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Barriers and Facilitators to Implementation of Family-Based Treatment for Opioid Use Disorder in Adolescents and Young Adults

对青少年和年轻人实施阿片类药物使用障碍家庭治疗的障碍和促进因素

基本信息

批准号：
9982042
负责人：
Melissa Pielech
金额：
$ 6.94万
依托单位：
BROWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-08-01 至 2021-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9982042
关键词：
Abstinence Address Adolescent and Young Adult Advocacy Advocate Affect Age Alcohol or Other Drugs use Alcohols Americas Applications Grants Behavior Therapy Behavioral Cessation of life Characteristics Clinic Clinical Research Communities Conflict (Psychology)Consensus Consultations Country Custom Data Data Analyses Data Collection Death Rate Dependence Development Effectiveness Elderly Ensure Environment Evidence based intervention Evidence based practice Evidence based treatment Family Feedback Funding Grant Health Health Personnel Intervention Interview Knowledge Leadership Left Legal Life Link Literature Manuscripts Measures Mentorship Methods National Institute of Drug Abuse Opioid Outcome Overdose Parents Participant Patients Pharmacotherapy Phase Policies Policy Maker Preparation Provider Public Health Qualitative Methods Quality of Care Recommendation Records Research Research Activity Research Design Research Methodology Research Personnel Research Training Resources Rhode Island Sampling Services Sexually Transmitted Diseases Structure Student Dropouts Surveys Symptoms System Testing Training Training Activity Translating Universities Writing addiction base career clinical practice experience implementation research implementation science implementation strategy improved informant opioid epidemic opioid overdose opioid use disorder premature system-level barriers treatment center treatment organization uptake

项目摘要

PROJECT SUMMARY Adolescents and young adults (AYA) have been severely affected by the opioid epidemic. In 2016 alone, over 4,000 AYA died from opioids, totaling 230,694 years of premature life lost. When left untreated or ineffectively treated, AYA with OUD experience an array of negative health outcomes including legal involvement, school dropout, family conflict, sexually transmitted infections, and death. Thus, increasing access to evidence-based treatments for AYA with OUD is a priority of great public health importance. The front-line evidence-based treatment for AYA with symptoms of dependency is pharmacotherapy; however, documented poor abstinence rates and rising overdose rates have highlighted the urgent need to augment pharmacotherapy with behavioral treatment. For AYA, there is critical consensus from multiple national organizations that treatment should use a developmentally sensitive, family-based approach. Family-based treatment approaches (FBT) have been evaluated rigorously, demonstrated effectiveness among AYA (particularly those age 12-20), and are endorsed for use with AYA up to age 25. Yet, the availability of FBT for AYA in community OUD treatment centers remains low. The current study aims to conduct a mixed-methods examination of systems-level barriers and facilitators to implementation of FBT approaches for AYA with OUD in community opioid treatment clinics, theoretically guided by the Consolidated Framework for Implementation Research (CFIR). Building upon the Primary Sponsor’s NIDA-funded parent study, data collection will occur in partnership with 12 opioid treatment centers throughout Rhode Island. Participants will be key informants with the ability to influence services offered within the opioid treatment system including clinic leaders, front-line treatment providers, policy makers, and patient advocates. Comprehensive data collection strategies include in-depth, semi-structured interviews as well as surveys utilizing a combination of validated implementation science measures and items derived from identified themes in qualitative interviews. Knowledge gained will be translated into customized feedback and recommendations about specific implementation strategies for each opioid treatment clinic. Policy makers and advocates will receive a summary of barriers and facilitators throughout the state with recommendations for specific policy actions. A highly structured training plan will ensure execution of the proposed research aims. Specifically, the candidate will receive training in (1) implementation science, (2) OUD in AYA, (3) FBT for AYA, (4) mixed-methods approaches, and (5) advocacy, grant writing, and manuscript preparation. Training will be guided by a stellar mentorship team with highly relevant expertise and long-standing track records of successful mentorship. The proposed research and training plan is further supported by the rich training environment at the Center for Alcohol and Addiction Studies at Brown University. Combined, the research and training activities will support the candidate’s pursuit of a clinical research career focused on facilitating the implementation of evidence-based interventions for AYA with OUD.

项目概要青少年和年轻人 (AYA) 受到阿片类药物流行的严重影响。仅2016年就超过 4,000 名 AYA 死于阿片类药物，总计过早死亡 230,694 岁。未经治疗或无效时经过治疗后，患有 OUD 的 AYA 经历了一系列负面的健康结果，包括法律介入、学校辍学、家庭冲突、性传播感染和死亡。因此，增加获得基于证据的机会使用 OUD 治疗 AYA 是具有重大公共卫生重要性的优先事项。前线循证对有依赖性症状的 AYA 的治疗方法是药物治疗；然而，据记录，节欲不佳率和不断上升的药物过量率凸显了迫切需要通过行为来增强药物治疗治疗。对于 AYA，多个国家组织达成了重要共识，即治疗应使用发展敏感、以家庭为基础的方法。以家庭为基础的治疗方法（FBT）经过严格评估，在 AYA（特别是 12-20 岁）中证明了有效性，并得到认可适用于 25 岁以下的 AYA。然而，社区 OUD 治疗中心可提供 AYA FBT 仍然很低。当前的研究旨在对系统级障碍进行混合方法检查促进者在社区阿片类药物治疗诊所实施 AYA 和 OUD 的 FBT 方法，理论上以实施研究综合框架（CFIR）为指导。建立在主要申办者 NIDA 资助的家长研究，数据收集将与 12 种阿片类药物治疗合作进行整个罗德岛州的中心。参与者将是有能力影响服务的关键信息提供者阿片类药物治疗系统内提供的服务包括诊所领导、一线治疗提供者、政策制定者、和患者倡导者。全面的数据收集策略包括深入的半结构化访谈以及结合经过验证的实施科学措施和衍生项目进行的调查来自定性访谈中确定的主题。获得的知识将转化为定制的反馈以及有关每个阿片类药物治疗诊所具体实施策略的建议。政策制定者倡导者将收到全州障碍和促进因素的摘要以及建议的具体政策行动。高度结构化的培训计划将确保拟议研究的执行目标。具体来说，候选人将接受 (1) 实施科学、(2) AYA 中的 OUD、(3) FBT 方面的培训对于 AYA，(4) 混合方法，以及 (5) 宣传、拨款写作和手稿准备。训练将由具有高度相关专业知识和长期跟踪记录的一流导师团队指导成功的指导。丰富的培训进一步支持了所提出的研究和培训计划布朗大学酒精与成瘾研究中心的环境。综合起来，研究和培训活动将支持候选人追求临床研究职业，重点是促进与 OUD 一起对 AYA 实施循证干预措施。