eHaRT-A: Adapting an evidence-based, in-person harm reduction treatment into a virtual care telehealth intervention for people with lived experience of homelessness and alcohol use disorder

项目摘要/摘要 K01指导研究科学家发展奖的长期目标是支持Tessa博士 在建立独立的研究职业生涯中，专注于适应、设计和实现有效 在边缘化社区中进行远程健康酒精干预。到目前为止，弗罗伊博士的研究主要集中在 与疼痛和药物使用相关的风险因素。在博士后培训期间，她已经开始工作 在以社区为基础的定性方法框架内，专门检查人群中的酒精使用情况 经历无家可归和澳元缺乏症；然而，弗罗厄博士试图从基本酒精开始扩大她的训练 研究实施和测试由社区利益相关者提供信息的基于技术的干预措施 以用户为中心的设计，以改善这一人群的治疗服务。这一长期目标将是 通过五年培训和研究计划实现，该计划涉及精心挑选的指导团队，有针对性 课程作业和实践培训经验。这项拟议的研究旨在改编一种人身伤害 减少干预(HART-A)到远程医疗平台(EHART-A)，并在有LIVE的个人中进行测试 无家可归和澳元的经历。该项目将分两个阶段进行：第一阶段将需要共同开发 利用社区咨询委员会(例如，住房优先)对远程医疗平台进行迭代可用性测试 居民)利用利益相关者的想法来告知和构建EHART-A原型(目标1)并进行设计 将提高EHART-A平台的可行性和可接受性的变化(目标2)。在第二阶段， 将进行随机对照试验，以比较EHART-A和支持服务的效果 一如既往地“改善与酒精有关的结果(即饮酒高峰、与酒精有关的伤害、AUD症状、 和尿乙基葡萄糖醛酸试验阳性)和随时间推移的与健康有关的生活质量(目标3)。 该建议与国家(NIH；非-AA-20-011)卫生倡议相一致，以整合以技术为基础的 针对弱势和边缘化社区的干预措施--使用预先存在的药物使用治疗。如果 成功后，这项研究将开发一种临床相关的干预措施，更容易移植到 被边缘化的社区环境，因为它将为社区开发，由其服务，并与其旨在服务的社区一起开发。 该应用程序的培训计划将侧重于干预开发和测试，创新方法以 加强以技术为基础的干预实施，并先进统计。导师(克里法菲博士、柯林斯博士、 Comtois，Hsieh)和合作者(拉里默，哈尔格伦博士)致力于Frohe博士的培训，每个人都将 为她提出的研究和培训计划提供独特的专业知识。来自这个奖项的支持将是必不可少的 弗罗厄博士作为一名独立科学家的发展，他可以通过共同开发为酒精研究做出贡献， 调整和测试成功的以技术为基础的干预措施，以减轻与酒精有关的伤害并改善 个人的生活质量。华盛顿大学非常适合提供一流的培训体验和 将促进NIH的使命，即培养能够在长期研究资金方面具有竞争力的早期研究人员。

Project Summary/Abstract The long-term objective of this K01 Mentored Research Scientist Development Award is to support Dr. Tessa Frohe, in building an independent research career focused on adapting, designing, and implementing efficacious telehealth alcohol interventions among marginalized communities. To date, Dr. Frohe’s research has focused on risk factors associated with pain and substance use. During her postdoctoral training, she has begun working within a community-based and qualitative methods framework to examine alcohol use specifically among people experiencing homelessness and AUD; however, Dr. Frohe seeks to expand her training from basic alcohol research to implementing and testing technology-based interventions informed by community stakeholders and user-centered design to improve treatment delivery among this population. This long-term objective will be achieved through a five-year training and research plan involving a carefully selected mentor team, targeted coursework, and hands-on training experiences. The proposed research aims to adapt an in-person harm reduction intervention (HaRT-A) into a telehealth platform (eHaRT-A) and test it among individuals with lived experience of homelessness and AUD. This project will occur in two phases: Phase 1 will entail codevelopment with iterative usability testing of the telehealth platform with a community advisory board (e.g., Housing First residents) to leverage stakeholder ideas to inform and build the eHaRT-A prototype (Aim 1) and to make design changes that will improve the feasibility and acceptability of the eHaRT-A platform (Aim 2). In Phase 2, a randomized controlled trial will be conducted to test the efficacy of eHaRT-A compared to “supportive services as usual” in improving alcohol-related outcomes (i.e., peak alcohol use, alcohol-related harm, AUD symptoms, and positive urinary ethyl glucuronide tests) and health related quality of life over time (Aim 3). This proposal aligns with national (NIH; NOT-AA-20-011) health initiatives to integrate technology-based interventions for vulnerable and marginalized communities with pre-existing substance use treatments. If successful, this study will develop a clinically relevant intervention that is more easily transportable to marginalized community settings because it will be developed for, by, and with the community it aims to serve. The training plan for this application will focus on intervention development and testing, innovative methods to enhance technology-based intervention implementation, and advanced statistics. Mentors (Drs. Clifasefi, Collins, Comtois, Hsieh) and collaborators (Drs. Larimer, Hallgren) are committed to Dr. Frohe’s training and each will provide unique expertise to her proposed research and training plan. Support from this award will be essential to Dr. Frohe’s development as an independent scientist who can contribute to alcohol research by codeveloping, adapting, and testing successful technology-based interventions to ameliorate alcohol-related harm and improve individuals’ quality of life. The University of Washington is well suited to provide a stellar training experience and will promote NIH’s mission to develop early investigators who can be competitive for long-term research funding.