Community Reinforcement and Family Training for Treatment Retention/HIV Risk(CDA

针对保留治疗/艾滋病毒风险的社区强化和家庭培训（CDA

• 批准号: 7648220
• 负责人: GREGORY S BRIGHAM
• 金额: $ 16.9万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7648220
• 关键词: Agonist; Area; Behavior Therapy; Behavioral; Buprenorphine; Clinical Data; Clinical Research; Clinical Trials; Clonidine; Colorado; Communities; Development; Development Plans; Disease; Dose; Drops; Drug Addiction; Drug Metabolic Detoxication; Drug abuse; Educational Intervention; Evaluation; Family; Goals; HIV; Health; Individual; Intervention; Knowledge; Lead; Licensing; Long-Term Care; Maintenance; Maintenance Therapy; Manuals; Measures; Medical; Medical Economics; Mentors; Modeling; Ohio; Opiate Addiction; Opiates; Opioid; Outcome; Patients; Persons; Pharmaceutical Preparations; Phase; Pilot Projects; Population; Procedures; Psychological reinforcement; Public Health; Publications; Randomized; Recovery; Research; Research Personnel; Risk; Risk Behaviors; Risk Reduction; Risk Reduction Behavior; Scientist; Services; Staging; Substance Use Disorder; Supervision; Testing; Time; Training; Universities; Work; Writing; career; career development; design; effective therapy; efficacy evaluation; efficacy trial; experience; high risk; improved; opioid withdrawal; patient oriented; patient oriented research; primary outcome; programs; secondary outcome; social; therapy development; treatment as usual; treatment program

DESCRIPTION (provided by applicant): This K23 mentored patient-oriented research application will support the career development of the candidate in the areas of integrated behavioral and pharmacological therapies development for drug dependence treatment and long- term maintenance of recovery. Dr. Eugene Somoza of the University of Cincinnati will serve as the primary mentor. Dr. Natasha Slesnick of the Ohio State University and Dr. Robert Booth of the University of Colorado will serve as secondary mentors for behavioral therapies development and HIV risk behavior reduction respectively. In addition a team of accomplished investigators will serve as consultants to provide both training and supervision in specialized areas of the career development and research plans. The goal of the career development plan is to provide the candidate with the training and practical experience necessary to succeed as an independent investigator. The plan includes a range of mentor supervised activities including: 1) management of clinical trials, 2) publications and proposal writing, 3) attendance of graduate course work and professional seminars and, 4) the conduct of original research. The planned research will adapt a therapy of known efficacy to target a new outcome of significant importance to public health. The Community Reinforcement and Family Training (CRAFT) procedures will be adapted, from reinforcing treatment entry, to reinforcing treatment retention and HIV risk behavior reduction in persons with opioid dependence who receive a buprenorphine taper detoxification. The research plan includes three phases: 1) development of a manual guided therapy, 2) development of therapist training and fidelity measures and, 3) a randomized pilot with 52 patients receiving either the new CRAFT treatment or treatment as usual. Assessments will occur at baseline, end of treatment, 3 months and, 6 months. The primary outcome is retention in drug abuse treatment, specifically time to the opiate dependent person's first drop from services of 30 consecutive days. Secondary outcomes include: HIV risk behavior reduction, utilization of available treatment and, drug abuse. Opiate dependent individuals present a significant health risk to themselves and the public. With the recent approval of buprenorphine for drug abuse treatment, detoxification programs have become more effective at managing opioid withdrawal and transitioning patients to ongoing treatment. Following transfer to ongoing treatment retention rates decline and persons who return to opiate use are at high risk for direct negative consequences such as accidental drug over-dose and associated health risks such as HIV. Further improvements in treatment retention, maintenance of recovery and, HIV risk reduction are needed. This research and career development plan will lead to significant knowledge for improving treatment retention and reducing HIV risk behavior and, will prepare the candidate for a productive career as an independent patient-oriented clinical research scientist.

描述（由申请人提供）：此K23指导的以患者为导向的研究申请将支持候选人在药物依赖治疗和长期维持恢复的综合行为和药理学疗法开发领域的职业发展。辛辛那提大学的尤金索摩查博士将担任主要导师。俄亥俄州州立大学的娜塔莎·斯莱斯尼克博士和科罗拉多大学的罗伯特·布斯博士将分别担任行为疗法开发和减少艾滋病毒危险行为的二级导师。此外，一组有成就的调查员将担任顾问，在职业发展和研究计划的专门领域提供培训和监督。职业发展计划的目标是为候选人提供成功担任独立调查员所需的培训和实践经验。该计划包括一系列导师监督的活动，包括：1）临床试验的管理，2）出版物和提案写作，3）研究生课程工作和专业研讨会的出席，以及4）原创性研究的进行。计划中的研究将调整已知疗效的疗法，以针对对公共卫生具有重大意义的新结果。社区强化和家庭培训（CRAFT）程序将进行调整，从加强治疗进入，到加强接受丁丙诺啡减量戒毒的阿片类药物依赖者的治疗保留和艾滋病毒风险行为减少。研究计划包括三个阶段：1）开发手动指导治疗，2）开发治疗师培训和保真度措施，3）随机试验，52名患者接受新的CRAFT治疗或常规治疗。将在基线、治疗结束、3个月和6个月时进行评估。主要结果是药物滥用治疗的保留，特别是阿片类药物依赖者连续30天首次停止服务的时间。次要结果包括：艾滋病毒风险行为减少，利用现有的治疗和药物滥用。阿片依赖者对自己和公众构成重大健康风险。随着丁丙诺啡最近被批准用于药物滥用治疗，戒毒计划在管理阿片类药物戒断和将患者过渡到持续治疗方面变得更加有效。在转为持续治疗后，继续使用率下降，重新使用阿片剂的人面临直接负面后果的高风险，如意外药物过量和相关的健康风险，如艾滋病毒。需要进一步改善治疗保留、维持康复和减少艾滋病毒风险。这项研究和职业发展计划将导致改善治疗保留和减少艾滋病毒风险行为的重要知识，并将为候选人作为独立的面向患者的临床研究科学家的富有成效的职业生涯做好准备。