mHealth to help pregnant and postpartum women in recovery for opioid use disorder

阿片类药物的流行在弱势群体中造成了广泛的有害后果， 密苏里州人群，尤其是使用阿片类药物的孕妇和产后妇女（PPW） 使用障碍（OUD）。围产期使用药物辅助治疗（MAT）在一个 全面的治疗计划是目前的标准治疗，但PPW挣扎与 OUD可能低估或误判了它的好处。与此同时，新的发现表明， 移动的健康（mHealth）技术有可能支持更健康的行为 在OUD患者中。在这个项目中，我们将测试一个基于理论的 数字治疗工具（uMAT-R），以鼓励MAT依从性和治疗保留， 考虑到PPW的独特需求。在目标#1中，我们将与PPW进行四个焦点小组讨论 与OUD（目标用户）就uMAT-R的干预组件进行沟通，收集以下方面的反馈： 理论驱动的组件，这些组件是工具中包含的候选组件，并可引出建议 额外的干预措施。在目标#2中，该工具将进行beta测试， 20名参与者讨论了技术/导航问题。在目标#3中，我们将进行试点 在患有OUD的成人PPW中进行的随机对照试验（RCT）（n=60）。本RCT旨在 测试uMAT-R（n=40）与对照品相比的可行性、可接受性和初步疗效 组（n=20，接受常规治疗）关于参与者的治疗依从性， 清醒，并改善MAT态度，规范和感知控制。为所有目标招聘 将在密苏里州圣路易斯的一家诊所进行，该诊所提供围产期药物辅助治疗 (MAT)和高风险的产妇护理，以PPW挣扎与OUD。临床意义的影响 规模和损耗估计将有助于计划一个更大的RCT，我们将在其中测试uMAT-R 在更大的范围内，并扩大我们的招聘到其他诊所在密苏里州和其他国家。 这项新技术可能是一个宝贵的工具，以协助医生在治疗OUD 在PPW。

The opioid epidemic has resulted in widespread detrimental consequences among vulnerable populations in Missouri, especially among pregnant and postpartum women (PPW) with opioid use disorder (OUD). Perinatal use of medication-assisted treatment (MAT) within a comprehensive treatment plan is the current standard of care, however PPW struggling with OUD may underestimate or misjudge its benefits. At the same time, emerging findings signal that mobile health (mHealth) technologies have the potential to support healthier behaviors among individuals with OUD. In this project, we will test the utility of a theoretically-based digital therapeutics tool (uMAT-R) to encourage MAT adherence and treatment retention while considering the unique needs of PPW. In Aim #1, we will conduct four focus groups with PPW with OUD (target users) on the intervention components of uMAT-R, gathering feedback on theory-driven components that are candidates for inclusion in the tool and eliciting suggestions for additional intervention components. In Aim #2, the tool will be beta-tested for technical/navigational issues among 20 participants. In Aim #3, we will conduct a pilot randomized controlled trial (RCT) among adult PPW with OUD (n=60). This RCT is designed to test the feasibility, acceptability, and preliminary efficacy of uMAT-R (n=40) versus a control group (n=20 who receive treatment-as-usual) regarding participants’ treatment adherence, sobriety, and improved MAT attitudes, norms, and perceived control. Recruitment for all Aims will occur at a clinic in St. Louis, Missouri that provides perinatal medication-assisted treatment (MAT) and high-risk maternity care to PPW struggling with OUD. Clinically meaningful effect size and attrition estimates will aid in the planning of a larger RCT in which we will test uMAT-R on a larger scale and expand our recruitment to other clinics across Missouri and other states. This novel technology could be an invaluable tool to assist physicians in the treatment of OUD among PPW.