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 Frohe 建立了独立的研究生涯，专注于适应、设计和实施有效的 对边缘化社区进行远程医疗酒精干预。迄今为止，Frohe 博士的研究重点是 与疼痛和药物使用相关的危险因素。在博士后培训期间，她开始工作 在基于社区的定性方法框架内专门检查人们的酒精使用情况 经历无家可归和澳元；然而，Frohe 博士试图将她的训练从基础酒精扩展到更多 研究实施和测试社区利益相关者告知的基于技术的干预措施 以用户为中心的设计，以改善该人群的治疗提供。这一长期目标将是 通过五年培训和研究计划实现，该计划涉及精心挑选的导师团队，有针对性 课程作业和实践培训经验。拟议的研究旨在适应人身伤害 减少干预（HaRT-A）到远程医疗平台（eHaRT-A）中，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：第一阶段将进行共同开发 与社区咨询委员会（例如，住房第一 居民）利用利益相关者的想法来告知和构建 eHaRT-A 原型（目标 1）并进行设计 这些变化将提高 eHaRT-A 平台的可行性和可接受性（目标 2）。在第 2 阶段， 将进行随机对照试验，以测试 eHaRT-A 与“支持服务”相比的功效 像往常一样”改善与酒精相关的结果（即酒精使用高峰、酒精相关伤害、AUD 症状、 和尿乙基葡萄糖醛酸测试阳性）以及随着时间的推移与健康相关的生活质量（目标 3）。 该提案与国家（NIH；NOT-AA-20-011）卫生倡议相一致，以整合基于技术的 对已有药物使用治疗的弱势和边缘化社区进行干预。如果 成功后，这项研究将开发一种临床相关的干预措施，更容易转移到 边缘化的社区环境，因为它将是为社区、由社区开发、与社区一起开发的。 该应用程序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 博士、Collins、 Comtois、Hsieh）和合作者（Larimer、Hallgren 博士）致力于 Frohe 博士的培训，并且每个人都会 为她提出的研究和培训计划提供独特的专业知识。该奖项的支持至关重要 Frohe 博士作为一名独立科学家的发展，他可以通过共同开发为酒精研究做出贡献， 调整和测试成功的基于技术的干预措施，以减轻与酒精相关的伤害并改善 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和 将促进 NIH 的使命，即培养能够在长期研究经费方面具有竞争力的早期研究人员。

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.