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

项目摘要/摘要 2014年，美国有500多万人接受了药物使用障碍(SODS)的治疗，这些疾病 需要持续护理并具有极大复发风险的慢性病。关系过程可以 在肥皂泡患者的康复轨迹中发挥着强大的作用，污名是阻碍和 社会支持作为减少药物使用、治疗保留和服药依从性的促进者。 披露肥皂剧代表着通往耻辱和他人社会支持的大门。有益的干预措施 恢复中的人决定向谁、为什么、何时、什么以及如何告诉他人他们的SUD恢复状态 可以帮助他们以将污名风险降至最低的方式进行披露，并最大限度地从 其他人，从而支持他们的恢复工作。拟议的导师制研究科学家的目标 发展奖(K01)是为了促进我成长为一名独立的调查员 研究 和 干预肥胖症康复期患者之间的关系进程，最终促进长期 在这群人中恢复。为了实现这一目标，我将实施一项培训计划，以积累肥皂泡方面的专业知识， 掌握社会网络研究，并接受干预科学方面的培训。这份培训计划制定了 马萨诸塞州波士顿儿童医院哈佛医学院丰富的机构资源 和哈佛临床和转化科学中心，并由来自 专家；通过课程、讲习班和方案进行的正式培训；出席国家会议；以及职业 发展活动。我将把我的培训应用到一个研究项目中，该项目旨在：(1)纵向考察 人们中披露、污名、社会支持和与SUD康复相关的结果之间的关系 接受sud治疗；(2)制定干预措施，帮助人们通过各种方式向他人披露sud恢复情况。 将污名风险降至最低并最大限度地获得社会支持；以及(3)试行披露干预措施 在接受肥皂泡治疗的人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以自我为中心的纵向社会网络研究达到 肥皂泡(150人用于研究+10人用于试点)；在线焦点小组，15-20人接受肥皂水治疗， 肥皂水治疗的提供者，以及接受肥皂水治疗的朋友和家人；以及混合- 方法对50例肥胖症患者进行干预试点研究。所有工作都将进行 在马萨诸塞州的波士顿，目前正在经历阿片类药物危机。研究结果将形成 建立NIH R01应用程序，以评估大规模背景下的披露干预 随机对照试验。这将确保我成为一名独立的调查员，并有助于 接受肥皂泡治疗的人的长期康复努力。

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.