Developing and testing an intervention to enhance recovery capital amid opioid use disorder pharmacotherapy: A pilot randomized trial of assertive linkage to recovery community centers

开发和测试一种干预措施，以在阿片类药物使用障碍药物治疗中增强康复资本：与康复社区中心建立肯定联系的随机试点试验

• 批准号: 10590626
• 负责人: Lauren A Hoffman
• 金额: $ 18.5万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-15 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10590626
• 关键词: Address; Adherence; Adopted; Aftercare; Ambulatory Care; Aphorisms; Assertiveness; Award; Buprenorphine; Capital; Chronic; Clinic; Clinical; Clinical Treatment; Communities; Coping Skills; Data; Development; Disease remission; Ensure; Evaluation; Exhibits; Feasibility Studies; Feedback; Foundations; Future; Goals; Guidelines; Happiness; Housing; Impairment; Individual; Intervention; Intervention Studies; Interview; Link; Maintenance; Manuals; Measures; Mentors; Methods; National Institute of Drug Abuse; Outcome; Overdose; Pathway interactions; Patients; Personal Satisfaction; Persons; Pharmaceutical Preparations; Pharmacotherapy; Procedures; Protocols documentation; Public Health; Publishing; Qualitative Methods; Randomized; Randomized, Controlled Trials; Recovery; Recovery Support; Research; Resources; Risk; Services; Stress; Substance Use Disorder; Telephone; Testing; Training; Visit; Work; biobehavior; buprenorphine treatment; clinical practice; clinically relevant; community center; design; experience; follow-up; health determinants; improved; insight; meetings; member; novel; opioid epidemic; opioid misuse; opioid use disorder; optimism; patient retention; peer; peer support; programs; protective effect; provider intervention; psychosocial; randomized trial; recovery services; recruit; relapse risk; retention rate; safety net; satisfaction; secondary outcome; sustained recovery; therapy development; treatment program; volunteer

(K.220) 7. Project Summary/Abstract Opioid use disorder (OUD) is associated with disproportionate deficits in the psychosocial determinants of health, with individuals exhibiting recovery capital (i.e. recovery resources) that is one standard deviation below that of other substance use disorders (SUDs) in the first year of recovery. OUD medications (MOUDs) are first-line treatments (Txs) that facilitate recovery by addressing the biophysiological disturbances caused by chronic opioid misuse. Yet, high rates of MOUD discontinuation and associated risks are ongoing concerns and, even when patients (Ps) are retained in Tx, psychosocial deficits often persist, increasing biobehavioral stress and hindering Tx/recovery. Thus, without a foundation of resources for recovery support/maintenance, current and former MOUD Ps are at ongoing risk for psychosocial impairment, which hinders recovery. The provision of recovery support services (RSS) offers one way to address extra-Tx needs and enhance recovery capital to ensure a safety net of resources and healthy coping skills to support MOUD Ps during and after Tx. Recovery Community Centers (RCCs) are a free, newly emerging, and rapidly growing tier of RSS that serve as ‘one-stop- shops’ for recovery capital, offering an array of services catered to the SUD community. RCCs seem to be especially well suited for MOUD Ps, as they operate under the maxim “many pathways [to recovery], all should be celebrated” (including MOUD), and the majority of RCC attendees have OUD and hold positive attitudes toward MOUD. Though early evidence suggests that RCCs can aid SUD recovery, its potential benefit to MOUD Ps has yet to be directly studied. Also, few MOUD Ps know of or use RCCs, and clinical linkage to them is uncommon. Thus, this 5-year project seek to advance our understanding of the clinical and public health utility of RCCs and help bridge the gap between clinical Tx and community-based RSS. As a first step in this work, we will develop and test a new intervention for peer-facilitated assertive linkage of MOUD Ps to RCCs (RCCL), relative to a matched control condition (CC). This study aims to: (1) develop, manualize, and refine RCCL/CC protocols via stakeholder feedback; (2) determine feasibility, acceptability, and preliminary efficacy (RCC attendance, service use, recovery capital) of RCCL vs. CC, via a pilot randomized controlled trial (RCT); (3) Gain in-depth insight to RCCL via qualitative interviews. This study will be the first to test RCCL for MOUD Ps, providing a foundation for larger-scale RCTs, with the potential to ultimately change clinical practice paradigms to address Ps’ extra-Tx needs and inform our ability to expand RCCL provision nationally. The aims support advanced training in: psychosocial determinants of health; RSS; intervention development/testing (via RCT); qualitative methods; ongoing OUD training, with a new focus on intervention research. Training will be fulfilled with expert guidance from Drs. John Kelly, Roger Weiss, Joanne Neale, David Best, Christine Timko, and Corrie Vilsaint. The training and experience provided by this award will serve as a critical foundation from which to build a an important and clinically relevant program of independent research.

（K.220）7。项目摘要/摘要 阿片类药物使用障碍（OUD）与健康的社会心理决定者的定义不成比例有关， 个人表现出恢复资本（即恢复资源），这是低于 在恢复的第一年，其他物质使用障碍（SUD）。 OUD药物（MOUDS）是一线 通过解决由慢性造成的生物生理灾难来促进恢复的治疗（TXS） opioid滥用。然而，高度停产和相关风险的高率是持续的关注，甚至 当患者（PS）保留在TX中时，社会心理缺陷通常会持续存在，增加了生物行为压力和 阻碍TX/恢复。这是没有用于恢复支持/维护的资源的基础，当前和 前MOUD PS持续出现会员障碍的风险，这阻碍了康复。提供 恢复支持服务（RSS）提供了一种满足超级TX需求并增强恢复资本的方法 确保资源和健康应对技巧的安全网，以支持TX期间和之后的MOUD PS。恢复 社区中心（RCC）是一个免费的，新兴的且迅速发展的RSS，它是一站式的 商店的恢复资本，提供适合SUD社区的一系列服务。 RCC似乎是 特别适合MOUD PS，因为它们在Maxim下运作“ [恢复]的许多途径，都应该 被庆祝”（包括穆德），大多数RCC与会者都有Oud并举行积极的参与者 走向穆德。尽管早期的证据表明RCC可以帮助SUD恢复，但其潜在的好处 PS尚未直接研究。另外，很少有Moud PS知道或使用RCC，与他们的临床联系是 罕见。这是这个5年的项目旨在提高我们对临床和公共卫生公用事业的理解 RCC的摄入量，并帮助弥合临床TX与基于社区的RSS之间的差距。作为这项工作的第一步，我们 将开发和测试针对MOUD PS与RCCS（RCCL）的同伴相关的自信联系的新干预措施， 相对于匹配的控制条件（CC）。这项研究的目的是：（1）开发，手动化和完善RCCL/CC 通过利益相关者反馈的协议； （2）确定可行性，可接受性和初步效率（RCC） RCCL与CC的出勤，服务使用，恢复资本）通过试点随机对照试验（RCT）； （3）增益 通过定性访谈深入了解RCCL。这项研究将是第一个测试MOUD PS的RCCL的研究， 为大型RCT提供基础，有可能最终改变临床实践范例 满足PS的超级-TX需求，并告知我们在全国范围内扩展RCCL提供的能力。目标支持 高级培训：健康的社会心理决定者； RSS;干预开发/测试（通过RCT）； 定性方法；正在进行的OUD培训，重点是干预研究。培训将得到实现 在博士的专家指导下。约翰·凯利（John Kelly），罗杰·魏斯（Roger Weiss），乔安妮·尼尔（Joanne Neale），大卫·贝斯特 Vilsaint。该奖项提供的培训和经验将成为建立的关键基础 独立研究的重要且与临床相关的计划。