Increasing Women's Engagement in Medication Treatment for Opioid Use Disorder through Digital Intervention

项目摘要 这项以患者为导向的导师研究职业发展奖(K23)的首要目标是 为Dawn Sugarman博士提供成为独立医生所需的培训和研究活动 具有利用数字技术增加获得循证治疗的专业知识的调查员 阿片类药物使用障碍妇女(OUD)。本申请概述了一项综合培训和研究计划， 将为苏加曼博士提供实现她的职业目标所需的技能。在专家的指导下 物质使用障碍、OUD和数字健康，Sugarman博士的培训将侧重于以下关键 领域：(1)数字健康设计和研究(丽莎·马奇博士和凯瑟琳·卡罗尔博士)；(2)病因学和 OUD患者的治疗(谢利·格林菲尔德和罗杰·韦斯博士)；和(3)统计方法 纵向数据分析(加勒特·菲茨莫里斯博士)。这三个领域的培训将通过以下方式实现 教学活动和应用活动，参加国家会议和研究所，以及辅导会议。Dr。 Sugarman将把在培训活动中获得的技能应用于一个专注于 开发一种创新战略，以增加阿片类药物使用障碍的药物治疗的主动性 (Moud)在有OUD的女性中。研究表明，Moud是有效的，但没有得到充分利用。随着利率的上升 对于妇女致命的阿片类药物过量，至关重要的是制定可持续战略，以吸引和留住妇女 穆德。患有OUD的女性有更多的医疗问题，更严重的功能障碍，以及更严重的精神疾病 严重程度比患有自闭症的男性更严重。针对有药物使用的女性开发了针对性别的治疗方法 疾病，并与减少药物使用和增加护理的连续性有关；然而， 由于面对面的交付模式，广泛使用受到了限制，而且它们还没有明确 适应OUD治疗中的目标参与。此外，缺乏证明有效的研究。 为男女混合环境中的妇女实施这一关爱的战略。为了弥补这一差距，拟议的K23 研究项目将利用以用户为中心的设计过程来开发一个数字平台，以提供性别- 在男女混杂的环境中，提供具体的护理，以满足OUD妇女的个性化需求。这个 中心假设是，针对性别的数字干预将克服面对面交付的障碍 并将增加穆德妇女的印心。这项研究将解决女性患者在治疗方面的主要差距 OUD通过：(1)为患有OUD的妇女开发针对性别的数字干预(GSDI)；以及(2)进行 一项先导性随机对照试验，以检验将GSDI提供给有OUD的妇女的可行性 并在乌德稳定后立即恢复。GSDI对MUD启动影响的初步估计 还将接受检查。这些数据将为未来R01的更大II阶段疗效试验的设计提供信息 申请。Sugarman博士的培训和拟议的研究将在McLean医院和哈佛大学进行 医学院，这将为她提供大量的资源来实现她的目标。

Project Summary The overarching goal of this Mentored Patient-Oriented Research Career Development Award (K23) is to provide Dr. Dawn Sugarman with the training and research activities needed to become an independent investigator with expertise in using digital technology to increase access to evidence-based treatment for women with opioid use disorder (OUD). This application outlines an integrated training and research plan that will provide Dr. Sugarman with the skills needed to achieve her career goal. Under the mentorship of experts in substance use disorders, OUD, and digital health, Dr. Sugarman’s training will focus on the following key areas: (1) digital health design and research (Drs. Lisa Marsch and Kathleen Carroll); (2) etiology and treatment of individuals with OUD (Drs. Shelly Greenfield and Roger Weiss); and (3) statistical methods for longitudinal data analysis (Dr. Garrett Fitzmaurice). Training in these three areas will be achieved through didactic and applied activities, participation in national conferences and institutes, and mentoring meetings. Dr. Sugarman will apply the skills acquired during the training activities to a research project focused on developing an innovative strategy for increasing initiation in medication treatment for opioid use disorder (MOUD) in women with OUD. Research shows that MOUD is effective but underutilized. With rising rates of fatal opioid overdoses in women, it is critical to develop sustainable strategies to engage and retain women in MOUD. Women with OUD have more medical problems, greater functional impairment, and greater psychiatric severity than men with OUD. Gender-specific treatments have been developed for women with substance use disorders and are associated with reduced substance use and increased continuity of care; however, widespread use has been restricted due to in-person delivery models, and they have not been specifically adapted to target engagement in OUD treatment. Moreover, there is a lack of research demonstrating effective strategies to implement this care for women in mixed-gender settings. To address this gap, the proposed K23 research project will utilize a user-centered design process to develop a digital platform to deliver gender- specific care that addresses the individualized needs of women with OUD in mixed-gender settings. The central hypothesis is that a gender-specific digital intervention will overcome the barriers of in-person delivery and will increase women’s initiation in MOUD. This research will address key gaps in treatment for women with OUD by: (1) developing a gender-specific digital intervention (GSDI) for women with OUD; and (2) conducting a pilot randomized controlled trial to examine the feasibility of delivering the GSDI to women with OUD during and immediately after OUD stabilization. Preliminary estimates on the effect of the GSDI on MOUD initiation will also be examined. These data will inform the design of a larger Stage II efficacy trial for a future R01 application. Dr. Sugarman’s training and proposed research will be carried out at McLean Hospital and Harvard Medical School, which will provide her with a multitude of resources to meet her goals.