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Treating South African Pregnant Women for Methamphetamine

南非孕妇接受甲基苯丙胺治疗

基本信息

批准号：
8328902
负责人：
WENDEE M WECHSBERG
金额：
$ 19.78万
依托单位：
RESEARCH TRIANGLE INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-15 至 2014-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8328902
关键词：
AIDS prevention Address Adult African African American Alcohol or Other Drugs use Behavior Birth Weight Caring Child Collaborations Color Complement Country Data Development Drug Addiction Drug abuse Drug usage Employee Strikes Epidemic Evidence based intervention Foundations Frequencies Generations Gestational Age Goals Grouping HIV Health Health Personnel Healthcare Hospitalization International Intervention Length Length of Stay Life Methamphetamine Modeling Neonatal Operant Conditioning Outcome Participant Patients Personal Satisfaction Pharmaceutical Preparations Population Pregnancy Pregnant Women Prenatal care Prevention Principal Investigator Psychological reinforcement Public Health Punishment Race Randomized Controlled Trials Reaction Relative (related person)Reporting Research Rewards Risk Behaviors Risk Factors Sample Size Shapes Small for Gestational Age Infant South Africa Structure Subgroup Testing Time United States Unplanned pregnancy Unsafe Sex Visit Vulnerable Populations Woman Women&apos s Health base child bearing effective intervention empowerment evidence base experience improved innovation maternal drug abuse pregnant prenatal sex sex risk social social cognitive theory substance abuse treatment success theories

项目摘要

DESCRIPTION (provided by applicant): Background: Since 2001, the Women's Health CoOp (WHC) has successfully adapted an evidence-based intervention to reduce sex- and drug-risk behaviors in drug-using South African women. However, Cape Town has experienced a rapid rise in methamphetamine use, and the findings from our ongoing study indicate that the WHC has had limited success in reducing the use of this drug among women. Alarmingly, among WHC participants, a greater proportion of pregnant than nonpregnant women reported using meth (n=24/26=92 percent v. n=238/356=67 percent; p=.01). Further, 100 percent (n=31/31) of the Coloured versus 60 percent (n=12/20) of the Black substance-using pregnant participants reported at least 3 times/week meth use in the past month. These findings are underscored by a lack of a focused and intensive treatment for methamphetamine-using pregnant women who live in impoverished townships. Consequently, pregnant Coloured women are most in need of substance abuse treatment, and thus are they are the target of the proposed study. Therefore, this application responds to PA-09-021 International Research Collaboration on Drug Abuse and Addiction Research (R21) by focusing on developing treatment options for methamphetamine use among pregnant women. The proposed Principal Investigator has developed an efficacious, operant conditioning/social-learning-theory-driven, comprehensive drug abuse treatment model, Reinforcement-Based Treatment (RBT). The RBT model has improved maternal and neonatal outcomes of impoverished African American stimulant-using pregnant women in the United States. Thus, RBT is a promising treatment model to complement the empowerment-theory-driven WHC HIV prevention efforts; and together, they can effectively address methamphetamine use. Project Goal: To develop and initially evaluate an efficacious, comprehensive, culturally sensitive, women-centered model of care for pregnant South African Coloured women by adapting and refining RBT and at the same time integrating into it the WHC HIV prevention components, yielding an integrated treatment and prevention model, RBT+WHC. There are two sequential aims: Aim 1. Adapt and pretest a comprehensive drug abuse treatment model, RBT, into which will be integrated the evidence-based WHC HIV prevention model, yielding RBT+WHC. Aim 2. Conduct a small-scale RCT with pregnant Coloured women (N=40) to determine the acceptability, feasibility, and initial efficacy of the RBT+WHC model relative to a psycho-educational control condition in terms of their respective impacts on maternal outcomes, including (a) methamphetamine use, (b) frequency of unprotected sex acts, and (c) number of prenatal care visits; and neonatal outcomes, including (d) length of hospital stay, (e) birth weight, and (f) gestational age at delivery. Public Health Impact: The RBT+WHC model will lay the foundation for filling a void in substance use treatment research for women in a region where they are especially disenfranchised from receiving healthcare. The proposed study also holds the promise of helping to improve the health of two generations of South Africans, Coloured women and their children.

描述（由申请人提供）：背景：自 2001 年以来，妇女健康合作社 (WHC) 成功采用了循证干预措施，以减少南非吸毒妇女的性行为和吸毒风险行为。然而，开普敦的甲基苯丙胺使用量迅速增加，我们正在进行的研究结果表明，WHC 在减少女性使用这种药物方面取得的成功有限。令人震惊的是，在 WHC 参与者中，报告使用冰毒的孕妇比例高于非孕妇（n=24/26=92% vs. n=238/356=67%；p=0.01）。此外，100%（n=31/31）的有色人种和 60%（n=12/20）的黑人使用药物的怀孕参与者报告在过去一个月中每周至少使用冰毒 3 次。这些发现凸显了对居住在贫困乡镇的使用甲基苯丙胺的孕妇缺乏针对性和强化治疗的情况。因此，怀孕的有色人种女性最需要药物滥用治疗，因此她们是拟议研究的目标。因此，本申请响应 PA-09-021 国际药物滥用和成瘾研究合作 (R21)，重点开发针对孕妇使用甲基苯丙胺的治疗方案。拟议的首席研究员开发了一种有效的、操作性条件反射/社会学习理论驱动的综合药物滥用治疗模型，即强化治疗（RBT）。 RBT 模式改善了美国使用兴奋剂的贫困非洲裔美国孕妇的孕产妇和新生儿结局。因此，RBT 是一种很有前途的治疗模式，可以补充赋权理论驱动的 WHC 艾滋病毒预防工作；两者结合起来可以有效解决甲基苯丙胺的使用问题。项目目标：通过调整和完善 RBT，同时将 WHC 艾滋病毒预防部分纳入其中，形成一种综合治疗和预防模式 RBT+WHC，并初步评估针对南非有色人种孕妇的有效、全面、文化敏感、以妇女为中心的护理模式。有两个连续的目标：目标 1. 调整和预测试综合药物滥用治疗模型 RBT，其中将整合基于证据的 WHC HIV 预防模型，产生 RBT+WHC。目标 2. 对有色人种孕妇 (N=40) 进行小规模随机对照试验，以确定 RBT+WHC 模式相对于心理教育控制条件的可接受性、可行性和初步功效，以及它们各自对孕产妇结局的影响，包括 (a) 甲基苯丙胺使用、(b) 无保护性行为频率和 (c) 产前护理就诊次数；和新生儿结局，包括 (d) 住院时间、(e) 出生体重和 (f) 分娩时的孕龄。公共健康影响：RBT+WHC 模式将为填补妇女药物滥用治疗研究的空白奠定基础，该地区的妇女尤其被剥夺了接受医疗保健的权利。拟议的研究还有望帮助改善两代南非人、有色人种妇女及其子女的健康。