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

每日进度系统 - 一种恢复支持工具，可减少门诊药物使用治疗中的健康差异

• 批准号: 9901091
• 负责人: Steven Bernard Carswell
• 金额: $ 22.5万
• 依托单位: COG ANALYTICS, LLC
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-24 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9901091
• 关键词: 12 year old; Abstinence; Adult; Affect; African American; Alcohol or Other Drugs use; Ambulatory Care; Appointment; Asians; Baltimore; Caring; Cessation of life; Client; Clinical; Clinical Services; Collaborations; Communities; Computer software; Counseling; Criminal Justice; Data; Development; Dropout; Drug usage; Economics; Face; Family; Federally Qualified Health Center; Feedback; Focus Groups; General Population; Health; Health Insurance Portability and Accountability Act; Health Personnel; Healthcare; High Prevalence; Hispanics; Individual; Low income; Mental Health; Modality; Moods; Motivation; Notification; Online Systems; Outcome; Outpatients; Pharmacotherapy; Phase; Population; Process; Professional counselor; Public Health; Quality of Care; Questionnaires; Recording of previous events; Recovery; Relapse; Reporting; Research; Risk; Risk Factors; Sampling; Secure; Small Business Technology Transfer Research; Structure; Substance Use Disorder; Summary Reports; Supervision; Surveys; System; Systems Development; Technology; Testing; Therapeutic; Time; Treatment outcome; addiction; base; care outcomes; craving; design; ethnic minority population; experience; feasibility trial; health disparity; improved; inner city; innovation; innovative technologies; novel; opioid use disorder; parole; physical conditioning; premature; probation; probationer; product development; protective factors; prototype; psychosocial; racial and ethnic; reduced substance use; relapse risk; service delivery; societal costs; support tools; treatment center; treatment services; usability; web app; week trial

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.

摘要 物质使用障碍（SUD），包括阿片类药物使用障碍，仍然是最严重的疾病之一。 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， 过早死亡。2 -4在刑事司法监督下有吸毒史的非洲裔美国人， 特别容易受到与SUD相关的负面影响， 4在以社区为基础的环境中提供的门诊治疗是主要的方式。 对于SUD治疗，通常涉及个人和/或团体的每周心理社会咨询会议 格式5，6较长的治疗保留时间与更好的结果相关，包括物质减少 使用，心理健康问题和社会成本。7 -10不幸的是， 启动治疗成功完成治疗。6，50 -52非洲裔美国人的治疗保留率特别低 和完成率相比，白人，11，12构成复发和升级的持续风险 物质的使用6，13，14 改善物质使用治疗的参与和保留的一种潜在方法是持续进行 治疗过程中的客户和咨询师反馈。门诊治疗的结构通常包括 来访者和咨询师之间的间歇性临床接触，通常每周一次，而且经常是一个小组， 基于格式，使临床医生缺乏有关客户进展的信息， 治疗疗程最近的成瘾研究表明，从客户那里获得信息， 每周一次的治疗会议可以为咨询师提供有关客户治疗的有价值和及时的数据 需求，潜在地提高他们提供优质护理和以客户为中心的治疗的能力， 治疗参与和保留，以及可能的禁欲结果。15，16 每日进度系统（DPS）是一个移动友好的，基于Web的软件应用程序，旨在 改善治疗参与和保持并减少治疗信息缺陷。DPS将提供 预约提醒通知，并收集成瘾客户的风险和保护因素信息 每天治疗。在客户每周的咨询会议之前，DPS将生成简短的一页纸 为咨询师和客户提供每周总结报告，总结客户每日报告信息， 用于改善基于群体和个人的治疗服务的提供。通过改善客户 参与和保留治疗，这项创新技术有很大的潜力，以减少健康 药物使用治疗结果方面的差异，影响到世界上最脆弱的群体之一， 人口（即，在刑事司法监督下有吸毒史的非洲裔美国人）。鉴于 持续的SUD公共卫生危机，包括阿片类药物使用障碍，加强参与的技术 和保留治疗是迫切需要的。如证实有效，存保计划可在 不断增长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客户的结果，可能有很高的公众 健康影响。