Adaptive Treatment Models for the Management of Drug Use Disorders

在这份K24续订申请中，我正在寻求资金，以继续支持我在 以患者为中心的研究(POR)，从事进一步的职业发展活动，与指导对象进行POR， 并进行三项试验性研究，以扩大我目前拨款的目标。我的工作是专注于开发- 开发、评估和传播适应性的、以患者为中心的治疗模式 关注物质使用障碍(SUD)。这项工作的大部分都与确定治疗成分有关- 促进持续参与和更好结果的特点和特点，包括 解决患者无反应、移动健康通信技术和激励措施。 我将继续指导宾夕法尼亚大学的博士后研究员和新的临床医生研究员，治疗 研究所(TRI)和其他机构，并将增加更多的受训者。这项工作将包括时间 用于规划、审查和提供对手稿和拨款申请的反馈；给予职业生涯 咨询；以及在设计和评估适应性治疗干预措施方面提供进一步培训 物质使用障碍、序贯多分配随机试验(SMART)设计和移动健康 技术对于此次续签，学员将包括来自加州大学的一些初级教职员工。 密歇根大学(UMich)，对适应性治疗、智能设计和持续护理感兴趣。 关于职业发展，我将获得更多的行为经济学知识- ICS/奖励、适应性治疗和智能设计的新发展，以及移动保健技术。 为此，我将参加宾夕法尼亚大学健康激励和行为经济学中心的研讨会， 并咨询康涅狄格大学(UConn；博士南希·佩里)、康涅狄格大学的现有合作者 威斯康星州(UWISC；David Gustafson博士)、UMich(Susan Murphy博士)和北岸长岛犹太人 卫生系统(NSLIJHS；乔恩·摩根斯坦博士和弗雷德·芒奇博士)，他们都是这些领域的专家。 我目前是NIAAA R01的PI和相当于R01的国防部拨款，并且是 NIDA R01授予达特茅斯的Alan Budney博士，NIAAA R01授予Jon Morgenstein博士 NSLIJHS所有这些项目都是随机临床试验。我的NIAAA R01正在测试相对疗效 以及电话持续护理的成本效益、智能手机自动恢复应用程序以及 ED方案结合了这两种干预措施。国防部的拨款正在评估自适应的 预防干预旨在减少服用OPI的退伍军人中危险酒精和苯二氮卓类药物的使用。 旧的止痛药。请拨资金进行三项试验性研究，内容涉及：(1)顾问-- 移动技术在SUD治疗中作为临床医生延伸器的使用和价值，(2)患者使用不同的 ENT移动卫生技术的功能及其对SUD结果的贡献，以及(3)进一步的量身定做工作-- 对SUD进行适应性干预。

In this K24 renewal application, I am seeking funding to continue support for my mentoring activities in patient oriented research (POR), engage in further career development activities, conduct POR with mentees, and conduct three pilot studies that expand the aims of my current grants. My work is focused on the devel- opment, evaluation, and dissemination of adaptive, patient-oriented treatment models across the continuum of care for substance use disorders (SUD). Much of this work is concerned with identifying the treatment compo- nents and features that promote sustained participation and better outcomes, including adaptive protocols that address patient nonresponse, mobile health communication technology, and incentives. I will continue to mentor postdoctoral fellows and new clinician investigators at UPENN, the Treatment Research Institute (TRI), and other institutions, and will add additional mentees. This work will include time spent in planning, reviewing, and providing feedback on manuscripts and grant applications; giving career counseling; and providing further training in the design and evaluation of adaptive treatment interventions for substance use disorders, sequential multiple assignment randomized trial (SMART) designs, and mobile health technology. For this renewal, mentees will include a number of junior faculty members from the University of Michigan (UMICH), with interest in adaptive treatment, SMART designs, and continuing care. With regard to career development, I will obtain additional knowledge in behavioral econom- ics/incentives, new developments in adaptive treatments and SMART designs, and mobile health technology. To that end, I will attend workshops at UPENN at the Center for Health Incentives and Behavioral Economics, and consult with current collaborators at the University of Connecticut (UCONN; Dr. Nancy Petry), University of Wisconsin (UWISC; Dr. David Gustafson), UMICH (Dr. Susan Murphy), and North Shore Long Island Jewish Health System (NSLIJHS; Drs. Jon Morgenstern and Fred Muench) who are experts in these areas. I am currently the PI of a NIAAA R01 and a DoD grant equivalent to an R01, and a co-investigator on a NIDA R01 awarded to Dr. Alan Budney at Dartmouth and on a NIAAA R01 awarded to Dr. Jon Morgenstern at NSLIJHS. All of these projects are randomized clinical trials. My NIAAA R01 is testing the relative efficacy and cost-effectiveness of telephone continuing care, an automated smartphone recovery app, and an integrat- ed protocol that combines these two interventions. The DoD grant is evaluating the efficacy of an adaptive prevention intervention designed to reduce hazardous alcohol and benzodiazepine use in veterans taking opi- oid medications for pain. Funds are requested to conduct three pilot studies addressing: (1) Counselor percep- tions of use and value of mobile technology as a clinician extender in SUD treatment, (2) Patient use of differ- ent mobile heath technology functions and their contributions to SUD outcomes, and (3) Further work on tailor- ing of adaptive interventions for SUD.