Increasing Referrals to Medications for Opioid Use Disorders from Drug Treatment Courts using Organizational Linkage Intervention

项目总结/摘要 本补充材料旨在弥补Dr. Jasvarova的K23（DA 049953）初步研究和培训的延迟 从2020年1月9日至2020年1月12日的产假。补充资金将用于 雇用一名全职研究协调员，协助Dr. Dallavarova进行数据收集、分析和传播， 调查结果，并准备在她的K23的第3年R 01补助金提交。K23奖的目的是 获取培训和试点数据，以便在应用实施科学方面开展独立研究 增加获得经验为基础的物质使用障碍（SUD）治疗的司法涉及的个人。 与类阿片有关的药物过量是司法人员死亡的主要原因。然而，大多数 司法系统中的个人未能接受阿片类药物使用障碍的黄金标准治疗-药物 阿片类药物使用障碍（MOUD）药物治疗法庭（DTC）是利用法律的 制裁，以换取强制性和法院监督的参与SUD治疗。有超过3100个 DTC计划在全国范围内管理社区中数千名患有SUD的罪犯。尽管他们专注于 在戒毒治疗方面，接受治疗国家在纳入谅解备忘录方面进展缓慢。在DTC中使用MOUD的系统性障碍 已经有很好的记录，包括沟通不畅，缺乏与MOUD提供商的合作， 社会各界拟议的研究直接解决了沟通和转诊实践中的障碍， DTC和社区MOUD提供商通过调整实施策略，这已经在前面显示 在社区矫正项目中是有效的。阿片类药物使用障碍的药物实施-在 戒毒治疗法院是一项旨在改善机构间 关系，并增加高风险个人获得MOUD的机会。使用综合框架 实施研究（CFIR），一个混合方法的研究正在进行，以实现这些具体目标：1） 评估当前MOUD转介实践、障碍、促进者和变革准备情况2）制定MOUDI- DTC实施策略和手册，3）在三个DTC中实施MOUDI-DTC 12个月，并评估 执行战略的有效性、可接受性和可行性。调查结果将提供初步数据 关于MOUDI-DTC在增加转诊以及MOUDI-DTC的可接受性和可行性方面的功效， 在全国范围内推广和评估该战略。研究结果还将为开发R 01提供试验数据 随机临床试验，以比较MOUDI-DTC与DTC中通常的转诊实践。更广泛地说，这 研究将导致制定关于DTC应如何与MOUD合作的最佳实践指南 社区提供者增加获得护理和转诊到谅解备忘录的机会。完成这项研究将作为一个 一个严格的培训计划的一部分，为Dr. Zavarova接受定向培训1）实施科学， 2)MOUD，3）组织理论和系统层面的干预。除此之外，Dr. Zavarova正在接受 从领先的成瘾，卫生服务和实施科学研究人员的指导。

PROJECT SUMMARY/ABSTRACT This supplement is intended to offset delays in Dr. Pivovarova’s K23 (DA049953) pilot study and training associated with her maternity leave from 09/01/2020 to 12/01/2020. The supplemental funds will be used towards hiring a .6 FTE research coordinator to assist Dr. Pivovarova with data collection, analysis, dissemination of findings, and preparation for R01 grant submission in Year 3 of her K23. Dr. Pivovarova’s K23 award is designed to obtain training and pilot data necessary to conduct independent research in applying implementation science to increase access to empirically based substance use disorder (SUD) treatments for justice involved individuals. Opioid-related drug overdose is a leading cause of death for individuals with justice involvement. Yet, most individuals in the justice system fail to receive the gold standard treatment for opioid use disorder – medications for opioid use disorder (MOUDs). Drug treatment courts (DTC) are diversionary programs that leverage legal sanctions in exchange for mandatory and court-monitored engagement in SUD treatment. There are over 3,100 DTC programs nationwide that manage thousands of offenders in the community with SUDs. Despite their focus on addiction treatment, DTCs have been slow to incorporate MOUDs. Systemic barriers to use of MOUD in DTCs have been well documented and include poor communication and lack of collaboration with MOUD providers in the community. The proposed study directly addresses barriers in communication and referral practices between DTC and community MOUD providers by adapting an implementation strategy, which has been previously shown as effective in community corrections programs. The Medication for Opioid Use Disorders Implementation – in Drug Treatment Courts (MOUDI-DTC) is an implementation strategy that aims to improve interagency relationships and increase access to MOUDs for high-risk individuals. Using the Consolidated Framework for Implementation Research (CFIR), a mixed-methods study is being conducted to achieve these specific aims: 1) evaluate current MOUD referral practices, barriers, facilitators, and readiness for change 2) develop MOUDI- DTC implementation strategy and manual, 3) implement MOUDI-DTC for 12 months in three DTCs and evaluate efficacy, acceptance and feasibility of the implementation strategy. The findings will provide preliminary data about efficacy of MOUDI-DTC on increasing referrals and acceptability and feasibility of MOUDI-DTCs to ultimate expand and evaluate the strategy nationwide. The findings will also provide pilot data for developing an R01 randomized clinical trial to compare MOUDI-DTC to referral practices as usual in DTCs. More broadly, this research will lead to development of best-practice guidelines about how DTCs should work with MOUD community providers to increase access to care and referrals to MOUDs. Completing this study will serve as one component of a rigorous training plan for Dr. Pivovarova to receive directed training in 1) implementation science, 2) MOUD, and 3) organizational theory and systems level intervention. Alongside this, Dr. Pivovarova is receiving mentorship from leading addictions, health services, and implementation science researchers.