Adapting the Penny Chatbot for Perinatal OUD Patients: COPILOT

建议书摘要/摘要 美国的阿片类药物危机对许多人产生了重大影响，其中最小的影响是 围产期妇女。在医院分娩的妇女中阿片类药物使用障碍(OUD)的流行率增加 从2010-2017年增长131%。怀孕和产后的OUD增加了许多医学疾病的风险 并发症，并可能导致不良的分娩结局，包括早产和胎儿宫内死亡， 以及产妇发病率和死亡率。孤独和社会孤立也与较差的进步有关 急性、慢性、身体和精神状况以及死亡率，并在围产期期间加重 期间(定义为怀孕和产后第一年)。孤独和社会孤立都有 与阿片类药物使用量、复发率和过量有关，即使在控制OUD的情况下也是如此 治疗、就业、关系状况和抑郁。 为了解决围产期妇女的孤独感和对围产期和母体护理的参与度，我们计划 为了对现有的支持短信的聊天机器人Penny进行改造，使其适合怀孕女性使用 和产后，以及如何应对OUD。新改装的聊天机器人Penny Copilot将允许两种方式 使用自然语言处理来适当响应的短消息服务(SMS)消息收发 准确到用户生成的输入。通过这种方式，Penny Copilot感觉像是在给朋友发短信，因为它使用 真实的句子，最大限度地减少尴尬的确认性消息。我们的团队，与宾夕法尼亚混合大学合作 方法研究实验室(MMRL)和记忆健康技术公司，将使用干预地图指导 执行科学综合框架。我们将进行需求评估，组装 一个顾问委员会，进行预测试以确保安全并改进内容，并对结果进行试点测试 Penny Copilot在20例妊娠合并尿路感染的围产期妇女样本中评估可接受性、可行性和患者 满足感。我们的目标是开发和完善一个可接受的、可行的、令人满意的支持性短信聊天机器人 促进患者对围产期和妇产科护理的参与度，并减少感知的孤独感。

PROPOSAL SUMMARY/ABSTRACT The US opioid crisis has had a significant effect on many populations, not the least of which effected are perinatal women. The prevalence of opioid use disorder (OUD) among women giving birth in hospitals increased by 131% from 2010-2017. OUD in pregnancy and postpartum increases the risks for a host of medical complications and can lead to adverse birth outcomes including preterm delivery and intrauterine fetal demise, as well as maternal morbidity and mortality. Loneliness and social isolation are also linked to poorer progression of acute, chronic, physical, and mental conditions, as well as mortality, and are compounded during the perinatal period (which is defined as pregnancy and the first postpartum year). Both loneliness and social isolation have been linked to increased opioid use amount, relapse rates, and overdose even when controlling for OUD treatment, employment, relationship status, and depression. To address both loneliness and engagement in perinatal and OUD care among perinatal women, we plan to adapt an existing texting support chatbot, Penny, to make it appropriate for use by women who are pregnant and postpartum and dealing with OUD. The newly adapted chatbot, Penny COPILOT, will allow for two way short message service (SMS) messaging using natural language processing to respond appropriately and accurately to user generated input. In this way, Penny COPILOT feels like texting a friend, as it responds using real sentences and minimizes awkward confirmatory messages. Our team, in collaboration with the Penn Mixed Methods Research Lab (MMRL) and Memora Health Technology Company, will use intervention mapping guided by the Consolidated Framework for Implementation Science. We will conduct a needs assessment, assemble an advisory board, engage in pretesting to ensure safety and refine content, and pilot test the resultant adapted Penny COPILOT in a sample of 20 perinatal women with OUD to evaluate acceptability, feasibility, and patient satisfaction. Our goal is to develop and refine an acceptable, feasible, and satisfactory supportive texting chatbot to promote patient engagement in perinatal and OUD care and decrease perceived loneliness.