ASTERISK: Alcohol and Substance use Treatment and Engagement Research on Intervention Studies among Key populations

ASTERISK：重点人群中酒精和药物使用治疗和干预研究的参与研究

• 批准号: 10593145
• 负责人: Glenn-Milo Santos
• 金额: $ 18.76万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10593145
• 关键词: AIDS prevention; Acceleration; Address; Advanced Development; Alcohol consumption; Area; Behavioral; Caring; Categories; Complex Analysis; Data; Data Analyses; Data Set; Ethnic Origin; Gender; Gender Identity; HIV; HIV risk; Health; Health Services Accessibility; Homelessness; Homophobia; Human Resources; Imprisonment; Individual; Intervention; Intervention Studies; Measures; Mentors; Methodology; Morbidity - disease rate; National Institute of Drug Abuse; National Institute on Alcohol Abuse and Alcoholism; Outcome; Participant; Persons; Pharmacotherapy; Population; Populations at Risk; Psychosocial Factor; Public Health; Race; Research; Research Personnel; Research Project Grants; Role; Sample Size; Sampling; Services; Sex Discrimination; Sexism; Social support; Source; Statistical Models; Structure; Subgroup; Substance Use Disorder; Surveys; Training; Treatment outcome; Treatment/Psychosocial Effects; Visit; Work; alcohol services; alcohol use disorder; burden of illness; career development; disability-adjusted life years; efficacious intervention; ethnic identity; experience; experimental study; medication compliance; mortality; novel; patient oriented research; polysubstance use; preference; programs; psychological distress; racial identity; racism; reduced alcohol use; resilience; scale up; sex; skill acquisition; social; social capital; social group; social stigma; structural determinants; substance use; substance use treatment; syndemic; transphobia; treatment strategy; uptake; years of life lost

PROJECT SUMMARY Alcohol and substance use disorders (ASUD) are associated with substantial morbidity and mortality. Globally alcohol use disorders (AUD) were attributed to 99.2 million disability-adjusted life years (DALYs) while illicit substance use disorders (SUD) were attributed to 31.8 million DALYs lost in 2016. Despite the urgent need to reduce the public health impacts of ASUD and scale up efficacious interventions, treatment uptake worldwide remains low. Psychosocial and structural factors are major barriers to ASUD treatment and engagement. For example, psychological distress, polysubstance use, homelessness, incarceration, and engagement in sex work have been associated with lower ASUD treatment coverage and completion. When these factors co-occur, they may also generate synergistic negative effects that contribute to less optimal health outcomes and greater disease burden (defined as syndemics). Less research has empirically examined the syndemic effects of psychosocial and structural barriers on ASUD treatment and treatment engagement. To optimize ASUD treatments and maximize engagement, there’s an urgent need to examine the syndemic relationship of these conditions, especially across multiple and diverse studies. To address these gaps, Dr. Santos proposes to expand his patient oriented research (POR) program, and expand his capacity to train early stage investigators (ESIs), particularly those from underrepresented backgrounds. Dr. Santos will provide experiential training for ESIs in three complementary POR projects (Projects A, B, and C) that will examine the barriers to ASUD treatment access and engagement, and explore treatment preferences of individuals with ASUD. Project A will examine the syndemic effects of psychosocial and structural conditions on the use of ASUD treatment (AIM 1), and the moderators of those effects (AIM 2), leveraging five National HIV Behavioral Survey cycles (cumulative n=3848) using an Integrative Data Analysis (IDA) approach. Project B will examine the syndemic effects of psychosocial and structural conditions on ASUD treatment outcomes (AIM 3), and the moderators of those effects (AIM 4), leveraging 10 ASUD pharmacotherapy trials (cumulative n=722), also using an IDA approach. Project C will examine the preferred treatment attributes of individuals with ASUD using Discrete Choice Experiments (DCE; AIM 5) and examine how preferences differ between groups (AIM 6) among 250 individuals with ASUD. Ultimately, the findings from this study will be fill critical gaps in ASUD treatment implementation, particularly for key populations disproportionately impacted by HIV. In parallel to these research projects, Dr. Santos will provide structured mentoring and training to ESIs in three key areas of support: instrumental, professional and social. Instrumental support will focus on building ESIs capacity to become independent researchers. Professional support will focus on career development skills to thrive in research. Finally, social support aims to increase their social capital and resilience through networking opportunities, group social activities, and individual coaching.

项目摘要 酒精和物质使用障碍（ASUD）与大量发病率和死亡率有关。全球 酒精使用障碍（AUD）归因于9920万残疾调整的生活年（Dalys），而非法 药物使用障碍（SUD）归因于2016年丢失的3180万列莉。尽管迫切需要 减少ASUD的公共卫生影响并扩大有效的干预措施，全球治疗吸收 保持低。社会心理和结构性因素是ASUD治疗和参与度的主要障碍。为了 例如，心理困扰，多进步的使用，无家可归，进化和从事性工作 与较低的ASUD治疗范围和完成有关。当这些因素同时发生时，它们 还可能产生协同的负面影响，从而导致最佳健康结果和更大的影响 伯恩疾病（定义为联合学）。较少的研究在经验上研究了 ASUD治疗和治疗参与的心理和结构障碍。优化ASUD 治疗和最大化参与度，迫切需要研究这些关系 条件，尤其是在多种和多样化的研究中。为了解决这些差距，桑托斯博士提出了 扩大他的以患者为导向的研究（POR）计划，并扩大他培训早期调查人员的能力 （ESI），特别是来自代表性不足的背景的（ESIS）。 Santos博士将为 三个完整的POR项目（项目A，B和C）中的ESI将检查ASUD的障碍 治疗访问和参与，并探索ASUD个体的治疗偏好。项目遗嘱 检查社会心理和结构条件对使用ASUD治疗的联合作用（AIM 1）， 以及这些效果的主持人（AIM 2），利用五个国家艾滋病毒行为调查周期（累积 n = 3848）使用集成数据分析（IDA）方法。项目B将检查 关于ASUD治疗结果的社会心理和结构状况（AIM 3），以及这些的主持人 效果（AIM 4），利用10项ASUD药物治疗试验（累积n = 722），也使用IDA方法。 项目C将使用离散选择检查ASUD患者的首选治疗属性 实验（DCE； AIM 5），并检查250个个体之间的偏好在组之间如何差异（目标6） 与Asud。最终，这项研究的发现将填补ASUD治疗实施的关键空白， 特别是对于受艾滋病毒影响不成比例的关键人群。与这些研究项目平行，博士 桑托斯将在三个关键支持领域为ESI提供结构化的心理和培训：工具， 专业和社交。工具支持将集中于建立ESIS独立的能力 研究人员。专业支持将集中于职业发展技能，以蓬勃发展。最后，社交 支持旨在通过网络机会提高其社会资本和韧性，分组社会 活动和个人教练。