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

ELEVATE 中心：降低犹他州药物使用障碍导致的孕产妇发病率

• 批准号: 10748243
• 负责人: Torri D Metz
• 金额: $ 194.97万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-17 至 2030-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10748243
• 关键词: Accidents; Accounting; Active Learning; Address; Adverse effects; Affect; Alaska Native; American Indians; Caring; Cessation of life; Clinic; Collaborations; Communities; Dependence; Discipline of obstetrics; Discrimination; Disparity; Drug usage; Educational Curriculum; Elements; Equity; Family; Glean; Goals; Healthcare; Individual; Infrastructure; Inpatients; Intervention; Interview; Leadership; Learning; Link; Location; Maternal Health; Maternal Mortality; Medical Care Team; Medicine; Mental disorders; Methods; Mission; Morbidity - disease rate; Mothers; Names; Native Americans; Outpatients; Overdose; Patient-Focused Outcomes; Perinatal; Perinatal Care; Persons; Pharmaceutical Preparations; Population; Populations at Risk; Postpartum Period; Pregnancy; Provider; Recovery; Research; Research Infrastructure; Research Personnel; Research Project Grants; Research Training; Review Committee; Role; Rural; Rural Community; Scientist; Substance Use Disorder; Suicide; System; Testing; Time; Trainers Training; Training; Tribes; Universities; Utah; Work; addiction; community engagement; community partnership; community setting; disparity reduction; effectiveness/implementation trial; experience; future implementation; health training; implementation science; improved outcome; informant; maternal morbidity; member; multidisciplinary; next generation; pregnancy associated death; pregnant; programs; response; rural setting; scale up; simulation; substance use; success; tool

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.

项目总结提升中心 年，意外服药过量和自杀是犹他州妊娠相关死亡的主要原因。 2015-2020年，占同期所有与妊娠有关的死亡人数的近40%。处于危险之中 人口，包括那些在农村环境中的人和那些认为是美国印第安人或阿拉斯加原住民的人是 不成比例地受到产妇发病率的影响。我们汇聚了一支跨学科的团队，在 产科，成瘾医学，模拟训练，体验式学习，减少偏见和差距， 社区参与和实施科学。这个协作团队将共同建立 提升卓越妇幼保健中心。Elevate的命名包含了我们扩张的使命 我们覆盖犹他州和西部山区，利用现有基础设施，治疗孕妇和 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伙伴和不成比例受影响人口的需求，我们提出三项建议 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7.项目1(仪式)将实施文化上适当的多学科围产期护理 Sacred Circle诊所为SUD患者开设的诊所，这是一家为土著母亲提供服务的诊所。项目2 (INSPIRE)将开发、实施和测试以模拟培训为基础的模块学习干预， 医疗保健团队的跨专业成员，以减少怀孕期间与SUD相关的偏见。一列坚固的火车- 培训师课程将使我们能够在全州范围内实施该计划，并覆盖农村社区。 项目3(记忆)将改进和测试扩大的线人面谈工具，以确定社区和 系统对孕产妇死亡的贡献，以及歧视在南部非洲疾病死亡中的作用。然后，该工具将 在全国范围内分发给孕产妇死亡率审查委员会。 我们的提升中心的目标是：(1)提供对三个提议的综合高效的领导 项目，最大限度地与社区合作伙伴协调，并将研究培训纳入所有 提升中心的要素；(2)成熟我们现有的社区合作伙伴关系和全州范围的网络 为了促进今后实施科学和有效性试验，以减少孕产妇发病率和 犹他州的死亡率，以及(3)通过实施以下措施降低犹他州和全国的孕产妇发病率 社区主导的干预措施和卫生保健从业人员的培训。 提升中心将严格调查和确定孕产妇发病率和死亡率的贡献者 来自南加州，重点关注农村和土著人口。提升中心的多管齐下 将在犹他州减少因使用药物而导致的孕产妇发病率，同时培训下一代科学家 重点是减少发病率。我们的努力最终可以扩展到全国，以解决一个主要原因 在美国，与怀孕有关的死亡人数。