ELEVATE Center: Reduction of Maternal Morbidity from Substance Use Disorder in Utah

项目概要ELEVATE CENTER 意外药物过量和自杀是犹他州妊娠相关死亡的主要原因， 2015-2020年，占同期所有妊娠相关死亡的近40%。高危 人口，包括那些在农村环境和那些谁确定为美国印第安人或阿拉斯加原住民， 孕产妇发病率的影响尤为严重。我们汇集了一个跨学科的团队， 产科，成瘾医学，模拟培训，体验式学习，减少偏见和差异， 社区参与和实施科学。这个合作团队将共同建立 ELEVATE卓越产妇保健中心。ELEVATE的命名体现了我们的使命， 我们的覆盖范围横跨犹他州和西部山区，利用现有的基础设施， 产后患有物质使用障碍（SUD）的人，他们经历了实现公平的差异。 为了回应我们的社区合作伙伴和不成比例的受影响人口的需求，我们提出三个建议， 第1-5年的项目，将在全州范围内扩大和实施，并在几年内在全国范围内传播 6和图7项目1（典礼）将实施一项文化上适当的多学科围产期护理计划， 在Sacred Circle诊所为患有SUD的个人开设诊所，该诊所为土著母亲提供服务。计划2 （INSPIRE）将开发、实施和测试一个模块化学习干预措施，以模拟培训为基础， 医疗保健团队的跨专业成员，以减少与妊娠期SUD相关的偏倚。一列结实的火车- 培训师课程将使我们能够在全州范围内实施该方案，并覆盖农村社区。 项目3（记忆）将完善和测试一个扩大的线人访谈工具，以确定社区和 系统对孕产妇死亡的贡献，以及歧视在因SUD死亡中的作用。该工具将 向全国孕产妇死亡率审查委员会散发。 我们的ELEVATE中心的目标是：（1）提供综合和有效的领导， 项目，最大限度地与社区合作伙伴协调，并在所有项目中纳入研究培训 ELEVATE中心的要素;（2）成熟我们现有的社区伙伴关系和全州网络， 为促进今后实施科学和有效性试验，以降低孕产妇发病率， 死亡率在犹他州，和（3）降低孕产妇发病率在犹他州和全国通过实施 社区驱动的干预措施和对保健从业人员的培训。 Elevate中心将严格调查并确定孕产妇发病率和死亡率的影响因素 重点是农村和土著人口。ELEVATE中心多管齐下的方法 将减少犹他州因药物使用导致的孕产妇发病率，同时培训下一代科学家 重点是降低发病率。我们的努力最终可以扩大到全国，以解决一个主要原因 在美国，

PROJECT SUMMARY ELEVATE CENTER Accidental drug overdose and suicide were the leading causes of pregnancy-associated death in Utah from 2015-2020, accounting for nearly 40% of all pregnancy-associated deaths over that time period. At-risk populations, including those in rural settings and those who identify as American Indian or Alaska Native are disproportionately affected by maternal morbidity. We bring together a transdisciplinary team with expertise in obstetrics, addiction medicine, simulation training, experiential learning, bias and disparity reduction, community engagement and implementation science. Together, this collaborative team will establish the ELEVATE Maternal Health Center of Excellence. ELEVATE is named to encompass our mission to Expand our reach across Utah and the Mountain West, LEVerage existing infrastructure, And Treat pregnant and postpartum people with substance use disorder (SUD) who experience disparities to achieve Equity. In response to our community partners and needs of disproportionately affected populations, we propose three projects in years 1-5, which will be scaled up and implemented statewide and disseminated nationally in years 6 and 7. Project 1 (CEREMONY) will implement a culturally appropriate and multidisciplinary perinatal care clinic for individuals with SUD at Sacred Circle Clinic, which is a clinic serving Native mothers. Project 2 (INSPIRE) will develop, implement and test a modular learning intervention, anchored in simulation training, for interprofessional members of the healthcare team to reduce bias related to SUD in pregnancy. A robust train- the-trainer curriculum will allow us to implement the program across the state and reach rural communities. Project 3 (MEMORIES) will refine and test an expanded informant interview tool to ascertain community and systems contributions to maternal deaths, and the role of discrimination in deaths from SUD. The tool will then be disseminated nationally to Maternal Mortality Review Committees. Our ELEVATE Center aims are to: (1) provide integrated and efficient leadership of the three proposed projects, maximizing coordination with community partners and incorporating research training across all elements of the ELEVATE Center; (2) mature our existing community partnerships and statewide networks in order to facilitate future implementation science and effectiveness trials to reduce maternal morbidity and mortality in Utah, and (3) reduce maternal morbidity in Utah and nationally through implementation of community-driven interventions and training of health care practitioners. The ELEVATE Center will rigorously investigate and identify contributors to maternal morbidity and mortality from SUD with a focus on rural and Native populations. The multipronged approach of the ELEVATE Center will reduce maternal morbidity from substance use in Utah while training the next generation of scientists focused on morbidity reduction. Our efforts can ultimately be expanded nationally to address a leading cause of pregnancy-associated death in the U.S.