Treatment for Incarcerated Pregnant Women with Opioid Use Disorder: Implementaton Research on Medication Assisted Treatment in Jails

项目总结/摘要 为患有阿片类药物使用障碍（OUD）的孕妇提供循证治疗对于对抗 阿片类药物的流行许多患有OUD的人在监狱里呆了一段时间，他们最终被释放回监狱。 社区因此，监狱也是解决阿片类药物流行病战略的重要组成部分， 为被监禁的OUD患者提供治疗，并为释放后建立社区联系 治疗对于OUD孕妇尤其如此，因为阿片类药物戒断应避免， 母亲和胎儿的风险，他们应该接受药物辅助治疗（MAT）。然而，治疗 监狱中患有OUD的孕妇是可变的，许多妇女被迫戒毒。造成这种差距的原因是 对监狱中孕妇的照顾是多方面的，与独特的组织、后勤和文化有关。 在矫正环境中提供护理的环境。实施基于证据的MAT的策略 迫切需要监狱中的孕妇。 为了推进宣传和实施对患有OUD的孕妇的治疗的目标， 从而推进个人和公共卫生目标，将采取三个目标：（1）检查感知 重点监狱管理和临床对监狱内OUD孕妇MAT的障碍和态度 利益攸关方和社区治疗提供者使用混合方法进行调查， 定性访谈; 2）从监狱中的OUD孕妇中收集定性数据， 在监狱和释放后接受MAT的障碍和态度; 3）设计和试点监狱特定的，病人- 集中实施战略，结合监狱利益相关者和病人的观点，提供MAT， 怀孕的妇女在监狱里。 我的职业目标是成为以患者为导向的研究的领导者，专注于提高护理质量， 在刑事司法系统中对患有OUD的孕妇的结果。支持我在事业上 为了实现这些目标，我组建了一个由不同研究学科的高级研究人员组成的导师团队， 成功的研究合作和指导活动的跟踪记录。我还设计了一个 补充教学和体验式培训计划，以获得实施方面的知识和技能 科学，怀孕期间OUD的治疗，以及成瘾政策研究。拟议的职业发展 该计划包括培训、指导和资源，以成为一名成功的独立调查员。

PROJECT SUMMARY/ABSTRACT Providing evidence-based treatment to pregnant women with opioid use disorder (OUD) is essential to fighting the opioid epidemic. Many people with OUD spend time in jails, and they are eventually released back into the community. Jails thus also represent an important part of the strategy to address the opioid epidemic, by providing treatment to incarcerated people with OUD and creating community linkages for post-release treatment. This is especially true for pregnant women with OUD, as opioid withdrawal should be avoided due to maternal and fetal risks, and they should receive medication assisted treatment (MAT). However, treatment of pregnant people with OUD in jails is variable and many women are forced to detox. The reasons for this gap in care for pregnant women in jail are multifactorial, and relate to the unique organizational, logistical, and cultural environment of providing care in a correctional setting. Strategies to implement evidence based MAT for pregnant women in jails are urgently needed. In order to advance the goal of disseminating and implementing treatment for pregnant women with OUD and thereby advancing individual and public health goals, three aims will be undertaken: (1) to examine perceived barriers and attitudes about MAT for pregnant women with OUD in jail from key jail administrative and clinical stakeholders and from community treatment providers using a mixed methods approach with surveys and qualitative interviews; 2) to collect qualitative data from pregnant women with OUD in jail on their perceived barriers and attitudes about receiving MAT in jail and upon release; 3)to design and pilot a jail-specific, patient- centered implementation strategy that incorporates jail stakeholder and patient perspectives to provide MAT to pregnant women with OUD in jail. My career goal is to be a leader in patient-oriented research focused on improving quality of care and outcomes for pregnant women with OUD in the criminal justice system. To support me in meeting my career goals, I have assembled a mentorship team of senior investigators in different research disciplines, who have a track record of successful research collaborations and mentoring activities. I have also designed a complementary didactic and experiential training plan to acquire knowledge and skills in implementation science, treatment of OUD in pregnancy, and addiction policy research. The proposed career development plan contains the training, mentoring, and resources to become a successful independent investigator.