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.

项目概要 快感缺失，或者说从非药物奖励中失去快乐，对于多达一半的患有快感障碍的患者来说具有临床意义。 阿片类药物使用障碍 (OUD) 是不良结果的有力预测因素。然而，快感缺失很复杂， 因为在临床环境中报告快感缺乏的患者也可能报告频繁的、愉快的非药物 日常生活中的奖励。 OUD 患者的非药物奖励可能是由动态的个人、社会和内在因素驱动的。 环境（即社会空间）因素。研究人员了解每个因素的作用至关重要 快感缺失，以建立有效的非药物奖励干预措施。拟议的研究将审查 富兰克林 OUD 门诊患者实时和社会空间背景下的非药物奖励异质性 俄亥俄州县。该提案涉及 NIDA 研究重点，即确定环境、行为、 和成瘾的社会后果，并且能够将研究结果转化为可行的干预措施 对于 OUD——申请人职业生涯的主要目标。在目标 1 中，我们将深入了解毒品和毒品的经历 通过横断面调查（n = 200）、地理标记来确定典型的当地环境的非药物奖励 非药物奖励体验和探索性开放式问题。在目标 2 中，我们将检查日常工作 社会空间方面的非药物奖励体验（14 天，每天 2 次评估；n=50，从研究 1 中招募） 通过生态瞬时评估 (EMA) 和被动收集的 GPS 位置数据来了解环境。我们将 还测试非药物奖励的哪些方面可以预测 OUD 恢复结果。在目标 3 中，我们将描述 奖励体验及其社会空间背景的异质性。为了实现这些目标，分析 方法将包括回归（目标 1）、集成 EMA 和社会空间数据的多级建模（目标 2）、 和多级潜在类别分析（目标 3）。研究结果将阐明异质性和环境背景 非药物奖励经验并为非药物奖励干预措施的发展提供信息，这些干预措施针对个人和 根据具体情况进行调整，以支持个人从 OUD 中恢复。申请人优秀的导师团队拥有 强化纵向方法和异质性建模方面的专业知识（Stephanie Lanza）、健康地理学 和地理空间方法（Louisa Holmes）、OUD 治疗（David Epstein）以及物质使用和地理空间 俄亥俄州的分析（Bridget Freisthler）；当申请人成为一名 独立调查员。指导团队将支持以下领域的培训： 非药物的作用 成瘾奖励、健康的社会空间决定因素、地理空间分析和表征方法 异质性，与成瘾治疗中心合作从不同人群收集数据，以及 负责任地进行研究。拟议的工作将使申请人能够产生新的知识 非药物奖励在 OUD 中的作用，并在他的整个职业生涯中推进 OUD 治疗科学。