HD2A RASC-SUD Implementation Support Core

这项研究是美国国立卫生研究院帮助结束长期成瘾（HEAL）倡议的一部分，该倡议旨在加速科学解决全国阿片类药物公共卫生危机。NIH HEAL倡议支持NIH的研究，以改善对阿片类药物滥用和成瘾的治疗，并制定能够为阿片类药物危机提供快速和持久解决方案的具体战略。尽管联邦政府在开发和传播基于证据的药物和行为干预药物使用障碍（SUD）方面投入了大量资金，但药物过量死亡人数仍在继续上升。由于将研究知识和以证据为基础的SUD干预措施转化为公共卫生实践面临挑战，改变过量死亡的尝试已经停滞不前。在整个美国医疗保健系统中，以证据为基础的SUD干预措施仍然非常有限，特别是对于历史上被边缘化的人群，如黑人/非裔美国人、夏威夷原住民/太平洋岛民、亚裔美国人和没有保险的人。将研究成果公平地转化为实践是传播和实施（D&I）科学领域。作为HD2A研究采用支持中心（RASC）的核心组成部分，SUD实施支持（SUD- is）核心将为创新项目带来最好的D&I科学，指导以证据为基础的、适合当地的SUD干预措施的选择、实施和维持，以降低严重受灾社区的过量用药风险。核心领导层将统一实施科学家和南德意志集团的研究人员，通过利用尖端的D&I措施和方法，并利用我们团队对团队科学的承诺，以提高创新项目的影响为近期目标，改善公共卫生为最终目标。在主题和操作上，与RASC和其他核心相结合，SUD-IS核心将通过评估、协助和推进的动态和迭代阶段来提升创新项目。我们将首先评估SUD干预措施的证据现状，以便：a)制定基于证据和新兴实践的系统目录；b)为创新项目和任何SUD干预实施项目制定一份基于五个关键D&I结构（例如，背景决定因素、干预的证据支持、利益相关者参与、实施策略以及包括公平和污名在内的实施结果）的SUD干预D&I资源指南。然后，我们将使用在评估阶段收集的信息协助创新项目，以便：a)利用核心专业知识，通过量身定制的D&I方法，增强他们加强学习的动力；b)提供D&I实施支持计划，并使用共享决策方法来确定如何最好地提供技术援助；c)共同领导RASC学习协作。最后，我们将推进创新项目在可持续性、公平性和减少污名方面的活动：将项目与整个领域联系起来，促进对政策/融资的影响，并促进利益攸关方持续参与倡导。与RASC完全一致，我们共同迈出了重要的一步，以缩小在获得经证实的药物和社会心理治疗方面持续存在的不公平差距。

This study is part of the NIH’s Helping to End Addiction Long-term (HEAL) initiative to speed scientific solutions to the national opioid public health crisis. The NIH HEAL Initiative bolsters research across NIH to improve treatment for opioid misuse and addiction and to develop concrete strategies capable of providing rapid and durable solutions to the opioid crisis. SUD IMPLEMENTATION SUPPORT CORE: PROJECT SUMMARY/ABSTRACT Drug overdose fatalities have continued to rise despite massive federal investment in developing and disseminating evidence-based pharmacological and behavioral interventions for substance use disorders (SUDs). Attempts to move the needle on overdose deaths have stalled because of challenges translating research knowledge and evidence-based SUD interventions into public health practice. Access to evidence- based SUD interventions remains woefully limited throughout the U.S. health care system, particularly for historically marginalized populations such as Black/African-Americans, Native Hawaiians/Pacific Islanders, Asian Americans, and the uninsured. Equitable translation of research findings into practice is the domain of dissemination and implementation (D&I) science. A core component of the HD2A Research Adoption Support Center (RASC), the SUD Implementation Support (SUD-IS) Core will bring the best of D&I science to the Innovation Projects to guide the selection, implementation, and sustainment of evidence-based, locally appropriate SUD interventions to reduce overdose risk in hard hit communities. Core leadership will unify implementation scientists and SUD researchers - with the proximal goal of enhancing the impact of the Innovation Projects and the ultimate goal of improving public health - by leveraging cutting-edge D&I measures and methods, and capitalizing on our team’s commitment to team science. Thematically and operationally in tandem with the RASC and other cores, the SUD-IS Core will elevate the Innovation Projects through dynamic and iterative phases of ASSESS, ASSIST, and ADVANCE. We will first ASSESS the current state of evidence for SUD interventions in order to: a) develop a systematic catalog of evidence-based and emerging practices; and b) develop an SUD Intervention D&I Resource Guide for the Innovation Projects and any SUD intervention implementation project based on five key D&I constructs (e.g., contextual determinants, evidentiary support for the intervention, stakeholder engagement, implementation strategies, and implementation outcomes including equity and stigma). We will then ASSIST the Innovation Projects using information gathered in the ASSESS phase in order to: a) enhance motivation to enhance their studies with tailored D&I approaches that draw upon Core expertise; b) provide a D&I Implementation Support Plan and use a shared decision-making approach to determine how best to offer technical assistance; and c) co-lead the RASC Learning Collaborative. Finally, we will ADVANCE the Innovation Projects’ activities with respect to sustainment, equity, and stigma reduction: linking projects with the field at large, promoting impacts on policy/financing and facilitating ongoing stakeholder engagement towards advocacy. Perfectly aligned with the RASC, together we take a major step toward closing the persistent and inequitable gap of access to proven pharmacologic and psychosocial treatments for SUD.