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

摘要 新墨西哥州是美国阿片类药物危机的中心，自1990年以来过量死亡率最高。 海洛因引起的阿片类药物死亡和处方阿片类药物死亡都有所增加，特别是在 西班牙裔和美洲印第安人/阿拉斯加原住民群体。许多具有挑战性的社会决定因素，包括贫穷 和失业率导致新墨西哥州的OUD率很高。我们的团队非常适合领导NIDA CTN 由于我们参与OUD研究的广度和深度，广泛的临床试验 经验，与ECHO研究所的密切联系及其用于扩大SUD治疗的使用， 与AI/AN研究人员和临床医生的联系，我们招募不同农村人口参与的能力得到了证实 研究以及信息学和数据科学能力。NM节点的目标是：1）开发 并维持一个高效的平台，进行临床试验，为循证预防提供信息， 治疗OUD; 2）合作并领导研究，解决并改善整个 3）促进吸收北地中海地区在预防和护理上的最佳做法， 通过有效传播循证创新，在全国范围内推广。预期影响将是 扩大了对受阿片类药物危机影响的多样化、农村和服务不足人群的研究， 提供者和研究人员合作，领导和提出有影响力的研究的能力。纳米节点 研究将确保开发强大的和可推广的方法，用于预防，识别， 治疗OUD，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周期， 以证据为基础的做法，并促进对北卡罗来纳州社区的OUD CoC产生持续的积极影响 和全国范围内。我们的建议建立在多个资产上：1）与基层医疗保健的强大联盟 提供者在（一）现有的PBRN（RIOS网络），延伸到农村NM，（二）UNM社区为基础的小学 护理诊所;（iii）在整个北卡罗来纳州的多个农村和城市地点提供SUD/和OUD治疗 包括400多名参与ECHO学习网络的人; 2）15年的CTN和协议 管理经验; 3）进行研究的专业知识，包括SUD患者的临床试验， OUD; 4）在卫生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人群，包括医疗服务不足的农村地区， 西班牙裔和美国印第安人; 6）在MOUD方面具有强大的临床和教育专业知识，7）我们在以下方面的优势： 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 .