Using Implementation Interventions and Peer Recovery Support to Improve Opioid Treatment Outcomes in Community Supervision

项目摘要 在矫正环境中开始和/或继续使用OUD药物（MOUD）可改善健康结局 与OUD的人。尽管有这一证据，但在惩教机构中，MOUD方案仍然存在障碍。 系统已努力消除妨碍系统实施MOUD治疗的障碍 在惩教机构的项目。在全国范围内，在提供技术援助， 寻求实施MOUD的司法管辖区，但障碍仍然存在，关键的实用工具 needed.此补充应用程序的主要目标是验证两个独立但相关的工具， 评估刑事司法系统中的MOUD计划。我们将利用真实世界的数据来验证预算 监狱MOUD计划的影响工具以及最近自我报告的医疗保健利用情况 MOUD计划的参与者我们将主要根据我们过去在国际扶轮的经验来使用资料 五年，但这项研究具有广泛的适用性超越RI和JCOIN。我们的首要目标是验证预算 利用五年综合评估中观察到的成本值， MOUD程序在全州监狱和监狱系统，以及测试与天真的用户，以获得工具 为社区提供商最终用户提供工具改进和调整的反馈。我们的第二个目标是评估 自我报告的医疗保健利用率的有效性，使用涉及司法的客户之间的账单索赔， 缓刑/假释与OUD，识别和量化系统的差异，并制定和验证一个 预测模型，以调整和改善自我报告的利用率在这一人群。尽管我们会用真实的- 世界数据主要基于我们过去五年在国际扶轮的经验，这项研究具有广泛的适用性 除了RI和JCOIN。这项研究意义重大，具有高度创新性，因为涉及司法的个人 占美国吸毒者的大多数，也是吸毒者死亡的主要原因。 是阿片类药物过量MOUD在惩教方面的挑战是执行问题， 拟议的研究将提供所需的关键实用资源。这项研究将利用资源 我们的母公司JCOIN奖，同时扩大和加强我们的调查团队， 此外，威尔医学院的教师在卫生经济学和特殊的尖端专业知识 在成本建模和健康方面具有专业知识的初级教员。

PROJECT ABSTRACT Initiating and/or continuing medications for OUD (MOUDs) in the correctional setting improves health outcomes among persons with OUD. Despite this evidence, barriers remain to MOUD programming in the correctional system. Efforts have been made to address barriers preventing systematic implementation of MOUD treatment programs in correctional settings. Nationwide, there is progress in the availability of technical assistance for jurisdictions seeking to implement MOUD but barriers continue to exist and critical pragmatic tools are needed. The main objective of this supplement application is to validate two separate but related tools used to evaluate MOUD programs in the criminal justice system. We will utilize real-world data to validate a budget impact tool for MOUD programs in prisons and jails and self-reported healthcare utilization for recently released MOUD program participants. We will use data primarily based on our experiences in RI for the past five years, but this research has broad applicability beyond RI and JCOIN. Our first aim is to validate a budget impact tool developed with national metrics using observed cost values from five years of a comprehensive MOUD program in a statewide prison and jail system, as well as to test the tool with naïve users to obtain feedback for tool improvement and adaptation for a community provider end user. Our second aim is to assess the validity of self-reported healthcare utilization using billing claims among justice-involved clients on probation/parole with OUD, identify and quantify systematic discrepancies, and develop and validate a predictive model to adjust and improve self-reported utilization in this population. Although we will utilize real- world data primarily based on our experiences in RI for the past five years, this research has broad applicability beyond RI and JCOIN. This research is significant and highly innovative because justice-involved individuals account for the majority of persons who use drugs in the US and the leading cause of death among former prisoners is opioid overdose. The challenge of MOUD in corrections is one of implementation and our proposed research will provide needed critical pragmatic resources. This research will leverage the resources of our parent JCOIN award, while simultaneously expanding and enhancing our investigative team by the addition of Weill Medical College faculty with cutting edge expertise in health economics and an exceptional junior faculty member with expertise in cost modeling and health.