Evaluating Social Connectedness to Support Recovery from Opioid Use Disorder during the Postpartum Period

评估社会联系以支持产后阿片类药物使用障碍的恢复

• 批准号: 10681764
• 负责人: Alicia M Allen
• 金额: $ 23.03万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10681764
• 关键词: Academic achievement; Anxiety; Behavioral; Birth; Buffers; Child; Childbirth; Control Groups; Data; Data Analytics; Development; Ecological momentary assessment; Elements; Emotional; Evidence based treatment; Family; General Population; Generations; Goals; Health; Individual; Infant; Intervention; Interview; Knowledge; Loneliness; Machine Learning; Maternal Mortality; Medical Records; Mental Depression; Mothers; Motivation; Opioid; Outcome; Overdose; Pain; Pain management; Participant; Pattern; Perinatal; Play; Population; Postpartum Depression; Postpartum Period; Pregnancy; Prevalence; Prevention; Recovery; Recovery Support; Relapse; Research Project Grants; Risk; Risk Factors; Role; Sampling; Signal Transduction; Sleep disturbances; Social isolation; Social outcome; Social support; Specialist; Stress; Substance Use Disorder; Target Populations; Testing; Theoretical model; Time; Woman; Work; care giving burden; caregiving; craving; foster care; fourth trimester; high risk; illicit opioid; improved; individualized medicine; infant outcome; informant; novel; opioid misuse; opioid overdose; opioid use; opioid use disorder; overdose death; peer support; perinatal period; prevent; relapse prevention; relapse risk; social; social attachment; statistics; stress management; stressor

PROJECT SUMMARY The prevalence of opioid use disorder (OUD) during pregnancy has increased by nearly 500% over the past 15 years. While motivation for and compliance with OUD treatment during pregnancy is heightened, up to 80% of postpartum individuals with OUD relapse to illicit opioid use within six months of childbirth. A growing body of evidence indicates that, in the general population, positive social connectedness and strong social bonds are associated with improved OUD recovery outcomes (e.g., reduced craving, lower risk of relapse). Conversely, loneliness and social isolation are significant predictors of opioid misuse and relapse, particularly for women. Loneliness increases during transitional periods including from pregnancy to postpartum, signaling increased risk for adverse recovery outcomes. Moreover, relapse risk during the fourth trimester (i.e., the time from delivery to postpartum week 12) may be compounded by unique postpartum stressors, including postpartum depression and anxiety, sleep disturbances, heightened need for pain management, and caregiving-specific stress. Our overall goal is to understand the role of social connectedness in OUD-related recovery outcomes, specifically during the postpartum fourth trimester, an ideal inflection point with untapped potential. To achieve this goal we will pursue three aims. The first two aims will utilize existing data (derived from DP2-HD105541; PI: Allen) from 50 participants with OUD and 25 control participants who were followed from pregnancy through five months postpartum. Using ecological momentary assessments (EMA) paired with medical record data, we will assess social connectedness and OUD-related recovery outcomes. We will evaluate differing theoretical models of social connectedness in this population by testing the main and stress-buffering effects of social connectedness on recovery outcomes up to one year postpartum (Aim 1). Additionally, we will characterize dynamic changes in social connectedness across the fourth trimester and how patterns/changes relate to mothers’ recovery outcomes (Aim 2). Lastly, we will complete key informant interviews with 30 participants from the target population to explore the feasibility, acceptability, and opportunities for intervention to enhance social connectedness to improve the treatment of OUD and prevent postpartum relapse (Aim 3). The results of this study, regardless of outcome, will directly contribute to scientific knowledge on the role of social connectedness in postpartum OUD recovery. Moreover, this work will allow for the identification of new intervention targets, which will contribute to the development of novel, high-impact relapse prevention treatments tailored to the fourth trimester, a unique inflection point with ample untapped opportunity. This will be directly impactful to the 80,000- 120,000 women, infants, and families suffer the consequences of perinatal OUD every year.

项目摘要 在过去的15年中，妊娠期间阿片类药物使用障碍（OUD）的患病率增加了近500%。 年虽然怀孕期间接受OUD治疗的动机和依从性提高，但高达80%的 产后OUD患者在分娩6个月内复发非法阿片类药物使用。越来越多的 有证据表明，在一般人群中，积极的社会联系和强大的社会纽带是 与改善的OUD恢复结果相关（例如，减少渴望，降低复发风险）。相反地， 孤独和社会孤立是阿片类药物滥用和复吸的重要预测因素，特别是对妇女而言。 在过渡期（包括从怀孕到产后），信号传导增加， 不利恢复结果的风险。此外，在第四个三个月期间复发的风险（即，交货后的时间 到产后第12周）可能会受到独特的产后压力因素的影响，包括产后抑郁症 以及焦虑、睡眠障碍、对疼痛管理的高度需求和特定于工作的压力。我们 总体目标是了解社会联系在OUD相关恢复结果中的作用，特别是 在产后的第四个三个月，一个理想的转折点与未开发的潜力。为了实现这一目标， 我们将追求三个目标。前两个目标将利用现有数据（来自DP 2-HD 105541; PI：艾伦）， 50名OUD参与者和25名对照参与者从怀孕到5个月进行随访 产后使用生态瞬时评估（EMA）与医疗记录数据配对，我们将评估 社会联系和OUD相关的恢复结果。我们将评估不同的理论模型， 通过测试社会联系的主要作用和压力缓冲作用， 产后一年内的恢复结果（目标1）。此外，我们将描述动态变化， 第四个三个月的社会联系以及模式/变化与母亲恢复的关系 （目标2）。最后，我们将与目标公司的30名参与者进行关键线人访谈 探讨干预的可行性、可接受性和机会， 连通性，以改善OUD的治疗和预防产后复发（目标3）。的结果 研究，无论结果如何，将直接有助于科学知识的作用，社会联系 产后OUD恢复。此外，这项工作将有助于确定新的干预目标， 这将有助于开发新的，高影响力的复发预防治疗， 三个月，一个独特的转折点，有大量的未开发的机会。这将直接影响到80000- 每年有120，000名妇女、婴儿和家庭遭受围产期OUD的后果。