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

(K.220)7.项目摘要/摘要 阿片类药物使用障碍(OUD)与健康的心理社会决定因素不成比例的缺陷有关， 个人表现出回收资本(即回收资源)的标准差比 康复第一年的其他物质使用障碍(SODS)。OUD药物(Moud)是一线药物 通过解决慢性阻塞性肺疾病引起的生物生理障碍来促进康复的治疗(TXs) 阿片类药物滥用。然而，Moud的高停用率和相关风险是持续令人担忧的问题，甚至 当患者(P)被留在德克萨斯州时，心理社会缺陷往往持续存在，增加了生物行为压力和 阻碍TX/恢复。因此，如果没有用于恢复支持/维护的资源基础，当前和 前Moud P持续面临心理社会损害的风险，这阻碍了康复。提供以下服务 恢复支持服务(RSS)提供了一种方法来解决额外的TX需求，并增加恢复资金以 确保资源的安全网和健康的应对技能，以在TX期间和之后支持Moud P。恢复 社区中心(RCC)是一种免费的、新兴的、快速增长的RSS级别，它提供一站式服务 商店的恢复资金，提供一系列的服务迎合南德社区。农村信用社似乎是 特别适合于Moud P，因为他们在格言下运作，都应该 被庆祝“(包括Moud)，大多数RCC与会者都有自己的态度和积极的态度 向穆德进发。虽然早期证据表明RCCs可以帮助SUD恢复，但它对Moud的潜在好处 PS还有待于直接研究。此外，很少有Moud P知道或使用RCC，并且与它们的临床联系是 不同寻常。因此，这个为期5年的项目旨在增进我们对临床和公共卫生效用的理解 并帮助弥合临床TX和基于社区的RSS之间的差距。作为这项工作的第一步，我们 将开发和测试一种用于Moud P到RCC(RCCL)的同行促进的断言链接的新干预措施， 相对于匹配的控制条件(CC)。本研究的目的是：(1)开发、制作和完善RCCL/CC 通过利益相关者反馈确定方案；(2)确定可行性、可接受性和初步效果(RCC 通过试点随机对照试验(RCT)，RCCL与CC的上座率、服务使用、恢复资金)； 通过定性访谈深入了解RCCL。这项研究将是第一次测试RCCL对Moud P的影响， 为更大规模的随机对照试验奠定基础，有可能最终改变临床实践范例 以满足P的额外TX需求，并告知我们在全国范围内扩展RCCL条款的能力。AIMS支持 以下方面的高级培训：健康的心理社会决定因素；RSS；干预发展/测试(通过RCT)； 定性方法；持续的OUD培训，新的重点放在干预研究上。培训将会完成 由约翰·凯利博士、罗杰·维斯博士、乔安妮·尼尔博士、大卫·贝斯特博士、克里斯汀·蒂姆科博士和科里博士提供的专家指导 维尔桑特。该奖项提供的培训和经验将作为建立基础的重要基础 一个重要的和临床相关的独立研究项目。

(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.