A technology solution for peer-led Seeking Safety

摘要 同行越来越被认为是医疗保健的重要资产。同伴支持是历史上最突出的， 物质使用障碍（SUD），如酗酒者匿名会和其他12步小组的世界范围内的模型。然而对于 在创伤和创伤后应激障碍（PTSD）中，很少有人尝试同伴帮助。创伤的主要挑战 同龄人群体的一个特点是，他们通常专注于讲述成员的创伤历史，这可能会过度触发， 令人沮丧。寻求安全提供了一个很好的选择同行为主导的护理。这是一个以证据为基础，是最广泛的 采用SUD/PTD模型。它关注当下，认知行为，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--从对自己和他人的不安全行为中获得安全， 使用和创伤症状。它已经成功地实施了多年的同行领导的格式，并已研究 在各种试验中，包括最近的一项随机对照试验（RCT），比较了同行与专业人员的交付， 积极的结果。在第一阶段，我们开发了一个现有的测试版移动的应用程序，用于同行领导的寻求安全（PLSS）。 同伴安全（PS）应用程序基于最终用户的广泛输入，并在可行性研究中进行了评估。我们发现 在第一阶段取得了非常积极的成果，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，我们将加强 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 应用程序条件转换为控制应用程序。他们将有12周的时间使用该应用程序并参加每周在线PLSS，并且 将使用经验证的工具在随访前、后和3个月时进行评估。我们还将衡量应用程序的使用情况， 满意主要结果是物质使用和情绪调节。我们的团队提供了一个特殊的组合， 在SUD，PTSD，应用程序开发，临床试验，寻求安全，同行服务和SBIR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PLSS，支持“随时随地”恢复， 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。的PS 应用程序可以解决远程访问、匿名帮助以及方便、低成本帮助的需求， 由同龄人分享他们的经历。即使对于那些亲自参加的人来说，该应用程序也可以 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，为儿童提供护理， 重要的人群--SUD/PTSD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.