Adapting and Implementing a Chronic Disease Self-Management Program for Primary Care Patients with Opioid Use Disorder and Serious Mental Illness

这个K01奖项的申请者是伊丽莎白·西安茨博士，一位受过博士培训的社会工作者，她的主要任务是 职业目标是成为一名独立的临床研究员，利用实施科学来促进 循证慢性病自我管理方案的采纳和整合 慢性疾病，主要是阿片类药物使用障碍(OUD)和严重精神疾病(SMI)。这款K01将支持 职业发展的四个关键领域：1)干预适应，因为它关系到心理健康和初级 OUD患者的护理需求；2)在实际环境中进行临床试验设计和管理方面的培训；3) 定性评估干预实施情况的高级技能；以及4)加强研究 注重科学领域的性别平等和多样性的领导力。西安茨博士组装了一个跨学科的 由亚当·戈登医学博士(主要导师)组成的指导团队，他是一名传播和 实施(D&I)研究人员专注于提高弱势患者群体的护理质量 和Leopoldo Cabassa博士，MSW(共同导师)，一位专注于 促进重度精神障碍患者的身体健康。其他顾问包括：Gerald Cochran，博士，MSW，a 具有OUD专业知识的临床试验专家；劳伦斯·帕林卡斯博士，D&I混合方法设计专家 研究；Angela Presson博士，临床试验统计分析专家；Angela Fagerlin博士，And 在患者决策支持干预和研究领导中的性别公平和多样性方面的专家。 患有抑郁症的人严重精神疾病(SMI)和其他慢性疾病的发生率很高。 疾病，并经常受到其临床症状和社会脆弱性的挑战。虽然初级保健 环境经常治疗患有OUD和SMI的患者，初级保健提供者几乎没有工具来支持这一点 人口在自我管理这些复杂的健康状况方面的能力。慢性病自我管理计划 (CDSMPS)可以改善疾病管理技能和行为，但尚未适应初级保健 OUD和SMI患者。未改编的版本可能与这一人群和背景缺乏相关性。Dr。 Siantz将解决这一实施差距。这项研究将支持未来的混合有效性研究 测试适用于患有OUD和SMI的初级保健患者的CDSMP。本研究的具体目标包括：1) 调整CDSMP，使其适用于患有OUD和SMI的成年人，以便在初级保健环境中使用 协作干预规划框架；2)测试以下项目的可行性、可接受性和初步影响 为初级保健环境中的SMI和OUD患者调整CDSMP；以及3)评估实施情况 使用快速评估方法修改的CDSMP的过程和背景知情的临床民族志。 这项拟议的研究具有重要意义，因为它将为 早期死亡的高风险。拟议的研究具有创新性，因为它将现有的CDSMP扩展到 新的患者群体(患有OUD和SMI的人)和新的环境(初级保健)。

This K01 award application is for Dr. Elizabeth Siantz, a PhD-trained social worker whose overarching career goal is to become an independent clinical investigator who uses implementation science to promote the adoption and integration of evidence-based Chronic Disease Self-Management programs for persons with chronic disease, primarily opioid use disorder (OUD) and serious mental illness (SMI). This K01 will support four key areas of career development: 1) intervention adaptation as it relates to the mental health and primary care needs of persons with OUD; 2) training in clinical trial design and management in real-world settings; 3) advanced skills for qualitatively evaluating intervention implementation; and 4) strengthening research leadership with a focus on gender equity and diversity in science. Dr. Siantz has assembled an interdisciplinary mentoring team comprised of Adam Gordon, MD (Primary Mentor), who is an expert dissemination and implementation (D&I) researcher focused on improving quality of care to vulnerable patient populations with OUD; and Leopoldo Cabassa, PhD, MSW (co-mentor), an expert mixed-methods D&I researcher focused on promoting the physical health of persons with SMI. Additional advisors include: Gerald Cochran, PhD, MSW, a clinical trialist with OUD expertise; Lawrence Palinkas, PhD, an expert in mixed-method designs for D&I research; Angela Presson, PhD, an expert in clinical trials statistical analyses; and Angela Fagerlin, PhD, an expert in patient decision support interventions and in gender equity and diversity in research leadership. People with OUD have a high co-occurrence of serious mental illness (SMI) and other chronic diseases, and are often challenged by their clinical symptoms and social vulnerabilities. While primary care settings frequently treat patients with OUD and SMI, primary care providers have few tools to support this population in self-managing these complex health conditions. Chronic Disease Self-Management programs (CDSMPs) can improve disease management skills and behaviors, but have not been adapted for primary care patients with OUD and SMI. Un-adapted versions might lack relevance to this population and setting. Dr. Siantz will address this implementation gap. This research will support a future hybrid-effectiveness study to test the adapted CDSMP for primary care patients with OUD and SMI. This study’s Specific Aims include: 1) Adapt the CDSMP for adults with OUD and SMI for implementation in a primary care setting using the Collaborative Intervention Planning Framework; 2) Test the feasibility, acceptability, and initial impact of the adapted CDSMP for persons with SMI and OUD in a primary care setting; and 3) Evaluate implementation process and context of the adapted CDSMP using Rapid Assessment Method Informed Clinical Ethnography. This proposed research is significant because it will develop a health education resource for a population at high risk for early mortality. The proposed research is innovative because it will extend an existing CDSMP to a new patient population (persons with OUD and SMI) and novel setting (primary care).