eHaRT-A: Adapting an evidence-based, in-person harm reduction treatment into a virtual care telehealth intervention for people with lived experience of homelessness and alcohol use disorder

项目概要/摘要 K01指导研究科学家发展奖的长期目标是支持Tessa博士 弗罗赫，在建立一个独立的研究生涯，重点是适应，设计和实施有效的 在边缘化社区采取远程保健酒精干预措施。迄今为止，弗罗厄博士的研究主要集中在 与疼痛和药物使用相关的风险因素。在她的博士后培训期间，她已经开始工作 在以社区为基础的定性方法框架内， 经历无家可归和澳元;然而，弗罗赫博士寻求扩大她的培训，从基本的酒精 从研究到实施和测试社区利益攸关方提供信息的基于技术的干预措施， 以用户为中心的设计，以改善这一人群的治疗提供。这一长期目标将是 通过一个五年期培训和研究计划实现，该计划涉及一个精心挑选的导师团队， 课程作业和实践培训经验。拟议中的研究旨在适应一个人的伤害 减少干预（HaRT-A）到远程医疗平台（eHaRT-A），并在生活中的个人中进行测试 无家可归的经历和澳元。该项目将分两个阶段进行：第一阶段将涉及共同开发 利用社区咨询委员会对远程保健平台的迭代可用性测试（例如，壳体第一 居民）利用利益相关者的想法，为eHaRT-A原型（目标1）提供信息和构建，并进行设计 改进eHaRT-A平台的可行性和可接受性的变更（目标2）。在第二阶段，a 将进行一项随机对照试验，以测试eHaRT-A与"支持服务"相比的疗效 "照常"改善酒精相关的结果（即，饮酒高峰期，酒精相关危害，AUD症状， 和阳性尿乙基葡糖苷酸试验）和随时间推移的健康相关生活质量（目标3）。 该提案与国家（NIH; NOT-AA-20 - 011）卫生倡议一致，以整合基于技术的 针对弱势和边缘化社区的干预措施，包括预先存在的药物使用治疗。如果 成功，这项研究将开发一种临床相关的干预措施，更容易运输到 这是因为它将为它旨在服务的社区而开发，由社区开发，并与社区一起开发。 该应用的培训计划将侧重于干预开发和测试，创新方法， 加强基于技术的干预措施的实施和先进的统计。导师（Clifasefi、柯林斯、 Comtois，Hsieh）和合作者（Larimer，Hallgren博士）致力于Frohe博士的培训，每个人都将 为她提出的研究和培训计划提供独特的专业知识。这个奖项的支持将是必不可少的 弗罗赫博士作为一名独立科学家的发展，他可以通过共同开发， 调整和测试成功的基于技术的干预措施，以减轻酒精相关的伤害， 个人的生活质量。华盛顿大学非常适合提供一流的培训经验， 将促进国家卫生研究院的使命，即培养早期研究人员，使他们能够在长期研究资金方面具有竞争力。

Project Summary/Abstract The long-term objective of this K01 Mentored Research Scientist Development Award is to support Dr. Tessa Frohe, in building an independent research career focused on adapting, designing, and implementing efficacious telehealth alcohol interventions among marginalized communities. To date, Dr. Frohe’s research has focused on risk factors associated with pain and substance use. During her postdoctoral training, she has begun working within a community-based and qualitative methods framework to examine alcohol use specifically among people experiencing homelessness and AUD; however, Dr. Frohe seeks to expand her training from basic alcohol research to implementing and testing technology-based interventions informed by community stakeholders and user-centered design to improve treatment delivery among this population. This long-term objective will be achieved through a five-year training and research plan involving a carefully selected mentor team, targeted coursework, and hands-on training experiences. The proposed research aims to adapt an in-person harm reduction intervention (HaRT-A) into a telehealth platform (eHaRT-A) and test it among individuals with lived experience of homelessness and AUD. This project will occur in two phases: Phase 1 will entail codevelopment with iterative usability testing of the telehealth platform with a community advisory board (e.g., Housing First residents) to leverage stakeholder ideas to inform and build the eHaRT-A prototype (Aim 1) and to make design changes that will improve the feasibility and acceptability of the eHaRT-A platform (Aim 2). In Phase 2, a randomized controlled trial will be conducted to test the efficacy of eHaRT-A compared to “supportive services as usual” in improving alcohol-related outcomes (i.e., peak alcohol use, alcohol-related harm, AUD symptoms, and positive urinary ethyl glucuronide tests) and health related quality of life over time (Aim 3). This proposal aligns with national (NIH; NOT-AA-20-011) health initiatives to integrate technology-based interventions for vulnerable and marginalized communities with pre-existing substance use treatments. If successful, this study will develop a clinically relevant intervention that is more easily transportable to marginalized community settings because it will be developed for, by, and with the community it aims to serve. The training plan for this application will focus on intervention development and testing, innovative methods to enhance technology-based intervention implementation, and advanced statistics. Mentors (Drs. Clifasefi, Collins, Comtois, Hsieh) and collaborators (Drs. Larimer, Hallgren) are committed to Dr. Frohe’s training and each will provide unique expertise to her proposed research and training plan. Support from this award will be essential to Dr. Frohe’s development as an independent scientist who can contribute to alcohol research by codeveloping, adapting, and testing successful technology-based interventions to ameliorate alcohol-related harm and improve individuals’ quality of life. The University of Washington is well suited to provide a stellar training experience and will promote NIH’s mission to develop early investigators who can be competitive for long-term research funding.