New Mexico Clinical Trials Node: Clinical research and practice to address substance use in diverse, rural and underserved populations

摘要 NM是美国阿片类药物危机的震中，是自1990年以来过量死亡率最高的国家之一。 海洛因可归因于阿片类药物的死亡和处方阿片类药物造成的死亡都有所增加，特别是在#年。 西班牙裔和美国印第安人/阿拉斯加土著群体。许多具有挑战性的社会决定因素，包括贫困 失业是造成新墨西哥州高OUD率的原因之一。我们的团队非常适合领导NIDA CTN 由于我们在广度和深度上参与了OUD研究、广泛的临床试验 经验，与ECHO研究所的密切联系及其在扩大获得SUD治疗方面的使用， 与AI/AN研究人员和临床医生的联系，我们被证明有能力招募不同的农村人口参与 在研究方面，以及信息学和数据科学能力。网管节点的目标是：1)开发 并维护一个高效的平台来进行临床试验，为循证预防和 治疗OUD；2)协作并领导研究，以解决并改善整个 保健级联(COC)；3)促进采纳保健和保健领域的最佳做法 通过有效传播以证据为基础的创新，在全国范围内。预期的影响将是 在受阿片类药物危机影响的多样化、农村和服务不足的人群中扩大研究，并增加 提供者和研究人员协作、领导和提出有影响力的研究的能力。网管节点 研究将确保开发强有力的和可推广的方法来预防、识别和 OUD的治疗包括评估和修改COC，扩大地方和国家 知识库。我们的传播目标将确保一个富有成效的参与和翻译循环 以证据为基础的做法，并促进对NM社区的OUD COC产生持续的积极影响 以及全国范围内。我们的建议建立在多项资产的基础上：1)与初级保健健康 (1)现有的以农村为基础的PBRN(Rios网)的提供者；(2)以社区为基础的UNM小学 护理诊所；(3)在新墨西哥州的多个农村和城市地点提供南部和南部/南部和南部地区的治疗 包括400多家参与ECHO学习网络的公司；2)15年以前的CTN和协议 管理经验；3)进行研究的专业知识，包括对SUD患者和 在保健服务方面的领导地位，包括Echo项目、信息学和实施研究；5) 接触独特和多样化的社区和患者群体，包括医疗服务不足、农村、 西班牙裔和美国印第安人；6)在穆德有很强的临床和教育专业知识；7)我们在 以CASAA为中心的SUD行为干预。

ABSTRACT NM is an epicenter of the opioid crisis in the US, with one of the highest overdose mortality rates since 1990. Both heroin-attributable opioid deaths and deaths from prescription opioids have increased, especially in Hispanic and American Indian/Alaska Native groups. Many challenging social determinants, including poverty and unemployment contribute to high rates of OUD in NM. Our group is ideally suited to lead a NIDA CTN Node because of the breadth and depth of our involvement in OUD research, extensive clinical trials experience, intimate connection with the ECHO Institute and its use for expanding access to SUD treatments, links with AI/AN researchers and clinicians, our proven ability to recruit diverse rural populations to participate in research, as well as informatics and data science capacity. The Aims of the NM Node are to: 1) develop and maintain a highly efficient platform to conduct clinical trials that will inform evidence-based prevention and treatment of OUD; 2) collaborate on and lead research that addresses and improves outcomes across the OUD Cascade of Care (CoC); 3) promote uptake of best-practices in OUD prevention and care in NM and nationwide through effective dissemination of evidence-based innovations. The expected impacts will be expanded research in diverse, rural and underserved populations impacted by the opioid crisis, and increased capacity of providers and researchers to collaborate on, lead, and propose impactful research. NM Node research will ensure the development of robust and generalizable methods for prevention, identification, and treatment of OUD including evaluation and modification of the CoC expanding the local and national knowledge base. Our dissemination aim will ensure a productive cycle of engagement and translation of evidence-based practices and promote a sustained positive impact on the OUD CoC in communities in NM and nationwide. Our proposal builds on multiple assets: 1) a strong alliance with the primary care health providers in (i) an existing PBRN (RIOS Net) that extends into rural NM, (ii) UNM community-based primary care clinics; (iii) and providers of SUD/ and OUD treatment at multiple rural and urban sites across NM including over 400 that have engaged with ECHO learning networks; 2) 15 years of prior CTN and protocol management experience; 3) expertise conducting research including clinical trials with patients with SUD and OUD; 4) leadership in health services including Project ECHO, informatics, and implementation research; 5) access to unique and diverse communities and patient populations, including medically underserved, rural, Hispanic and American Indian; 6) strong clinical and educational expertise in MOUD and 7) our strength in behavioral interventions for SUD, centered in CASAA .