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）与大量的发病率和死亡率相关。全球 酒精使用障碍（AUD）归因于9920万残疾调整生命年（DADs），而非法 物质使用障碍（SUD）导致2016年损失了3180万美元。尽管迫切需要 减少ASUD对公共卫生的影响，扩大有效的干预措施， 仍然很低。心理和结构因素是ASUD治疗和参与的主要障碍。为 例如，心理困扰、多种物质使用、无家可归、监禁和从事性工作 与较低的ASUD治疗覆盖率和完成率有关。当这些因素同时发生时，它们 也可能产生协同的负面影响，导致不太理想的健康结果， 疾病负担（定义为综合征）。较少的研究经验性地研究了 心理社会和结构性障碍对ASUD治疗和治疗参与。优化ASUD 治疗和最大限度地参与，迫切需要检查这些疾病的发病关系， 条件，特别是在多个和不同的研究。为了弥补这些差距，桑托斯博士建议 扩大他的病人导向研究（POR）计划，并扩大他的能力，以培训早期研究人员 （三）来自弱势群体的，尤其是来自弱势群体的。桑托斯博士将提供经验培训， 三个补充POR项目（项目A、B和C）中的ESI，将检查ASUD的障碍 治疗的获取和参与，并探索患有ASUD的个体的治疗偏好。项目A将 检查心理社会和结构条件对使用ASUD治疗的综合影响（AIM 1）， 以及这些影响的调节者（AIM 2），利用五个国家艾滋病毒行为调查周期（累积 n=3848）使用整合数据分析（IDA）方法。项目B将研究 心理社会和结构条件对ASUD治疗结果（AIM 3）的影响，以及这些因素的调节因素 效果（AIM 4），利用10个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），并在250名个体中检查组间偏好的差异（AIM 6） 关于ASUD最终，这项研究的结果将填补ASUD治疗实施的关键空白， 特别是对受艾滋病毒影响不成比例的关键人群。在这些研究项目的同时，博士。 桑托斯将在三个关键支持领域为ESI提供结构化的指导和培训：工具， 专业和社会。工具性支持将侧重于建立环境服务机构的独立能力 研究人员专业支持将侧重于职业发展技能，以在研究中茁壮成长。最后，社会 支持的目的是通过建立网络的机会，小组社会， 活动和个人辅导。