A technology solution for peer-led Seeking Safety

摘要 同行越来越被认为是医疗保健领域的一项重要资产。同伴支持在历史上是最突出的 物质使用障碍(SUD)，例如戒酒互助会和其他12步组织的全球模式。到目前为止 创伤和创伤后应激障碍(PTSD)在同伴帮助方面的尝试很少。创伤的主要挑战 同龄人小组的特点是，他们通常专注于讲述成员的创伤史，这可能过度引发和 令人苦恼。寻求安全为同行主导的护理提供了一个极好的选择。它是一种以证据为基础的，也是最广泛的 采用的模型为SUD/PTD。它以当下为中心，认知行为，并提供心理教育和应对技能 帮助客户在生活中获得更大的安全--避免对自己和他人的不安全行为，物质 使用和创伤症状。多年来，它以同行主导的形式成功实施，并得到了研究 在各种试验中，包括最近的一项随机对照试验(RCT)，比较了同伴和专业人员的分娩， 结果是积极的。在第一阶段，我们为同行主导的寻求安全(PLSS)开发了一个退出的测试版移动应用程序。 Peer Security(PS)应用程序基于最终用户的广泛投入，并在可行性研究中进行了评估。我们发现 第一阶段取得了很大的积极成果，现在提出了一个第二阶段项目来继续这项工作。在第二阶段，我们将增强 该应用程序的功能和内容，并在目前患有SUD/PTSD的成年人样本中进行RCT，以比较PS 控制应用程序的应用程序条件。他们将有12周的时间使用这款应用程序，并参与每周的在线PLSS，以及 将使用有效的工具在治疗前、治疗后和3个月后进行评估。我们还将衡量应用程序的使用情况，并 满足感。主要结果是物质使用和情绪调节。我们的团队提供了出色的组合 在SUD、PTSD、应用程序开发、临床试验、寻求安全、同行服务和SBIRS方面的专业知识。我们的公共卫生 目标是利用技术在在线环境中创建支持恢复的PLSS， 由极具吸引力的内容和交付提供支持。大多数患有SUD/PTSD的人没有得到正式的治疗。The PS APP可以解决远程访问、匿名帮助和方便、低成本帮助的需求， 由以同龄人的身份分享经验的人提供。即使对于那些参加面对面医疗活动的人来说，这款应用程序也可以 提供额外的支持和独特的功能。该项目提出了一种新的技术解决方案，以提供对 重要人群--SUD/创伤后应激障碍患者。

Abstract Peers are increasingly recognized as an important asset in healthcare. Peer support is historically most prominent for substance use disorder (SUD), such as the world-wide model of Alcoholics Anonymous and other 12-step groups. Yet for trauma and posttraumatic stress disorder (PTSD) there have been few attempts at peer help. A major challenge of trauma peer groups is that they usually focus on telling the story of members' trauma histories, which can be overly triggering and distressing. Seeking Safety offers an excellent choice for peer-led care. It is an evidence-based and is the most widely adopted model for SUD/PTD. It is present-focused, cognitive-behavioral, and provides psychoeducation and coping skills to help clients attain greater safety in their lives-- safety from unsafe behavior toward themselves and others, substance use, and trauma symptoms. It has been successfully implemented in peer-led format for many years and has been studied in various trials, including a recent randomized controlled trial (RCT) comparing peer versus professional delivery, with positive results. In Phase 1 we developed an exiting, beta version of a mobile app for peer-led Seeking Safety (PLSS). The Peer Safety (PS) app was based on extensive input from end users and was evaluated in a feasibility study. We found strong positive results in Phase 1 and now propose a Phase 2 project to continue this work. In Phase 2 we would enhance the app features and content and also conduct an RCT in a sample of adults with current SUD/PTSD to compare the PS app condition to a control app. They would have 12 weeks to use the app and participate in weekly online PLSS, and would be assessed pre, post and at 3-month followup using validated instruments. We will also measure app usage and satisfaction. The primary outcomes are substance use and emotion regulation. Our team offers an exceptional mix of expertise in SUD, PTSD, app development, clinical trials, Seeking Safety, peer services, and SBIRs. Our public health goal is to leverage technology to create PLSS in an online environment that would support recovery “anytime, anywhere,” powered by highly engaging content and delivery. Most people with SUD/PTSD do not obtain formal treatment. The PS app could address the need for access in remote locations, for anonymous help, and for convenient, low cost help, delivered by people who share their experiences as peers. Even for those who do attend in-person modalities, the app can provide additional support and unique features. This project proposes a novel technology solution to provide care for an important population-- people with SUD/PTSD.