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 They rely on outdated risk prediction tools yet risk factors for HIV and overdose are context-specific and are impacted by the interplay between patient-, provider-, and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 对药物使用的监督努力正在使我们失望。他们依赖于过时的风险预测工具， 对于艾滋病毒和过量是特定的环境，并受到患者，提供者和 系统层面的因素以及社区的流行病学现实。它们依赖于直接估算方法 用于衡量流行率，但障碍，如缺乏获得阿片类药物使用障碍（MOUD）的药物 减少伤害服务，耻辱，毒品使用的刑事化，以及负担不起的住房， 使用毒品（PWUD）被计算在内。此外，它们很少涉及社区参与， 监测数据没有有效地传播到社区，以实现最大效益。背景下 在印第安纳州，马萨诸塞州， 在肯塔基州和西弗吉尼亚州，这一公共卫生基本工具的失败具有新的紧迫性。数量 预防和治疗药物使用和艾滋病毒的有效方案和干预措施继续增长，但 没有准确估计有过量用药风险和感染艾滋病毒风险的人群的规模， 由于缺乏对他们具体风险因素的了解，这些干预措施无法充分发挥其潜力。我们不能达成 我们不知道的人存在并处于危险之中。因此，我们需要立即实现现代化和升级 我们的监测能力，以了解吸毒人口的规模和组成。我提议 创新，跨学科的研究计划，整合流行病学，社区参与， 生物统计学，计量经济学和信息传播，以创建一个新的社区为基础的，高， PWUD的性能监控网络。我将通过（1）创建一个社区参与研究来做到这一点 （2）建立针对艾滋病毒的社区特定风险预测算法 PWUD的获得、疾病进展和失访;（3）使用增强的间接估计 确定PWUD人群规模和评估干预措施影响的方法;以及（4） 传播研究结果并将研究成果转化为行动。该计划的数据中心将是 公共卫生数据仓库，来自超过15个马萨诸塞州政府的独立链接数据库 机构，其中包括超过97%的马萨诸塞州人口。初步分析， 数据库正在建设中，并将实时提供给社区。该项目代表了一个 这种方法与传统的监视技术完全不同，它使用复杂的 社区始终处于过程的中心-从启动到最终输出。这 一个新的马萨诸塞州社区毒品使用监督（“Moma舞蹈”）网络将于开始， 马萨诸塞州，但将作为其他国家和司法管辖区的模式，因为他们与失败的斗争， 他们自己的监控系统这些努力将把研究转化为社区的行动 毒品和犯罪问题办公室的报告指出，毒品和犯罪问题办公室的工作人员在吸毒和艾滋病毒流行的水平，并立即和持续的公共卫生影响。