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，特别是服用阿片类药物的孕妇和产后妇女(PPW) 使用无序(OUD)。围产期药物辅助治疗(MAT)的使用 综合治疗计划是目前的护理标准，但PPW正在努力 OUD可能低估或误判了它的好处。与此同时，新的发现表明 移动健康(MHealth)技术有可能支持更健康的行为 在患有OUD的个体中。在这个项目中，我们将测试一个基于理论的实用程序 数字治疗工具(UMAT-R)可促进垫子的粘连和治疗保留，同时 考虑到PPW的独特需求。在目标1中，我们将用PPW进行四个焦点小组 与OUD(目标用户)一起了解UMAT-R的干预组件，收集关于 理论驱动的组件，这些组件是工具中的候选组件，并引发建议 有关其他干预组件的信息。在Aim#2中，该工具将进行Beta测试 20名参与者之间的技术/导航问题。在目标3中，我们将进行一项试验 随机对照试验(RCT)：60例成人PPW伴OUD。此RCT旨在 测试UMAT-R(n=40)与对照组的可行性、可接受性和初步疗效 关于参与者治疗依从性的组(n=20，接受照常治疗)， 戒酒，并改善了垫上的态度、规范和感知的控制力。面向所有目标招聘 将发生在密苏里州圣路易斯市一家提供围产期药物辅助治疗的诊所 (MAT)和高风险的产妇护理到PPW正在努力应对OUD。临床有意义的效果 规模和损耗估计将有助于规划更大的RCT，我们将在其中测试UMAT-R 在更大的规模上，并将我们的招聘扩大到密苏里州和其他州的其他诊所。 这项新技术可能是帮助医生治疗尿路狭窄的无价工具。 在PPW中。

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.