Increasing Peer Support for OUD Recovery during COVID-19 through Digital Health: A National Randomized Controlled Trial

通过数字健康在 COVID-19 期间增加 OUD 恢复的同行支持：一项全国随机对照试验

• 批准号: 10672255
• 负责人: Francesca Beaudoin
• 金额: $ 80.55万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10672255
• 关键词: Acute; Adult; Adverse effects; Adverse event; Advertisements; Ambulatory Care; American; Anxiety; Behavior Therapy; Buprenorphine; COVID-19; COVID-19 impact; COVID-19 pandemic; Capital; Cellular Phone; Collaborations; Communities; Complement; Control Groups; County; Data; Data Set; Dedications; Distress; Drug usage; Education; Electronic Health Record; Emergency department visit; Enrollment; Ethics; Ethnic Origin; Evidence based treatment; Exclusion; Facebook; Geography; Grant; Health; Health Services Accessibility; Home; Incidence; Income; Indiana; Individual; Intervention; Intervention Studies; Loneliness; Low income; Measures; Methods; Minority Groups; Natural Language Processing; Outcome; Participant; Patient Outcomes Assessments; Patient Self-Report; Patients; Persons; Process; Psychosocial Stress; Public Health; Quality of life; Race; Randomized; Randomized, Controlled Trials; Recording of previous events; Recovery; Recovery Support; Recurrence; Regulation; Reporting; Research; Resources; Rhode Island; Rural; Sampling; Secure; Security; Self Efficacy; Self-Injurious Behavior; Services; Social Distance; Social support; Socioeconomic Status; Stress; Structure; Support Groups; System; Testing; Text; Time; Treatment/Psychosocial Effects; United States; Validation; Vulnerable Populations; acceptability and feasibility; addiction; administrative database; barrier to care; clinically relevant; comparison control; density; depressive symptoms; digital health; efficacy outcomes; efficacy study; efficacy testing; ethnic minority; evidence base; experience; follow-up; improved; low socioeconomic status; medication for opioid use disorder; mobile application; novel; opioid overdose; opioid use disorder; overdose risk; pandemic disease; peer; peer recovery; peer support; prevent; primary endpoint; primary outcome; programs; psychosocial; racial minority; recovery services; recruit; response; rural area; secondary endpoint; secondary outcome; social; social group; social media; social stigma; substance use; tool; treatment as usual; treatment program

PROJECT SUMMARY Increasing numbers of opioid overdoses have been observed during the COVID-19 pandemic, likely reflecting the pandemic’s multiple effects on this already vulnerable population. People in recovery from opioid use disorder (OUD) have reported disproportionate psychosocial distress and isolation, as well as significant disruptions in access to treatment including peer support, during the COVID-19 pandemic. These negative outcomes are especially acute for rural, low-income, and minority populations in recovery from OUD. Peer support is a key component of many evidence-based OUD recovery programs: it improves recovery capital, improves treatment engagement, improves perceived social support, and reduces psychosocial distress, particularly when used in conjunction with other evidence-based treatments such as medication for opioid use disorder (MOUD). This grant, submitted in response to PA 20-237, therefore proposes a randomized controlled trial of a novel mobile peer support app platform among a national sample of 1300 patients in recovery from opioid use disorders (OUDs), as an adjunct to usual care, during COVID-19. Our previously piloted online-only recruitment and follow- up strategy – in which we meld patient-reported outcomes with administrative datasets – allows strategic recruitment of often-excluded participants from across the United States, including those facing the highest barriers to treatment. The mobile app-based peer support intervention, provided as an individual-level enhancement of existing treatment and recovery programs, will allow individuals in OUD recovery to access a tailored, anonymous, peer-moderated support group 24/7. The app is augmented with natural language processing tools capable of automatically ‘flagging’ critical or clinically relevant content, thereby creating a scalable system to keep groups safe and constructive. Participants will be followed for 6 months through both self-report and administrative outcomes. The study’s primary outcome is self-reported recovery capital, complemented by objectively measured administrative data on retention in treatment programs from our community and governmental partners in a sub-sample of 650 patients from RI and IN. Hypothesized secondary outcomes are mitigation of psychosocial effects of COVID-19 on this vulnerable population, including depressive symptoms, stress, and loneliness, as well as objective adverse events of emergency department visits and opioid overdoses. Finally, we will explore whether state- and county-level variables moderate efficacy. SIGNIFICANCE: OUD is a major public health problem, and patients in recovery from OUD are experiencing worse outcomes during the COVID-19 pandemic. If this mobile app demonstrates efficacy among a large national sample of patients, it has the potential to augment existing treatment programs, improve recovery capital, and reduce disproportionate impacts of COVID-19 on this vulnerable population.

项目摘要 在Covid-19大流行期间，已经观察到越来越多的阿片类药物过量药物，这可能反映了 大流行对这个已经脆弱的人群的多重影响。从阿片类药物使用障碍中恢复的人 （OUD）报告了不成比例的社会心理困扰和孤立，以及严重的破坏 在COVID-19大流行期间获得包括同伴支持在内的治疗。这些负面结果是 特别是从OUD恢复的粗糙，低收入和少数族裔的急性。同伴支持是关键 许多基于证据的OUD恢复计划的组成部分：它改善恢复资本，改善治疗 参与，改善感知的社会支持并减少社会心理困扰，尤其是在使用 与其他基于证据的治疗（例如阿片类药物使用障碍药物（MOUD））的结合。这 格兰特（Grant）是针对PA 20-237提交的，因此提出了一项新型移动的随机对照试验 同行支持应用程序平台在全国1300名从阿片类药物使用障碍中恢复的患者中 （Ouds）作为常规护理的辅助，在Covid-19期间。我们以前试用的仅在线招聘和跟随 - UP策略（我们将患者报告的结果与行政数据集融合在一起）允许策略 招募来自美国各地的经常被排除的参与者，包括面对最高的参与者 治疗的障碍。基于移动应用的同行支持干预措施，作为个人级别提供 加强现有治疗和恢复计划，将允许Oud恢复中的个人访问 量身定制的，匿名的，同行调整的支持小组24/7。该应用程序以自然语言增强 处理能够自动“标记”关键或临床相关内容的处理工具，从而创建一个 可扩展的系统，以确保团体安全有建设性。参与者将通过两者遵循6个月 自我报告和行政成果。该研究的主要结果是自我报告的恢复资本， 通过客观测量的有关在我们的治疗计划中保留的管理数据完成 来自RI和IN的650名患者的子样本的社区和政府伙伴。假设的次要 结果是减轻Covid-19对这一脆弱人群的心理社会影响，包括抑郁症 症状，压力和孤独感，以及急诊就诊的客观不利事件和OOID 过量服用。最后，我们将探讨州和县级变量是否适中效率。意义： OUD是一个主要的公共卫生问题，从Oud中恢复的患者正在经历更糟糕的结果 在19号大流行期间。如果此移动应用在大型国家样本中显示出有效性 患者，它有可能增加现有治疗计划，改善恢复资本并减少 Covid-19对这一脆弱人群的不成比例影响。