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CEREMONY: Culturally Engaged REcovery - MOms connected through Native community

仪式：文化参与式恢复 - MOms 通过原住民社区建立联系

基本信息

批准号：
10748244
负责人：
Michelle Precourt Debbink
金额：
$ 56.35万
依托单位：
UNIVERSITY OF UTAH
依托单位国家：
美国
项目类别：
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/10748244
关键词：
Address Adult Alaska Native American Indians Area Caring Cessation of life Cities Clinic Clinical Clinical Services Clinical effectiveness Communities Complement Contracts Counseling County Data Dependence Diné Nation Education Enrollment Evidence based practice Face Feedback Foundations Goals Health Personnel Hybrids Infant Intervention Interview Knowledge Length of Stay Manuals Maternal Mortality Measures Medical Records Mental Health Mental Health Services Modeling Morbidity - disease rate Mothers Native-Born Navajo Neonatal Not Hispanic or Latino Outcome Participant Patient-Focused Outcomes Perception Perinatal Perinatal Care Persons Phase Population Postpartum Period Pregnancy Pregnancy Outcome Prenatal care Process Assessment Production Protocols documentation Randomized Recovery Research Reservations Review Committee Risk Risk Reduction Rural Services Social support Sodium Chloride Substance Use Disorder Testing Toxicology Training Trauma Tribes Universities Urine Utah Work addiction care coordination clinical center clinical implementation cohort community based participatory research community engagement design disorder risk effectiveness/implementation study evidence base follow-up high risk human centered design hybrid type 1 design implementation evaluation implementation process implementation science improved informant innovation lens maternal morbidity maternal outcome medication for opioid use disorder mortality multidisciplinary neonatal outcome novel patient oriented peer support phase 2 testing postpartum care pregnant preventable death prospective resilience simulation social stigma substance use substance use prevention tribal community virtual experiments

项目摘要

ABSTRACT: PROJECT 1 CEREMONY Pregnant and postpartum American Indian and Alaska Native people (Native mothers) face a more than two- fold higher risk of maternal mortality compared to non-Hispanic White mothers. Deaths related to substance use (SU) and mental health conditions reflect a leading cause of preventable maternal mortality, including among Native mothers, making these conditions a strong target for reducing maternal mortality and morbidity. The Utah Maternal Mortality Review Committee (MMRC) has identified access to substance use disorder (SUD) treatment including medication for opioid use disorder (MOUD), mental health care, improved social support, decreased stigma against SUD, and care coordination, particularly in the postpartum period (when the majority of deaths occur) as actionable intervention points. The objective of our study, Culturally- Engaged REcovery – MOms connected through Native CommunitY (CEREMONY), is to adapt evidence-based perinatal care models that integrate pregnancy and postpartum care with SU/SUD treatment and care to meet the needs of Native mothers. With our partners at Sacred Circle Clinic, a federal Tribal Contract clinic operated by the Confederated Tribes of the Goshute Reservation, we are uniquely poised to respond to the expressed needs of Native mothers and stakeholders, who identified a lack of culturally-integrated SUD care as a significant gap in perinatal care for Native mothers. We will do this by building upon the strong, evidence- based foundation of our University of Utah integrated perinatal SUD clinic called Substance Use and Pregnancy – Recovery, Addiction, and Dependence (SUPeRAD). The SUPeRAD model directly addresses the actionable intervention points identified by the MMRC to prevent SUD-related maternal deaths, but is not specifically adapted to Native mothers’ needs. The rationale for this study is that there is a critical knowledge gap in the adaptation and implementation of integrated perinatal SUD care specifically for Native mothers. The CEREMONY study will fill this gap by adapting the SUPeRAD clinic model to the needs of Native mothers using the validated ADAPT-ITT adaptation framework, informed by human centered design and community-based participatory research (Aim 1); and then testing the adapted, culturally-integrated perinatal SUD care intervention at Sacred Circle Clinic using a Hybrid Type 1 effectiveness-implementation study (Aim 2a&b). The Hybrid Type 1 design will provide important, reliable data on the clinical effectiveness of culturally adapted perinatal SUD care for Native mothers (Aim 2a) while also producing novel data on the implementation process (Aim 2b). Successful completion of these Aims will provide implementation and training protocols that can be used to guide adaptation and implementation of culturally-adapted perinatal SUD care in other settings across the US. Our study is innovative and significant because it employs strong community engagement principles and a robust implementation science approach to produce novel clinical effectiveness and implementation data that can be rapidly disseminated to dramatically improve the care of Native mothers with SUD and reduce risks for maternal mortality and morbidity.

摘要：工程1仪式