Increasing Peer Support for OUD Recovery during COVID-19 through Digital Health: A National Randomized Controlled Trial

通过数字健康在 COVID-19 期间增加 OUD 恢复的同行支持：一项全国随机对照试验

• 批准号: 10459602
• 负责人: Francesca Beaudoin
• 金额: $ 81.06万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10459602
• 关键词: Acute; Adult; Adverse effects; Adverse event; Advertisements; Ambulatory Care; American; Anxiety; Behavior Therapy; Buprenorphine; COVID-19; COVID-19 impact; COVID-19 pandemic; Capital; Cellular Phone; Collaborations; Communities; Complement; Control Groups; County; Data; Data Set; Distress; Drug usage; Education; Electronic Health Record; Emergency department visit; Enrollment; Ethics; Ethnic Origin; Evidence based treatment; Facebook; Geography; Government; Grant; Health; Health Services Accessibility; Home; Incidence; Income; Indiana; Individual; Intervention; Intervention Studies; Loneliness; Low income; Measures; Methods; Minority Groups; Natural Language Processing; Outcome; Participant; Patient Outcomes Assessments; Patient Self-Report; Patients; Persons; Pharmaceutical Preparations; Process; Psychosocial Stress; Public Health; Quality of life; Race; Randomized; Randomized Controlled Trials; Recording of previous events; Recovery; Recovery Support; Recurrence; Regulation; Reporting; Research; Resources; Rhode Island; Rural; Sampling; Secure; Security; Self Efficacy; Self-Injurious Behavior; Services; Social support; Socioeconomic Status; Stress; Structure; Support Groups; System; Testing; Text; Time; Treatment/Psychosocial Effects; United States; Validation; Vulnerable Populations; acceptability and feasibility; addiction; administrative database; barrier to care; base; clinically relevant; density; depressive symptoms; digital health; efficacy study; efficacy testing; ethnic minority population; evidence base; experience; follow-up; improved; intervention effect; low socioeconomic status; mobile application; novel; opioid overdose; opioid use disorder; overdose risk; pandemic disease; peer; peer support; prevent; primary endpoint; primary outcome; programs; psychosocial; racial minority; recruit; response; rural area; secondary endpoint; secondary outcome; social; social group; social media; social stigma; substance use; tool; treatment as usual; treatment program

PROJECT SUMMARY Increasing numbers of opioid overdoses have been observed during the COVID-19 pandemic, likely reflecting the pandemic’s multiple effects on this already vulnerable population. People in recovery from opioid use disorder (OUD) have reported disproportionate psychosocial distress and isolation, as well as significant disruptions in access to treatment including peer support, during the COVID-19 pandemic. These negative outcomes are especially acute for rural, low-income, and minority populations in recovery from OUD. Peer support is a key component of many evidence-based OUD recovery programs: it improves recovery capital, improves treatment engagement, improves perceived social support, and reduces psychosocial distress, particularly when used in conjunction with other evidence-based treatments such as medication for opioid use disorder (MOUD). This grant, submitted in response to PA 20-237, therefore proposes a randomized controlled trial of a novel mobile peer support app platform among a national sample of 1300 patients in recovery from opioid use disorders (OUDs), as an adjunct to usual care, during COVID-19. Our previously piloted online-only recruitment and follow- up strategy – in which we meld patient-reported outcomes with administrative datasets – allows strategic recruitment of often-excluded participants from across the United States, including those facing the highest barriers to treatment. The mobile app-based peer support intervention, provided as an individual-level enhancement of existing treatment and recovery programs, will allow individuals in OUD recovery to access a tailored, anonymous, peer-moderated support group 24/7. The app is augmented with natural language processing tools capable of automatically ‘flagging’ critical or clinically relevant content, thereby creating a scalable system to keep groups safe and constructive. Participants will be followed for 6 months through both self-report and administrative outcomes. The study’s primary outcome is self-reported recovery capital, complemented by objectively measured administrative data on retention in treatment programs from our community and governmental partners in a sub-sample of 650 patients from RI and IN. Hypothesized secondary outcomes are mitigation of psychosocial effects of COVID-19 on this vulnerable population, including depressive symptoms, stress, and loneliness, as well as objective adverse events of emergency department visits and opioid overdoses. Finally, we will explore whether state- and county-level variables moderate efficacy. SIGNIFICANCE: OUD is a major public health problem, and patients in recovery from OUD are experiencing worse outcomes during the COVID-19 pandemic. If this mobile app demonstrates efficacy among a large national sample of patients, it has the potential to augment existing treatment programs, improve recovery capital, and reduce disproportionate impacts of COVID-19 on this vulnerable population.

项目总结 在新冠肺炎大流行期间观察到越来越多的阿片类药物过量，这可能反映了 这场大流行对本已脆弱的人群产生了多重影响。人们正在从阿片类药物使用障碍中恢复 (OUD)报告了不成比例的心理社会痛苦和孤立，以及在 在新冠肺炎大流行期间获得包括同行支持在内的治疗。这些负面结果是 尤其是对农村、低收入和少数民族人口来说，他们正在从乌尔德人的生活中恢复。同伴的支持是关键 许多循证康复计划的组成部分：它提高了康复资本，改善了治疗 参与度，改善感受到的社会支持，并减少心理社会痛苦，特别是在 与其他循证治疗相结合，如阿片类药物使用障碍(Moud)。这 因此，Grant应PA 20-237提交，建议对一种新型移动设备进行随机对照试验 全国1300名阿片类药物使用障碍康复期患者同伴支持APP平台调查 (ODS)，作为常规护理的补充，在新冠肺炎期间。我们之前试点的仅限在线招聘和跟踪- UP策略-我们将患者报告的结果与管理数据集相结合-允许战略 从全美各地招募经常被排除在外的参与者，包括那些面临最高 治疗的障碍。基于移动应用的同伴支持干预，作为个人级别提供 加强现有的治疗和康复计划，将使处于康复中的个人能够获得 定制的、匿名的、由同行主持的全天候支持小组。该应用程序使用自然语言进行了增强 能够自动标记关键或临床相关内容的处理工具，从而创建 可扩展的系统，以确保团队的安全和建设性。参与者将接受为期6个月的跟踪调查 自我报告和行政结果。这项研究的主要结果是自我报告的复苏资本， 辅以来自我们的治疗计划中关于保留的客观测量的管理数据 来自RI和IN的650名患者的子样本中的社区和政府合作伙伴。假想的二级 结果是新冠肺炎对这一弱势群体的心理社会影响得到缓解，包括抑郁 急诊科就诊和阿片类药物的症状、压力、孤独以及客观不良事件 吸毒过量。最后，我们将探讨州和县级变量是否具有适度的疗效。重要意义： OUD是一个主要的公共卫生问题，从OUD恢复中的患者正在经历更糟糕的结果 在新冠肺炎大流行期间。如果这款移动应用程序在全国范围内的大样本中显示出有效性 患者，它有可能增加现有的治疗计划，提高恢复资本，并减少 新冠肺炎对这一弱势群体的影响不成比例。