Document text
Principal Investigator: Shoshana V. Aronowitz
Organization: UNIVERSITY OF PENNSYLVANIA
Fiscal Year: 2024
Award: $75,600
Funding agency: National Institute on Drug Abuse
PROJECT SUMMARY/ABSTRACT: The goal of this K23 award is to give the PI the skills and preliminary data
needed to improve access to opioid use disorder (OUD) treatment with buprenorphine among marginalized
individuals via telehealth care. Dr. Aronowitz is proposing a research and career development plan that will
prepare her to become an independent investigator focused on expanding access to OUD treatment and harm
reduction services via innovative care delivery models. OUD continues to be a leading cause of morbidity and
mortality in the United States. Substantial evidence supports the use of medications for OUD (MOUD) like
buprenorphine; however, 80% of people with OUD receive no treatment; of those who receive treatment, only
a third receive MOUD. Preliminary evidence suggests that a COVID-era policy change allowing for
buprenorphine induction and management via telehealth expanded access. There is little evidence, however,
about how to tailor telehealth models to promote equitable and effective OUD care. Providers may hesitate to
offer MOUD via telehealth to patients they deem “unstable,” even if these patients lack other treatment options.
Given the dearth of accessible treatment options for many individuals, the decision not to offer telehealth may
result in a patient receiving no OUD treatment. Therefore, clinicians need evidence to guide how and to whom
they deliver telehealth OUD treatment. Dr. Aronowitz will develop and test a telehealth model in partnership
with Prevention Point Philadelphia, a harm reduction organization providing MOUD and other services to the
most marginalized people with OUD in the city. The specific aims are to: 1) identify components of an effective
telehealth intervention and barriers to implementation, 2) partner with an advisory board of OUD treatment
stakeholders from different settings to develop a telehealth intervention for OUD treatment with buprenorphine,
and 3) conduct a pilot trial of the telehealth intervention for OUD treatment. The mentorship team brings
together experts in health services research, human-centered design, intervention development, and evidence-
based OUD treatment, and key stakeholder advisors from diverse community settings. This K23 extends Dr.
Aronowitz’s experience as a clinician scientist with four training goals: 1) build skills in contextual inquiry and
human-centered design to support effective intervention development; 2) develop expertise in intervention
mapping, community-partnered research with Black and Latino communities, and stakeholder engagement to
inform intervention development, implementation and sustainment; 3) learn how to conduct field trials ethically
and effectively with marginalized populations; and 4) enhance grant-writing skills for transition to
independence. With successful completion of this project and training Dr. Aronowitz will be well-prepared to
lead an independent research agenda dedicated to improving access to care for people who use drugs. This
project is well-aligned with the strategic objectives of NIDA to leverage technology and innovation, reduce
health disparities, and develop models that address the real-world complexities of substance use.
Terms: <Access to Care><Address><Black><Black race><Buprenorphine><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Caring><Cities><Communities><Data><Decrease health disparities><Dedications><Development Plans><Development and Research><Drug user><Drugs><Equity><Ethics><Goals><Grant><Harm Minimization><Harm Reduction><Health Services Accessibility><Health Services Evaluation><Health Services Research><Health disparity mitigation><Health disparity reduction><Improve Access><Individual><Intervention><Intervention Strategies><Intervention Studies><Investigators><K23 Award><K23 Mechanism><K23 Program><Latino><Lead><Learning><Lower health disparities><Medical Care Research><Medication><Mentored Patient-Oriented Research Career Development Award><Mentored Patient-Oriented Research Career Development Award (K23)><Mentorship><Mitigate health disparities><Modeling><Morbidity><Morbidity - disease rate><NIDA><National Institute of Drug Abuse><National Institute on Drug Abuse><PWUD><Patients><Pb element><Persons><Pharmaceutical Preparations><Philadelphia><Policies><Prevention><Provider><Public Health><R & D><R&D><Reduce health disparities><Research><Research Activity><Research Personnel><Researchers><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Scientist><Service delivery model><Service model><Services><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Substance Use Disorder><Technology><Testing><Training><Training Activity><United States><Writing><access to health services><access to services><access to treatment><accessibility to health services><availability of services><barriers to implementation><care access><care delivery model><career><career development><community engaged participatory research><community engaged research><community partnered research><community setting><community-engaged study><community-partnered study><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><design><designing><develop therapy><drug/agent><effective intervention><ethical><evidence base><experience><health care delivery model><health service access><health services availability><healthcare delivery model><heavy metal Pb><heavy metal lead><human centered design><implementation barriers><implementation challenges><innovate><innovation><innovative><intervention development><intervention mapping><intervention research><interventional research><interventional strategy><interventional study><interventions research><marginalization><marginalized group><marginalized individual><marginalized people><marginalized population><medication for opioid use disorder><mortality><opiate use disorder><opioid use disorder><people who use drugs><people who use illicit drugs><persons who use drugs><pilot trial><research and development><service availability><services research><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><skills><substance use><substance use and disorder><substance using><telehealth><telehealth care><telehealthcare><therapy development><training module><treatment access><treatment development>