The Role of Nondrug Reward in Recovery from Opioid Use Disorder: Intrapersonal and Socio-spatial Contexts in Daily Life

非药物奖励在阿片类药物使用障碍康复中的作用：日常生活中的个人和社会空间背景

• 批准号: 10677912
• 负责人: Samuel Stull
• 金额: $ 3.86万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10677912
• 关键词: Address; Ambulatory Care; Anhedonia; Area; Behavioral; Cellular Phone; Clinic; Clinical; Clinical Treatment; Communities; Complex; County; Cross-Sectional Studies; Data; Data Analyses; Development; Drug usage; Ecological momentary assessment; Environment; Epidemic; Feeling; Frequencies; Friends; Future; Geographic Locations; Geography; Goals; Health; Heterogeneity; Home; Individual; Intervention; Investigation; Knowledge; Life; Location; Measures; Mentors; Mentorship; Methods; Modeling; National Institute of Drug Abuse; North America; Ohio; Opiate Addiction; Outcome; Outpatients; Overdose; Participant; Patient Recruitments; Patient Self-Report; Patients; Persons; Pharmaceutical Preparations; Population Heterogeneity; Positioning Attribute; Recovery; Recovery Support; Reporting; Research Personnel; Research Priority; Rewards; Role; Route; Rural; Safety; Science; Specialist; Statistical Models; Subgroup; Techniques; Technology; Testing; Time; Training Support; Translating; Work; addiction; built environment; career; clinically significant; craving; diverse data; experience; health determinants; insight; mHealth; multilevel analysis; neurochemistry; non-drug; opioid epidemic; opioid overdose; opioid use disorder; pleasure; racial diversity; recruit; residence; responsible research conduct; social; substance use; treatment center

PROJECT SUMMARY Anhedonia, or loss of pleasure from nondrug rewards, is clinically significant for up to half of patients with an opioid use disorder (OUD) and is a strong predictor of poor outcome. Anhedonia is complex, however, because patients who report anhedonia in clinical settings may also report frequent, enjoyable nondrug rewards in daily life. Nondrug reward in people with OUD may be driven by dynamic personal, social, and built- environmental (i.e. socio-spatial) factors. It is critical that researchers understand the role of each factor in anhedonia, in order to build effective nondrug-reward interventions. The proposed studies will examine nondrug-reward heterogeneity in real time and socio-spatial context among OUD outpatients in Franklin County, Ohio. This proposal addresses the NIDA research priority of identifying the environmental, behavioral, and social consequences of addiction and is well positioned to translate findings into actionable interventions for OUD—a primary goal of the applicant’s career. In Aim 1 we will gain insight into experiences of drug and nondrug reward through a cross-sectional survey (n=200), geotagging to identify local contexts of typical nondrug reward experiences, and exploratory open-ended questions. In Aim 2 we will examine day-to-day experiences of nondrug reward (14 days, 2 assessments per day; n=50 recruited from Study 1) in socio-spatial contexts via ecological momentary assessments (EMAs) and passively collected GPS location data. We will also test which aspects of nondrug reward predict OUD recovery outcomes. In Aim 3 we will characterize heterogeneity in experiences of reward and their socio-spatial contexts. To achieve these aims, the analytical approach will include regression (Aim 1), multilevel modeling integrating EMA and socio-spatial data (Aim 2), and multilevel latent class analysis (Aim 3). Findings will clarify heterogeneity and environmental contexts of nondrug reward experiences and inform development of nondrug reward interventions that are personally and contextually adapted to support individuals’ recovery from OUD. The applicant’s exceptional mentor team has expertise in intensive longitudinal methods and modeling heterogeneity (Stephanie Lanza), health geography and geospatial methods (Louisa Holmes), OUD treatment (David Epstein), and substance use and geospatial analysis in Ohio (Bridget Freisthler); this team will provide outstanding support as the applicant becomes an independent investigator. The mentorship team will support training in the following areas: the role of nondrug reward in addiction, socio-spatial determinants of health, methods for geospatial analysis and characterizing heterogeneity, partnering with addiction treatment centers to collect data from diverse populations, and the responsible conduct of research. The proposed work will position the applicant to generate new knowledge on the role of nondrug reward in OUD and to advance the science of OUD treatment throughout his career.

项目摘要 Anhedonia或Nondrug Rewards失去愉悦的丧失，对于多达一半的患者，临床意义 Opioid使用障碍（OUD），是预后不佳的有力预测指标。 Anhedonia很复杂，但是 因为在临床环境中报告Anhedonia的患者也可能会经常举报，愉快的Nondrug 奖励日常生活。 OUD的人的Nondrug奖励可能是由动态的个人，社交和内置的驱动的 环境（即社会空间）因素。研究人员了解每个因素在 Anhedonia，以建立有效的Nondrug-Reward干预措施。拟议的研究将检查 富兰克林的Oud门诊患者之间的非奖励 - 奖励异质性和社会空间环境 俄亥俄州县。该建议旨在确定环境，行为， 和成瘾的社会后果，并且可以很好地将发现转化为可行的干预措施 对于Oud，这是申请人职业生涯的主要目标。在目标1中，我们将深入了解药物的经历和 通过横截面调查（n = 200）进行非赠款奖励，地面标记以识别典型的本地环境 Nondrug奖励经验和探索性开放性问题。在AIM 2中，我们将每天检查 Nondrug奖励的经验（每天14天，2次评估；从研究1招募的50个n = 50） 通过生态瞬时评估（EMA）和被动收集的GPS位置数据的上下文。我们将 还测试Nondrug奖励的哪些方面可以预测OUD恢复结果。在AIM 3中，我们将描述 奖励经验及其社会空间环境中的异质性。为了实现这些目标，分析 方法将包括回归（AIM 1），多级建模集成EMA和社会空间数据（AIM 2）， 和多级潜在类别分析（AIM 3）。调查结果将阐明异质性和环境环境 Nondrug奖励经验并为个人提供的Nondrug奖励干预措施的发展提供信息 上下文适应以支持个人从OUD恢复。申请人的杰出导师团队拥有 密集纵向方法和建模异质性（Stephanie Lanza）的专业知识，健康地理 和地理空间方法（Louisa Holmes），Oud治疗（David Epstein）以及药物使用和地理空间 俄亥俄州的分析（布里奇特·弗里斯特勒）；随着申请人成为一个，该团队将提供出色的支持 独立研究者。 Mentalship团队将支持以下领域的培训：Nondrug的角色 成瘾的奖励，健康的社会空间决定者，地理空间分析的方法和表征 异质性，与成瘾治疗中心合作，以收集潜水员人群的数据， 负责任的研究。拟议的工作将定位申请人以产生有关的新知识 Nondrug奖励在Oud中的作用，并在整个职业生涯中推进了Oud治疗的科学。