Patient Navigator plus Remote mHealth Adherence Support with Incentives: Understanding Criminal Justice Effects

患者导航器加上带有激励措施的远程 mHealth 依从性支持：了解刑事司法影响

• 批准号: 10840579
• 负责人: Judith Tsui
• 金额: $ 14.21万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2024-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10840579
• 关键词: Address; Adherence; Administrative Supplement; Adverse effects; Affect; Behavioral; Buprenorphine; Caring; Communities; Complex; Crime; Criminal Justice; Data; Disease; Diversion Program; Drug Combinations; Drug user; Education; Emergency department visit; Epidemic; Exclusion; Funding Mechanisms; Future; Gender; Grant; Health; Healthcare; Hospitalization; Imprisonment; Incentives; Individual; Intervention; Interview; Jail; Knowledge; Law Enforcement; Legal; Legal system; Link; Medical; Methamphetamine; Navigation System; Opioid; Outcome; Overdose; Parents; Participant; Patient Education; Patient advocacy; Patients; Persons; Pharmaceutical Preparations; Police; Policies; Prisons; Public Health; Punishment; Qualitative Methods; Race; Recording of previous events; Research; Research Support; Resources; Risk; Role; Services; Social support; Structure; Subgroup; Substance Use Disorder; Training; Twin Multiple Birth; United States; Violence; War; arm; barrier to care; comorbidity; court; experience; health care service utilization; improved; improved outcome; innovation; insight; lifetime risk; mHealth; medication for opioid use disorder; methamphetamine use; mortality risk; multidisciplinary; opioid use; opioid user; parole; patient navigator; peer; personal narratives; polysubstance use; poor health outcome; probation; programs; psychosocial; reduced substance use; reincarceration; response; secondary outcome; social capital; social stigma; social structure; structural determinants; substance use; substance use treatment; success; treatment program; treatment site; treatment strategy

PROJECT SUMMARY/ABSTRACT Polysubstance use and mass incarceration are twin epidemics. The rise in combined methamphetamine and opioid use along with the simultaneous creeping of mechanisms to address substance use disorder into the many arms of the criminal legal system from prisons/jails, probation/parole, policing, and court-mandated treatment or diversion programs have imbedded the legal system in the lives of people who use drugs. Combined use is already associated with more medical and psychosocial comorbidities, more stigma, less frequent treatment, and more legal system involvement. Despite mechanisms within the criminal legal system to address substance use, it is often combined with exclusion, punishment, violence, poor health outcomes, and isolation from services. Thus, involvement in the criminal legal system is likely to impact treatment for substance use disorder in complex ways that have not yet been studied. This administrative supplement in response to PA-20-272 proposes to investigate the role of the criminal legal system in the parent R34 grant “Patient Navigator plus Remote mHealth Adherence Support with Incentives to Improve Linkage and Retention among Hospitalized Patients with Opioid and Methamphetamine Use Who Initiate Buprenorphine.” We will conduct qualitative interviews among approximately 20 participants in the parent study, exploring encounters with various arms of the legal system and the effects it has had on their substance use and treatment, focusing specifically on the unique experiences of people who use methamphetamine and opioids. We will then apply the insights from these interviews to improve resources and training for the patient navigator arm of the parent trial so that they can help patients avoid adverse effects of criminal legal system involvement. This study will address gaps in knowledge about the effects of legal system involvement—which is already common in people who use drugs and may be an even greater challenge for people who also use methamphetamine—on linkage to and retention in treatment, helping to better understand the social-structural determinants and develop better treatment and intervention strategies. To that end, it will also apply the knowledge generated from interviews to enhance the parent study objectives of increasing linkage and retention in treatment and improve secondary outcomes of reduced substance use and emergency room visits.

项目摘要/摘要 使用多种药物和大规模监禁是两种流行病。联合起来的增长 甲基苯丙胺和阿片类药物的使用沿着的同时， 药物使用障碍从监狱/监狱进入刑事法律的系统的许多部门， 缓刑/假释，警务，法院授权的治疗或分流计划已经嵌入了 法律的系统在吸毒者的生活中。组合使用已经与更多 医学和心理社会共病，更多的耻辱，更少的治疗频率，更多的法律的 系统参与。尽管刑事法律的系统内有处理药物使用问题的机制， 它往往与排斥、惩罚、暴力、健康状况不佳和与世隔绝相结合。 服务因此，参与刑事法律的系统可能会影响物质治疗 以尚未被研究的复杂方式使用障碍。这一行政补充 对PA-20-272的回应建议调查刑事法律的系统在母R34中的作用 授予“患者导航器+远程mHealth依从性支持，并激励改善链接 阿片类药物和甲基苯丙胺使用住院患者中的药物潴留 丁丙诺啡。”我们将在大约20名参与者中进行定性访谈， 家长研究，探索遇到的各种武器的法律的制度和影响， 他们的物质使用和治疗，特别关注使用者的独特经历， 冰毒和阿片类药物然后，我们将应用这些访谈中的见解， 为母试验的患者导航器组提供资源和培训，以便他们能够帮助患者 避免刑事法律的系统介入的不良影响。这项研究将解决知识差距 关于法律的系统参与的影响--这在吸毒者中已经很常见了 对于那些同时使用甲基苯丙胺的人来说，这可能是一个更大的挑战。 和保留治疗，有助于更好地了解社会结构的决定因素， 制定更好的治疗和干预战略。为此，它还将运用知识， 从访谈中产生的，以提高家长的研究目标，增加联系和保留 在治疗和改善减少物质使用和急诊室访问的次要结果。