HD2A RASC - Pain Implementation Support Core

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PAIN IMPLEMENTATION SUPPORT CORE: PROJECT SUMMARY/ABSTRACT The ongoing opioid overdose crisis – the leading cause of accidental deaths among Americans – has at its roots inadequately treated opioid use disorder (OUD) and pain. This reality has been recognized by the National Academy of Medicine and the Centers for Disease Control and Prevention, among other major organizations charged with protecting the public health, sparking an unprecedented influx of funding and policy changes to stem the tide of overdose deaths. The nationwide attention and funding increase have driven a marked rise in the development of evidence-based, high-quality pain treatments and treatment guidelines addressing the full spectrum of public health need: from prevention to harm reduction to treatment to recovery support. However, there has been woefully inadequate uptake of these treatments in real-world practice. For example, primary care providers--the most frequent prescribers of long-term opioid therapy for pain--often lack skills and/or time to fully implement evidence-based guidelines, putting already vulnerable patients at even higher risk for opioid-related harms, including overdose, and poorly-controlled chronic pain. Effectively translating research findings into practice and ameliorating these real-world quality of care deficits are the domains of dissemination and implementation (D&I) science. As a key RASC core, the overarching goal of the Pain Implementation Support (Pain-IS) Core is to support HD2A Innovation Projects in successful implementation of effective pain interventions through the coordinated efforts of a highly expert collaborative team, deploying and advancing cutting edge D&I methods. We will bring the best of D&I science to the pain treatment quality gap, unifying implementation scientists and pain researchers—with the proximal goal of enhancing research in the Innovation Projects and the ultimate goal of impacting the public health. Specifically, in alignment with the other Cores, we will ASSESS the current status of key components of the Innovation Projects on D&I capability in 5 key dimensions: a) evidentiary basis for the intervention; b) stakeholder engagement c) contextual determinants; d) selection of implementation strategies; and, e) implementation outcomes including the critically important but often overlooked domain of equity. We will ASSIST the Innovation Projects using the information gathered in the ASSESS phase in order to: a) enhance motivation to enhance their studies with tailored D&I approaches that draw upon the Core’s expertise; b) provide a D&I Implementation Support Plan on the components above and using a shared decision-making approach to determine how best to offer technical assistance (implementation support); and, c) to co-lead the RASC Learning Collaborative. In concert with the RASC and other cores, we will ADVANCE the innovation projects activities with respect to sustainment and equity: linking projects with the field at large, promoting projects’ impacts on policy/financing, and facilitating ongoing stakeholder engagement towards advocacy.