Increasing Women's Engagement in Medication Treatment for Opioid Use Disorder through Digital Intervention

项目摘要 该指导的以患者为导向的研究职业发展奖（K23）的总体目标是 为Dawn Sugarman博士提供成为独立研究员所需的培训和研究活动。 具有使用数字技术以增加循证治疗机会专门知识的研究人员， 阿片类药物使用障碍（OUD）该应用程序概述了一个综合的培训和研究计划， 将为Sugarman博士提供实现职业目标所需的技能。在专家的指导下， 物质使用障碍，OUD和数字健康，Sugarman博士的培训将侧重于以下关键 领域：（1）数字健康设计和研究（丽莎马施和凯瑟琳卡罗尔博士）;（2）病因学和 OUD个体的治疗（Shelly格林菲尔德和罗杰韦斯博士）;和（3）统计方法， 纵向数据分析（加勒特菲茨莫里斯博士）。这三个领域的培训将通过 教学和应用活动，参加国家会议和研究所，以及指导会议。博士 Sugarman将在培训活动中获得的技能应用于一个研究项目，重点是 制定创新战略，增加阿片类药物使用障碍药物治疗的启动 （MOUD）在女性OUD。研究表明，MOUD是有效的，但未得到充分利用。随着人口增长率的不断上升， 妇女中致命的阿片类药物过量，至关重要的是制定可持续的战略， MOUD。患有OUD的女性有更多的医疗问题，更大的功能障碍和更大的精神问题。 比男性更严重。已经为使用药物的妇女开发了针对性别的治疗方法 疾病，并与减少物质使用和增加护理的连续性有关;然而， 由于亲自交付模式，广泛使用受到限制，并且它们没有被具体地 适于OUD治疗中的靶向接合。此外，缺乏研究表明， 在混合性别环境中实施这种对妇女的照顾的战略。为了弥补这一差距，拟议的K23 研究项目将利用以用户为中心的设计过程，开发一个数字平台， 针对男女混合环境中患有开放式发展障碍的妇女的个性化需求的具体护理。的 核心假设是，针对性别的数字干预将克服面对面交付的障碍 并将增加妇女在发展部的参与。这项研究将解决妇女治疗的关键差距， OUD通过：（1）为患有OUD的女性开发针对性别的数字干预（GSDI）;以及（2）进行 一项试验性随机对照试验，以检查在治疗期间向OUD妇女提供GSDI的可行性。 并且在OUD稳定之后立即。GSDI对MOUD启动影响的初步估计 也将被审查。这些数据将为未来R01的更大规模II期疗效试验的设计提供信息 应用程序. Sugarman博士的培训和拟议的研究将在麦克莱恩医院和哈佛进行 医学院，这将为她提供多种资源，以满足她的目标。

Project Summary The overarching goal of this Mentored Patient-Oriented Research Career Development Award (K23) is to provide Dr. Dawn Sugarman with the training and research activities needed to become an independent investigator with expertise in using digital technology to increase access to evidence-based treatment for women with opioid use disorder (OUD). This application outlines an integrated training and research plan that will provide Dr. Sugarman with the skills needed to achieve her career goal. Under the mentorship of experts in substance use disorders, OUD, and digital health, Dr. Sugarman’s training will focus on the following key areas: (1) digital health design and research (Drs. Lisa Marsch and Kathleen Carroll); (2) etiology and treatment of individuals with OUD (Drs. Shelly Greenfield and Roger Weiss); and (3) statistical methods for longitudinal data analysis (Dr. Garrett Fitzmaurice). Training in these three areas will be achieved through didactic and applied activities, participation in national conferences and institutes, and mentoring meetings. Dr. Sugarman will apply the skills acquired during the training activities to a research project focused on developing an innovative strategy for increasing initiation in medication treatment for opioid use disorder (MOUD) in women with OUD. Research shows that MOUD is effective but underutilized. With rising rates of fatal opioid overdoses in women, it is critical to develop sustainable strategies to engage and retain women in MOUD. Women with OUD have more medical problems, greater functional impairment, and greater psychiatric severity than men with OUD. Gender-specific treatments have been developed for women with substance use disorders and are associated with reduced substance use and increased continuity of care; however, widespread use has been restricted due to in-person delivery models, and they have not been specifically adapted to target engagement in OUD treatment. Moreover, there is a lack of research demonstrating effective strategies to implement this care for women in mixed-gender settings. To address this gap, the proposed K23 research project will utilize a user-centered design process to develop a digital platform to deliver gender- specific care that addresses the individualized needs of women with OUD in mixed-gender settings. The central hypothesis is that a gender-specific digital intervention will overcome the barriers of in-person delivery and will increase women’s initiation in MOUD. This research will address key gaps in treatment for women with OUD by: (1) developing a gender-specific digital intervention (GSDI) for women with OUD; and (2) conducting a pilot randomized controlled trial to examine the feasibility of delivering the GSDI to women with OUD during and immediately after OUD stabilization. Preliminary estimates on the effect of the GSDI on MOUD initiation will also be examined. These data will inform the design of a larger Stage II efficacy trial for a future R01 application. Dr. Sugarman’s training and proposed research will be carried out at McLean Hospital and Harvard Medical School, which will provide her with a multitude of resources to meet her goals.