Project-007

项目-007

• 批准号: 10121549
• 负责人: Randall J Urban
• 金额: $ 48.06万
• 依托单位: UNIVERSITY OF TEXAS MED BR GALVESTON
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10121549
• 关键词: 14 year old; Address; Adolescent; Adoption; Age; Alcohol or Other Drugs use; Caring; Case Based Learning; Cessation of life; Clinic; Clinical Research; Clinical and Translational Science Awards; Communities; Community Healthcare; Community Physician; Community of Practice; County; Databases; Development; Ecosystem; Education; Effectiveness; Electronic Health Record; Epidemiologic Monitoring; Faculty; Family Practice; Future; Goals; Health Personnel; Healthcare; Information Technology; Knowledge; Maintenance; Maternal and Child Health; Mental Health Services; Mental disorders; Opioid; Patient Care; Pattern; Perinatal mortality demographics; Physicians; Poison; Population; Pregnancy; Prevention program; Prevention strategy; Quality of Care; Reporting; Research; Risk Factors; Rural Community; Schools; Students; Substance Use Disorder; Texas; Translating; Translations; United States; Woman; Work; base; care outcomes; evidence base; experience; high risk; improved; opioid mortality; opioid overdose; opioid use; opioid use disorder; perinatal morbidity; programs; rural underserved; teacher; violence prevention

Opioid overdose deaths and the rise in problematic opioid use patterns that indicate the development of opioid use disorder (OUD) have reached crisis levels in the United States. The highest risk for OUD and other substance use disorders (SUDs) associates with use instigated before 14 years of age. The Poison Center Network reported 102,940 opioid-related exposures in Texas from 2000-2017, including 21,723 exposures attributed to adolescents. Deaths attributed to opioids numbered 16,843 from 1999-2015, with 2,200 deaths in the age range of 15-24 years, tracking with a steady escalation over this period. While Texas ranks among the states with the lowest rate of opioid overdoses per capita, a 7.4% increase was reported between 2015 and 2016. The Ecosystem Optimization for Translation (EOT) optional function will harness our rich information technology and clinical and research excellence to create a Project ECHO (Extension for Community Healthcare Outcomes) network. UTMB’s networking in rural and underserved communities is historically strong and this experience is a central strength of the goal of the EOT to address existing gaps in integrated care in SUDs/OUD. The initial focus for the teleECHO network builds on the existing relationship with community physicians in 14 family medicine clinics in rural and underserved Texas counties to promote integration of OUD/SUD and mental health services into family medicine practices. Telementoring will create a community of practice across healthcare workers (physicians, faculty, residents, students) to facilitate case-based learning and disseminate best practices in OUD/SUD care, improve quality of care of patients, and build the relationships required to conduct research in rural and underserved communities. Partnering with the Texas Regional CTSA Consortium (TRCC), the EOT will work with the UTMB Regional Maternal and Child Health Program (RMCHP) network of 31 clinics to enhance teleECHO with targeted, women- and pregnancy-centered topics based upon contemporary knowledge of OUD/ SUDs and mental health disorders. This partnership will capture a quantitative and categorized electronic health record database for epidemiological surveillance and clinical research in opioids, other risk factors and their interactions in maternal-perinatal mortality and morbidity. To inform the use of contemporary knowledge, the teleECHO network will be expanded with adolescent-centered topics, delivered through a community of practice with teachers and healthcare providers in schools. Working with these schools and communities, we will translate our evidence-based findings into practice via a Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) approach focused on evidence-based substance use and violence prevention programs. The EOT is a pivot in emphasis grounded in our collective strengths to move us to a future in which the best practices of health care for OUD/SUDs, and evidence-based, culturally sensitive education and prevention strategies are promulgated across diverse urban and rural communities in Texas, and ultimately the national network of CTSAs and their populations served.

阿片类药物过量死亡和表明阿片类药物发展的有问题的阿片类药物使用模式的增加 使用障碍（OUD）在美国已达到危机水平。OUD和其他物质的最高风险 使用障碍（SUD）与14岁之前的使用有关。毒药中心网络 2000年至2017年，德克萨斯州报告了102，940例阿片类药物相关暴露，其中21，723例暴露归因于 青少年。从1999年到2015年，阿片类药物导致的死亡人数为16，843人，其中2，200人死亡， 范围为15-24年，在此期间稳步上升。虽然德克萨斯州在美国各州中 人均阿片类药物过量率最低，2015年至2016年期间报告增加了7.4%。的 翻译生态系统优化（EOT）可选功能将利用我们丰富的信息技术， 卓越的临床和研究，以创建一个项目ECHO（扩展社区医疗保健成果） 网络UTMB在农村和服务不足的社区的网络是历史上强大的，这种经验是一个 EOT目标的核心优势是解决SUD/OUD中综合护理的现有差距。最初的重点 远程ECHO网络建立在与14个家庭医学社区医生的现有关系基础上， 在德克萨斯州的农村和服务不足的县设立诊所，以促进OUD/SUD和精神卫生服务的整合 家庭医疗实践。远程管理将在医疗保健工作者中创建一个实践社区 （医生，教师，居民，学生），以促进基于案例的学习和传播最佳做法， OUD/SUD护理，提高患者的护理质量，并建立进行研究所需的关系， 农村和服务不足的社区。与德克萨斯州区域CTSA联盟（TRCC）合作，EOT将 与UTMB地区妇幼保健计划（RMCHP）的31个诊所网络合作， 根据对OUD/OUD的现代知识， SUD和精神健康障碍。这种合作关系将捕捉一个定量和分类的电子健康 阿片类药物、其他危险因素及其 产妇-围产期死亡率和发病率的相互作用。为了利用当代知识， 将扩大欧洲经委会通讯网，通过实践社区提供以信息中心为中心专题 与学校的教师和医疗服务提供者进行沟通。与这些学校和社区合作，我们将 我们的循证调查结果通过覆盖、有效性、采用、实施和维护 （RE-AIM）方法侧重于循证药物使用和暴力预防方案。EOT是 一个以我们的集体力量为基础的重点支点，使我们走向一个未来， 为经常外出和经常外出的人提供保健服务，以及基于证据、对文化敏感的教育和预防战略， 在德克萨斯州的不同城市和农村社区颁布，并最终在全国CTSA网络 和他们的人民服务。