Understanding and Addressing Disclosure to Members of Social Networks among People Recovering from Substance Use Disorders

项目总结/摘要 2014年，美国有超过500万人接受了药物使用障碍（SUD）的治疗， 需要持续护理并有很大复发风险的慢性疾病。关系过程可能 在SUD患者的康复轨迹中发挥着重要作用，耻辱感是一种障碍， 社会支持作为减少物质使用，治疗保留和药物依从性的促进剂。 披露SUD代表了从他人那里获得耻辱和社会支持的途径。干预有助于 处于恢复期的人决定向谁、为什么、何时、告诉什么以及如何告诉其他人他们的SUD恢复状态 可以帮助他们以最小化耻辱风险和最大限度地获得社会支持的方式披露， 其他人，从而支持他们的恢复努力。建议的导师研究科学家的目标 发展奖（K 01）是为了帮助我成长为一名独立的调查员， 研究 和 干预从SUD中恢复的人之间的关系过程，最终促进长期 在这一人群中复苏。为了实现这一目标，我将实施一项培训计划，以建立SUD方面的专业知识， 掌握社会网络研究，并获得干预科学的培训。该培训计划吸引了 利用哈佛医学院、波士顿儿童医院、马萨诸塞州的丰富机构资源 总医院，和哈佛临床和转化科学中心，并包括导师从 专家;通过课程、讲习班和方案进行的正式培训;参加国家会议;职业生涯 发展活动。我将把我的训练应用于一个研究项目，目的是：（1）检查纵向 披露，耻辱，社会支持和SUD恢复相关结果之间的关联 接受SUD治疗;（2）制定干预措施，帮助人们以各种方式向他人披露SUD康复情况 最大限度地减少污名风险，最大限度地获得社会支持;（3）试点披露干预 在接受SUD治疗的人群中评估其可接受性和可行性。这些目标将是 通过对160名接受治疗的人进行纵向自我中心社会网络研究， SUD（研究150人+试点10人）; 15-20人接受SUD治疗的在线焦点小组， 治疗者，以及接受SUD治疗的人的朋友和家人; 方法对50名接受SUD治疗的患者进行干预的试点研究。所有的工作都将在 在马萨诸塞州的波士顿，目前正在经历阿片类药物危机。研究结果将构成 基金会NIH R 01应用程序，以评估大规模背景下的披露干预 随机对照试验。这将确保我过渡到一个独立的调查员，并有助于 接受SUD治疗的人的长期恢复努力。

PROJECT SUMMARY/ABSTRACT Over 5 million people in the US received treatment in 2014 for substance use disorders (SUDs), which are chronic illnesses that require ongoing care and carry significant risk of relapse. Relationship processes may play a powerful role in the recovery trajectories of people with SUDs, with stigma acting as a barrier to and social support acting as a facilitator of reduced substance use, treatment retention, and medication adherence. Disclosure of SUDs represents a gateway to stigma and social support from others. Interventions that help people in recovery decide to whom, why, when, what, and how to tell others about their SUD recovery status may help them disclose in ways that minimize risk of stigma and maximize access to social support from others, thereby supporting their recovery efforts. The goal of the proposed Mentorship Research Scientist Development Award (K01) is to facilitate my growth into an independent investigator who studies and intervenes in relationship processes among people in recovery from SUDs, ultimately promoting long-term recovery among this population. To achieve this goal, I will pursue a training plan to build expertise in SUDs, develop mastery in social network research, and gain training in intervention science. This training plan draws on a wealth of institutional resources at Harvard Medical School, Boston Children's Hospital, Massachusetts General Hospital, and the Harvard Clinical and Translational Science Center, and consists of mentorship from experts; formal training via courses, workshops, and programs; attendance at national meetings; and career development activities. I will apply my training to a research project that aims to: (1) examine longitudinal associations between disclosure, stigma, social support, and SUD recovery-related outcomes among people receiving SUD treatment; (2) develop an intervention to help people disclose SUD recovery to others in ways that minimize risk of stigma and maximize access to social support; and (3) pilot the disclosure intervention among people receiving treatment for SUDs to evaluate its acceptability and feasibility. These aims will be reached by conducting a longitudinal egocentric social network study with 160 people receiving treatment for SUDs (150 for study + 10 for pilot); online focus groups with 15-20 people receiving treatment for SUDs, providers of SUD treatment, and friends and family of people receiving treatment for SUDs; and a mixed- methods pilot study of the intervention with 50 people receiving treatment for SUDs. All work will be conducted in Boston, Massachusetts, which is currently experiencing an opioid crisis. Results of the study will form the foundation an NIH R01 application to evaluate the disclosure intervention in the context of a large-scale randomized control trial. This will ensure my transition into an independent investigator and contribute to the long-term recovery efforts of people receiving treatment for SUDs.