentored research mixed-methods study will identify risk factors for SUD and facilitators of treatment among trans people in Oregon’s Medicaid program. The first aim of this proposal is to identify predictors of SUDs and overdose among trans people. The second aim is to identify predictors of substance use treatment among trans people with a history of a substance use disorder. The third aim proposes to understand mechanisms by which screening and treatment for SUD among trans people occur by conducting interviews with trans people and providers who serve this patient population. This proposal is highly innovative because it: 1) provides the first representative estimates of SUD and treatment among trans people enrolled in Medicaid, 2) employs a quasi-experimental approach to evaluate the impact of insurance coverage of gender-affirming care on SUD; and 3) uses a mixed methods approach to provide context for findings. This training will expand the candidate’s ability to conduct research that specifically meets three NIDA key goals: identifying the behavioral and social causes of drug use and addiction, developing new and improved interventions to prevent drug use and its consequences, and assessing the impact of polices on SUD.

项目总结/摘要 拟议中的K 01奖提供唐宁博士，在俄勒冈州健康和健康的新助理教授， 科学大学/波特兰州立大学公共卫生学院，提供所需的培训和技能， 实现他们的长期目标，成为一个独立的研究者，专注于预防和治疗 物质使用障碍（SUD）在跨性别和性别不符合（transs）的人。反式 人们面临着与SUD预防和治疗相关的独特挑战，包括较低的医疗保健可及性 由于医疗保健支付者未能支付医疗必要的跨专业护理。唐宁医生 卫生政策背景、性别和性少数群体人口健康以及 除了他们作为性别少数群体的生活经历外，他们还具有独特的资格， 对这一领域的重大贡献。有三个领域的额外培训将提高他们的能力， 实现他们的长期职业目标：1）国家医疗补助计划的融资和护理交付，2） SUD的流行病学和治疗; 4）定性和混合方法研究。 唐宁博士的培训目标将通过课程作业，指导性阅读，一对一 与导师会面，并指导研究活动。K 01指导研究混合方法研究 将在俄勒冈州的医疗补助计划中确定SUD的风险因素和跨性别者的治疗促进者 程序.该提案的第一个目的是确定跨性别者中SUD和过量的预测因素。的 第二个目标是确定有跨性别史的跨性别者中物质使用治疗的预测因素。 物质使用障碍第三个目标是了解筛查和治疗的机制， 对于跨性别者之间的SUD发生通过与跨性别者和提供者谁服务， 患者人群。这一建议具有很强的创新性，因为它：1）提供了第一个代表性的估计 的SUD和治疗的跨人参加医疗补助，2）采用准实验的方法， 评估性别肯定护理的保险覆盖范围对SUD的影响; 3）使用混合方法 为调查结果提供背景的方法。这项培训将扩大候选人进行研究的能力 这特别符合NIDA的三个关键目标：确定吸毒的行为和社会原因， 吸毒成瘾，制定新的和改进的干预措施，以预防吸毒及其后果， 评估政策对可持续发展的影响。