Development of a novel community-based high-performance surveillance network for drug use

开发基于社区的新型高性能毒品使用监测网络

• 批准号: 10054384
• 负责人: Joshua Adam Barocas
• 金额: $ 7.76万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10054384
• 关键词: Alcohol or Other Drugs use; Big Data; Biometry; Communities; Complex; Dancing; Data; Databases; Development; Disease Outbreaks; Disease Progression; Drug usage; Drug user; Epidemic; Epidemiology; Failure; Government Agencies; HIV; Harm Reduction; Housing; Indiana; Individual; Information Dissemination; Interdisciplinary Study; Intervention; Kentucky; Knowledge; Link; Machine Learning; Massachusetts; Measures; Methodology; Methods; Modeling; Modernization; Output; Overdose; Patients; Performance; Pharmaceutical Preparations; Policies; Population; Population Sizes; Prevalence; Process; Provider; Public Health; Research; Resource Allocation; Risk; Risk Factors; Science; Services; System; Techniques; Time; Translating; West Virginia; base; clinical care; community building; community involvement; data warehouse; econometrics; follow-up; innovation; interdisciplinary approach; novel; opioid use disorder; overdose risk; prediction algorithm; prescription opioid; prevent; programs; social stigma; surveillance data; surveillance network; tool

PROJECT SUMMARY Surveillance efforts for substance use are failing us. They rely on outdated risk prediction tools yet risk factors for HIV and overdose are context-specific and are impacted by the interplay between patient-, provider-, and system-level factors as well as epidemiologic realities in a community. They rely on direct estimation methods for measuring prevalence yet barriers such as lack of access to medications for opioid use disorder (MOUD) and harm reduction services, stigma, criminalization of drug use, and unaffordable housing prevent people who use drugs (PWUD) from being counted. Additionally, they rarely involve community engagement and surveillance data are not disseminated effectively to communities to achieve maximum benefit. In the context of the ongoing overdose crisis and recent outbreaks of HIV among PWUD in Indiana, Massachusetts, Kentucky, and West Virginia, the failures of this basic tool of public health take on a new urgency. The number of efficacious programs and interventions to prevent and treat substance use and HIV continues to grow, but without accurate estimates of the size of the pool of people at risk of overdose and for acquiring HIV and knowledge of their specific risk factors, these interventions cannot reach their full potential. We cannot reach people who we do not know exist and are at risk. We, therefore, need to immediately modernize and upgrade our surveillance capacity to understand the size and composition of drug-using populations. I am proposing an innovative, interdisciplinary research program that integrates epidemiology, community engagement, biostatistics, econometrics, and information dissemination to create a novel community-based, high- performance surveillance network for PWUD. I will do this by (1) creating a community engaged research (CEnR) process around big data for PWUD; (2) building community-specific risk prediction algorithms for HIV acquisition, disease progression, and loss to follow up among PWUD; (3) using enhanced indirect estimation methods to determine the size of populations of PWUD and to evaluate the impact of interventions; and (4) disseminating findings and translating research into action. The data centerpiece of this program will be the Public Health Data Warehouse, an individually-linked database from more than 15 Massachusetts government agencies, which includes more than 97% of the Massachusetts population. Preliminary analyses with this database are underway and will be made accessible to communities in real-time. This project represents an approach that is entirely divergent from traditional surveillance techniques by using a combination of complex methodologies with the community always at the center of the process—from initiation to final output. This novel Massachusetts cOMmunity-bAsed Drug use surveillANCE (“Moma Dance”) Network will begin in Massachusetts, but will serve as a model for other states and jurisdictions as they contend with the failures of their own surveillance systems for PWUD. These efforts will translate research into action at the community level and have an immediate and sustained public health impact on the drug use and HIV epidemics.

项目摘要 用于吸毒的监视工作使我们失败了。他们依靠过时的风险预测工具，但风险因素 因为艾滋病毒和用药是特定于上下文的，并且受患者，提供者和提供者之间的相互作用的影响 系统级因素以及社区的流行病学现实。他们依靠直接估计方法 用于衡量患病率，但障碍，例如缺乏使用阿片类药物障碍的药物（MOUD） 以及减少损害服务，污名，毒品使用定罪以及无法承受的住房阻止 使用药物（PWUD）进行计数。此外，它们很少涉及社区参与和 监视数据没有有效地传播到社区以获得最大的收益。在上下文中 在正在进行的过量危机和最近在马萨诸塞州印第安纳州的普瓦德爆发的艾滋病毒爆发中， 肯塔基州和西弗吉尼亚州，这种基本的公共卫生工具的失败采取了新的迫切措施。数字 有效的计划和干预措施以预防和治疗药物使用，艾滋病毒继续增长，但 没有准确估算过过量风险的人群的规模，并获得艾滋病毒和艾滋病毒和 了解其特定风险因素，这些干预措施无法发挥其全部潜力。我们无法达到 我们不认识的人存在危险。因此，我们需要立即现代化和升级 我们了解使用毒品种群的大小和组成的监视能力。我正在提议 创新的跨学科研究计划，该计划整合流行病学，社区参与， 生物统计学，经济学和信息传播，以创建一种新型的基于社区的高级，高级 PWUD的性能监视网络。我将通过（1）创建社区参与的研究来做到这一点 （CENR）围绕PWUD的大数据的过程； （2）建立艾滋病毒的社区特定风险预测算法 在PWUD中的收购，疾病进展和损失； （3）使用增强的间接估计 确定普华角人群大小并评估干预措施的影响的方法； （4） 传播发现并将研究转化为行动。该程序的数据核心将是 公共卫生数据仓库，来自15多个马萨诸塞州政府的单独链接数据库 机构，其中包括超过97％的马萨诸塞州人口。对此进行初步分析 数据库正在进行中，并将实时访问社区。这个项目代表 通过使用复杂的组合，与传统监视技术完全不同的方法 与社区的方法始终位于过程的中心 - 从启动到最终输出。这 新颖的马萨诸塞州社区毒品使用监视（“ MOMA舞蹈”）网络将开始 马萨诸塞州，但将作为其他州和管辖区的模型，因为它们的失败 他们自己的PWUD监视系统。这些努力将把研究转化为社区行动 水平，对吸毒和艾滋病毒流行病产生直接和持续的公共卫生影响。