The Daily Progress System - A Recovery Support Tool to Reduce Health Disparities in Outpatient Substance Use Treatment

摘要 物质使用障碍，包括阿片类药物使用障碍，仍然是最严重的问题之一。 美国的公共卫生问题，1导致负面的身心健康问题，家庭破裂，以及 过早死亡2-4名有吸毒史的非裔美国人正在接受刑事司法监督 由于更高的水平，特别容易经历与肥皂泡相关的负面后果 4在以社区为基础的环境中提供门诊治疗是主要的方式 对于SUD治疗，通常包括每周一次的个人和/或团体的心理社会咨询会议 5、6在治疗中保留时间越长，结果越好，包括物质的减少 使用、心理健康问题和社会成本。7-10不幸的是，只有不到一半的人 启动治疗成功完成。尤其是650-52名非洲裔美国人的治疗保留率较低 和完成率，与白人相比，11，12构成了复发和升级的持续风险 物质使用6，13，14 在物质使用治疗中提高参与度和保留率的一个潜在方法是持续 治疗过程中当事人和咨询师的反馈。门诊治疗的结构通常包括 客户和咨询师之间的间歇性临床接触，通常是每周一次，而且通常是在一个小组中- 基于格式，使得临床医生在每周之间缺乏关于客户进展的信息 治疗疗程。最近的成瘾研究表明，从客户那里获取信息 每周的治疗会议可以为咨询师提供有关客户治疗的宝贵和及时的数据 需求，潜在地增强他们提供高质量护理和以客户为中心的治疗的能力，并改善 治疗参与和保留，或许还有禁欲的结果。15、16 每日进度系统(DPS)是一款移动友好的基于Web的软件应用程序，旨在 提高治疗参与度和保留率，减少治疗信息缺失。存款保障计划将提供 预约提醒通知，并收集成瘾患者的风险和保护因素信息 每天接受治疗。在客户每周咨询之前，DPS将生成一个简短的一页 为咨询师和客户提供的每周总结报告，汇总客户每日报告信息，可以 用于改善以群体和个人为基础的治疗服务的提供。通过改进客户端 在治疗中的参与和保留，这项创新技术具有降低健康的巨大潜力 影响最脆弱部分之一的药物使用治疗结果的差异 人口(即在刑事司法监督下有吸毒史的非裔美国人)。给定 肥皂水持续的公共卫生危机，包括阿片类药物使用障碍，加强参与的技术 和治疗中的留存是迫切需要的。如果证明是有效的，DPS可以部署在 不断扩大的全国门诊药物使用治疗提供者网络，以及提供 物质使用治疗，以提高质量的护理和改善患者的结果，可能有较高的公众 对健康的影响。

ABSTRACT Substance use disorders (SUDs), including opioid use disorders, continue to be one of the most serious public health issues in the US,1 leading to negative physical and mental health problems, family disruption, and premature death.2-4 African Americans with drug use histories that are under criminal justice supervision are particularly vulnerable to experiencing the negative consequences associated with SUDs due to higher levels of economic hardship.4 Outpatient treatment delivered in community-based settings is the dominant modality for SUD treatment, typically involving weekly psychosocial counseling sessions in an individual and/or group format.5,6 Longer retention in treatment is associated with better outcomes including reductions in substance use, mental health problems, and societal costs.7-10 Unfortunately, less than half of those individuals who initiate treatment successfully complete it. 6,50-52 African Americans in particular have lower treatment retention and completion rates as compared to Whites,11,12 constituting an ongoing risk for relapse and escalating substance use.6,13,14 One potential way to improve engagement and retention in substance use treatment involves ongoing client and counselor feedback during treatment. The structure of outpatient treatment typically involves intermittent clinical contact between client and counselor, generally on a weekly basis, and often in a group- based format, leaving clinicians with a deficit of information regarding client progress between weekly treatment sessions. Recent addiction research suggests that obtaining information from clients between weekly treatment sessions could provide counselors with valuable and timely data regarding client treatment needs, potentially enhancing their ability to deliver quality care and client-centered treatment, and improving treatment engagement and retention, and perhaps abstinence outcomes.15,16 The Daily Progress System (DPS) is a mobile-friendly, web-based software application designed to improve treatment engagement and retention and reduce therapeutic information deficits. The DPS will provide appointment reminder notifications and collect risk and protective factor information from clients in addiction treatment on a daily basis. Prior to clients’ weekly counseling sessions, the DPS will generate a brief, one-page weekly summary report for counselors and clients that will summarize client daily report information, which can be used to improve the delivery of group- and individual-based treatment services. By improving client engagement and retention in treatment, this innovative technology has great potential to reduce health disparities regarding substance use treatment outcomes that affect one of the most vulnerable segments of the population (i.e., African Americans with drug use histories under criminal justice supervision). Given the continued public health crisis of SUDs, including opioid use disorders, technologies to enhance engagement and retention in treatment are urgently needed. If proven efficacious, the DPS could be deployed across the growing national network of outpatient substance use treatment providers, and health care centers that provide substance use treatment, to enhance quality care and improve client outcomes, potentially having high public health impact.