Capturing Rural Risk Network Structures from Continuous-time Interaction Data (RISC)

从连续时间交互数据 (RISC) 中捕获农村风险网络结构

• 批准号: 10117091
• 负责人: Jeffrey Smith
• 金额: $ 24.95万
• 依托单位: UNIVERSITY OF NEBRASKA LINCOLN
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-05 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10117091
• 关键词: Address; Admission activity; Affect; Behavioral; Communicable Diseases; Communities; Computer Models; Country; Coupled; Data; Disease; Disease Outbreaks; Drug usage; Drug user; Economics; Epidemic; Epidemiology; Excision; Gender; Geography; Goals; HIV; HIV Infections; HIV/HCV; Health; Hepatitis C; Hepatitis C Transmission; Hepatitis C co-infection; Hepatitis C virus; Hospitalization; Illicit Drugs; Indiana; Individual; Intervention; Iowa; Knowledge; Laws; Life Cycle Stages; Measures; Mentors; Methamphetamine; Methodology; Mission; Missouri; Modeling; Monitor; National Institute of Drug Abuse; Nebraska; Needle Sharing; Needle-Exchange Programs; Needles; Opioid; Outcome; Pattern; Pharmaceutical Preparations; Pharmacotherapy; Play; Population; Populations at Risk; Positioning Attribute; Prevention strategy; Process; Public Health; Public Policy; Research; Risk; Risk Behaviors; Risk Factors; Rural; Rural Population; Rural drug addiction; Social Mobility; Social Network; Strategic Planning; Stress; Structure; Substance abuse problem; Surveys; Syringes; Time; Vulnerable Populations; Work; addiction; combat; comorbidity; contextual factors; drug structure; epidemiological model; experience; high risk behavior; high risk population; illicit drug use; improved; infection rate; infection risk; innovation; models and simulation; network models; novel; physical conditioning; resilience; rural area; rural drug use; rural setting; simulation; social; substance abuse treatment; substance use; therapy development; urban setting

PROJECT ABSTRACT Rural drug use in the Central Plains is a large and growing public health problem. Recent substance abuse data show that Nebraska, Iowa, and Missouri are all in the top 10 states for methamphetamine-related hospital admissions. The high level of substance abuse is coupled with a severe lack of treatment facilities in these rural areas, as well as restrictive syringe access laws. These conditions (high substance use, few treatment facilities, and lack of access to clean needles) combine to create a vulnerable population, one particularly at risk for the spread of infectious diseases, like HIV and hepatitis C virus (HCV). For example, a well-publicized HIV outbreak in southern Indiana occurred in 2015, revealing widespread rural drug use. Outbreaks like this demonstrate that even populations with low rates of HIV (for example) may be structurally at risk for an epidemic. Despite the urgency of the rural drug use problem, relatively little is known about the network and behavioral risk factors of rural drug users. Most of the data on illicit drugs come from urban settings, even while rural drug use and related health outcomes have increased over the last few decades. The lessons learned from urban drug users are unlikely to hold in rural areas, where conditions and experiences can be quite different; for example, rural drug users tend to have small social circles, limited chances for social or economic mobility, high availability of drugs, and few drug treatment venues. This project, as part of the larger Rural Drug Addiction Research Center, will fill in crucial gaps in the knowledge of rural drug use and associated health risks while investigating the potential efficacy of different interventions. In particular, the social network dynamics and behavioral contexts that contribute to the risk of HCV and HIV infection will be investigated in three rural areas surrounding communities in Nebraska, Iowa, and Missouri. Behavioral risks associated with HIV and HCV spread, as well as the structure of the drug use network, will be measured as important risk factors for disease spread (Aim 1). Using these data, an empirically-grounded, epidemiological simulation will be developed. The simulation approach makes it possible to pinpoint the conditions under which an epidemic is possible and describe the possible efficacy of different interventions in limiting a potential outbreak. Previous network models will be extended by combining traditional survey data with innovative, continuous-time interaction data, resulting in an epidemiological framework that measures factors like relationship timing, context, and geography (Aim 2), factors that are known to affect disease spread but have previously been difficult to quantify. This simulation will then be used to characterize the risk of HIV/HCV spread in this drug user population (Aim 3). Overall, the project will offer timely, crucial information about a rural, at-risk population. The broad, long-term objective is to establish an empirically- validated, epidemiological model with clear public policy applications, such as the monitoring of disease spread in rural, at-risk populations and the development of interventions to combat addiction related harms.

项目摘要 在中原地区，农村吸毒是一个日益严重的公共卫生问题。最近的药物滥用数据 显示内布拉斯加州、爱荷华州和密苏里州都在与甲基苯丙胺有关医院排名前10位的州 招生这些农村地区药物滥用率高，同时严重缺乏治疗设施， 以及限制注射器使用的法律。这些条件（大量使用药物，治疗设施很少， 和缺乏清洁针头）联合收割机，造成了一个脆弱的群体，特别是在危险的， 传染病的传播，如艾滋病毒和丙型肝炎病毒（HCV）。例如，一次广为人知的艾滋病毒爆发 2015年发生在印第安纳州南部，揭示了广泛的农村毒品使用。像这样的爆发表明， 即使是艾滋病毒感染率低的人群（例如）也可能在结构上面临流行病的风险。尽管 由于农村吸毒问题的紧迫性，人们对吸毒的网络和行为危险因素知之甚少， 农村吸毒者。大多数非法药物数据来自城市环境，即使农村药物使用和相关的 过去几十年来，健康结果有所增加。从城市吸毒者身上吸取的教训是 在农村地区不太可能成立，那里的条件和经验可能大不相同;例如，农村毒品 吸毒者的社交圈往往很小，社会或经济流动的机会有限，药物的可获得性很高， 戒毒场所也很少这个项目，作为更大的农村药物成瘾研究中心的一部分，将填补 在调查农村毒品使用和相关健康风险的可能性时， 不同干预措施的效果。特别是，社会网络动态和行为环境， 将在社区周围的三个农村地区调查导致HCV和HIV感染的风险 在内布拉斯加州、爱荷华州和密苏里州。与HIV和HCV传播相关的行为风险，以及 将作为疾病传播的重要风险因素加以衡量（目标1）。利用这些数据， 将建立一个以实验为基础的流行病学模拟系统。模拟方法使其 可能查明流行病可能发生的条件，并描述 不同的干预措施来限制潜在的爆发。以前的网络模型将通过结合 传统的调查数据与创新的，连续时间的相互作用数据，导致流行病学 一个衡量关系时间、背景和地理等因素的框架（目标2），这些因素是已知的 影响疾病传播，但以前很难量化。该模拟将用于 描述HIV/HCV在该吸毒人群中传播的风险（目标3）。总的来说，该项目将提供及时， 关于农村高危人群的重要信息。长远的目标是建立一个经验- 经验证的流行病学模型，具有明确的公共政策应用，如监测疾病传播 在农村高危人群中，制定干预措施，以消除与成瘾有关的危害。