Examining patterns of opioid overdose hotspots and opioid treatment deserts in California

项目总结 阿片类药物使用障碍(OUD)已被证明是一种虚弱和致命的疾病。弱势群体 包括无家可归者、种族和少数民族群体、贫困人口和农村居民 最大的负担。以前的研究表明，有必要进行本地化的分县分析来理解 阿片类药物过量的模式和决定因素。然而，大多数地方公共卫生部门没有 费力地收集、清理和分析所需数据的资源。我们的目标是为子县提供 阿片类药物过量热点和阿片类药物治疗沙漠的分析将揭示可采取行动的模式 加州公共卫生官员直接解决他们县的需求。具体目标：(1)使用 应用SATScan和贝叶斯空间分析检测2005-2022年阿片类药物过量用药热点 建模，(2)使用急救医疗服务和治疗中心位置数据来映射阿片类药物的治疗 由长途旅行到治疗中心所定义的沙漠，以及(3)应用定性研究方法 县官员确定了热点和治理沙漠的其他当地决定因素 对人口层面的数据进行量化分析。我们将使用我们的网络平台，公共卫生数据 生态系统，可视化我们关于热点、治理沙漠和社会、 健康的经济、环境决定因素。这些相关且易于理解的仪表板 将直接用于资源分配、政策变化和制定有针对性的干预措施。 培训计划为奖学金申请者提供了开始成功职业生涯所需的技能 阿片类药物使用障碍转化型公共卫生研究的独立研究员。他将承担 临床阿片类药物使用和治疗方面的培训；先进的地理空间方法和建模；以及定性 方法应用和定制公共健康影响的研究结果。候选人将由以下人员指导 来自各个学科的教师，包括流行病学、精神病学、数据科学、地理空间分析和 统计数据。Nelson博士是主要赞助商，负责T32行为、社会和人口方面的培训拨款 候选人将继续受益的健康研究，以及埃默里大学的另一位T32董事， 沃勒博士将在高级地理空间分析的应用方面发挥重要的指导作用。其他 导师包括精神病学系阿片成瘾方面的主要研究人员汉弗莱斯博士和 麦戈文；两位社会流行病学研究导师Rehkopf博士和Kiang博士；以及一位健康心理学家 专门研究定性方法和公民科学的金博士。通过这项奖学金，申请者将 阿片类药物使用障碍的先进翻译方法，接受世界级的培训和指导 赞助商和合作者，并为他的博士后工作中的独立公共卫生研究做好准备。

PROJECT SUMMARY Opioid use disorder (OUD) has proven to be a debilitating and deadly disease. Vulnerable populations including the homeless; racial and ethnic minority groups; people in poverty; and rural residents often bear the highest burden. Previous research suggests that localized sub-county analyses are necessary to understand the patterns and determinants of opiate overdoses. However, most local public health departments do not have the resources to laboriously collect, clean, and analyze the required data. We aim to provide sub-county analyses of opioid overdose hotspots and opioid treatment deserts that will reveal actionable patterns for California public health officials to directly address their county’s needs. Specific Aims: (1) to use hospitalizations from 2005-2022 to detect opioid overdose hotspots using SaTScan and Bayesian spatial modeling, (2) to use emergency medical services and treatment center location data to map opioid treatment deserts defined by long travel times to treatment centers, and (3) to apply qualitative research methods with county officials identifying additional local determinants of hotspots and treatment deserts not obvious from quantitative analyses of population-level data. We will use our web platform, the Public Health Data Ecosystem, to visualize our conclusions about the link between hotspots; treatment deserts; and the social, economic, and environmental determinants of health. These relevant and easily comprehendible dashboards will lend themselves directly to resource allocation, policy changes, and development of targeted interventions. The training plan provides the skills needed for the fellowship applicant to begin a successful career as an independent investigator in translational public health research on opioid use disorder. He will undertake training in clinical opioid use and treatment; advanced geospatial methods and modeling; and qualitative methods to apply and tailor research findings for public health impact. The candidate will be mentored by faculty from across disciplines including epidemiology, psychiatry, data science, geospatial analyses, and statistics. Dr. Nelson, the primary sponsor, leads the T32 training grant in behavioral, social, and population health research that the candidate will continue to benefit from, and a fellow T32 director at Emory University, Dr. Waller, will serve an important mentoring role for the application of advanced geospatial analyses. Other mentors include leading researchers in opiate addiction from the Department of Psychiatry Drs. Humphries and McGovern; two social epidemiology research mentors Drs. Rehkopf and Kiang; and a health psychologist specializing in qualitative methods and citizen science Dr. King. Through this fellowship, the applicant will advance translational methods in opioid use disorder, receive training and mentorship from world-class sponsors and collaborators, and be prepared for independent public health research in his postdoctoral work.