Methods for Optimizing the Integration of Adaptive Human-Delivered and Digital SUD/HIV Services

项目总结：项目2 数字技术的进步(例如，电子健康记录、远程医疗和移动医疗技术) 创造了前所未有的机会，为个人扩展自适应服务的覆盖范围和影响 患有或面临物质使用障碍(SUD)和艾滋病毒的风险。虽然由自动化软件提供的服务 数字实时自适应干预(JITAI)等工具相对便宜，可以提供 目前，不充分的参与仍然是一个主要障碍。服务的人工交付可以是 更有吸引力，但往往更昂贵和负担更重。因此，数字和人类的融合-- 提供的服务需要在利弊之间权衡，这就需要平衡 对可扩展性和可持续性的有效性。了解如何最好地利用数字化和人性化 提供适应性干预措施的方式对于建立有效和可扩展的SUD/艾滋病毒服务至关重要。一个 主要挑战是确定如何最好地使用数据来优化干预之间的集成 人工交付的适应强度较低的组件(例如，每周、每月)和 以数字方式传送，适应强度很高(例如，每分钟或每天)。中国的长期目标是 提出的项目是使科学家能够优化多模式自适应干预(MADIS)，其中既 人类交付的和数字组件随着时间的推移以不同的时间尺度进行排序和调整。至 为了实现这一长期目标，我们将：(目标1)开发一种新的、灵活的试验设计，其中个人可以 在不同的时间尺度上对人类提供的和数字干预同时随机进行；(目标2) 开发新的统计方法，与来自新实验设计的数据一起使用，以解决新的 关于人工提供的服务和数字服务之间的协同作用的问题；(目标3)确定样本规模 计算器，使SUD/HIV科学家能够计划新的实验研究，以解决这些问题；以及 (目标4)将这些方法直接交到SUD/艾滋病毒科学家手中，以便它们可以容易地应用 推进SUD/HIV预防、治疗和康复服务。我们将为SUD/HIV举办研讨会 科学家并出版在药物使用、艾滋病毒和方法学方面的教程和应用程序。我们会工作的 与传播和培训核心一起开发免费、用户友好的软件，使SUD/艾滋病毒成为可能 科学家们在自己的工作中采用了这种新方法.本项目将提供脚手架支撑 证据驱动的人类交付和数字服务的整合和适应，加速了新的 产生有效和可扩展的SUD/艾滋病毒干预措施。

PROJECT SUMMARY: PROJECT 2 Advances in digital technologies (e.g., electronic health records, telehealth, and mobile health technologies) have created unprecedented opportunities to extend the reach and impact of adaptive services for individuals with or at risk for substance use disorders (SUD) and HIV. While services delivered by automated software tools, such as digital just-in-time adaptive interventions (JITAIs), are relatively inexpensive and can deliver support in the moment, insufficient engagement remains a major barrier. Human delivery of services can be more engaging but often more expensive and burdensome. Hence, the integration of digital and human- delivered services requires a trade-off between benefits and drawbacks that necessitates balancing effectiveness against scalability and sustainability. Understanding how to best leverage digital and human modalities to deliver adaptive interventions is critical for building effective and scalable SUD/HIV services. A major challenge is determining how best to use data to optimize the integration between intervention components that are human-delivered with a low intensity of adaptation (e.g., weekly, monthly) and those that are digitally delivered with a high intensity of adaptation (e.g., every minute or day). The long-term goal of the proposed project is to enable scientists to optimize Multimodality Adaptive Interventions (MADIs), in which both human-delivered and digital components are sequenced and adapted over time, at different time scales. To achieve this long-term goal, we will: (Aim 1) Develop a new, flexible trial design in which individuals can be randomized simultaneously to human-delivered and digital interventions at different time scales; (Aim 2) Develop new statistical methods for use with data from the new experimental design to address novel questions about synergies between human-delivered and digital services; (Aim 3) Develop sample size calculators to enable SUD/HIV scientists to plan novel experimental studies to address these questions; and (Aim 4) Place these methods directly into the hands of SUD/HIV scientists so that they can be readily applied to advance SUD/HIV prevention, treatment, and recovery services. We will conduct workshops for SUD/HIV scientists and publish both tutorials and applications in drug-use, HIV, and methodology outlets. We will work with the Dissemination and Training Core to develop free, user-friendly software that will enable SUD/HIV scientists to employ the new method in their own work. This project will provide the scaffolding to support evidence-driven integration and adaptation of human-delivered and digital services, accelerating a new generation of effective and scalable SUD/HIV interventions.