The unprecedented global pandemic has highlighted the digital divide and limited access to alcohol-related treatments among marginalized communities, specifically individuals with lived experience of homelessness. In line with the NIAAA health initiative seeking to integrate technology-based interventions among vulnerable populations, this study directly addresses this mission by proposing innovative methods (i.e., user-centered design + a community based participatory research framework) to adapt an in-person harm reduction for alcohol (HaRT-A) intervention into a telehealth platform (eHaRT-A) that can then be tested and successfully implemented into low-barrier Housing First settings. As healthcare continues to move more services online, it is essential to understand ways to successfully adapt and implement rigorously tested telehealth treatment services for marginalized communities to ameliorate alcohol-related harms.
Funding Type: Federal
Implementation Toolkit to Enhance EBP Among Marginalized Families (I-TEAM)
Although the efficacy of early intervention (EI) for autistic children and their families has been established, many marginalized families with diverse cultural and linguistic backgrounds still report inequitable access to evidence-based practices (EBP). The proposed research addresses three aims including: AIM 1. Identify facilitators and barriers of EBP implementation among marginalized families of young autistic children in EI; AIM 2. Develop an implementation toolkit with a focus on capacity building of EI providers to implement EBP with cultural responsiveness; and AIM 3. Examine the feasibility, acceptability, and appropriateness of this toolkit through a pilot trial using RUBI behavioral parent training program.
Evaluation of an asynchronous remote communities approach to behavioral activation for depressed adolescents
In an effort to address the significant challenges in access to and engagement with evidence-based psychosocial interventions for adolescent depression, the proposed research is piloting the use of Asynchronous Remote Communities (ARC) supported behavioral activation (BA) to treat adolescent depression. We aim to 1) build and conduct usability testing on a functional and robust ActivaTeen platform that will satisfy the needs of mental health clinicians and adolescent patients and 2) test the feasibility, usability, and change in proposed target mechanisms (therapist alliance, timeliness of intervention, social belongingness, and engagement) and outcomes of BA+ActivaTeen compared to BA treatment only within a moderately-sized randomized control trial conducted within Seattle Children’s Hospital outpatient psychiatry clinic.
Brain maturation in adults with FASD
This application seeks to address gaps in our understanding of fetal alcohol spectrum disorder in adults (FASD) by evaluating protracted effects of prenatal alcohol exposure (PAE) on the brain. Individuals aged 30 and 60, who were diagnosed with FASD in childhood, and matched controls, who had previous structural MRI scans in their teens and twenties will be recruited to have another MRI session in which structural, DTI, and connectivity assessments will be conducted. Comparisons between these and earlier scans will provide insight into the changes in overall brain structure, white matter integrity, and function with age in subjects with alcohol exposure histories. We postulate that brain maturation following PAE follows an altered trajectory relative to normal developing controls.
Patient perspectives on prescribing opioid discontinuation: understanding and promoting safe transitions
Development of a monoclonal antibody to reverse overdose from fentanyl and its analogs: from manufacturing to clinical trials
The widespread availability of fentanyl and other potent synthetic opioids has dramatically increased opioid-related fatal overdoses. This project will develop and manufacture immune molecules (monoclonal antibodies) to reverse and treat overdose from fentanyl by keeping it out of the brain. This research will advance promising results in animal studies (preventing and reversing fentanyl- and carfentanil-induced breathing problems and irregular heartbeat) to clinical testing in people with opioid use disorder and others at high risk of opioid overdose from accidental or deliberate exposure to fentanyl and fentanyl-like drugs.
Parent and teacher engagement as an undervalued implementation determinant
The proposed research addresses three important objectives (1) complete a scoping review to map determinants of teacher implementation of evidence-based practices for child behavior in preschool , (2) identify strategies to improve teacher implementation through a series of casual pathway diagrams, and (3) conceptualize and operationalize strategies with stakeholders to increase feasibility.
Opportunity Based Probation
Opportunity-Based Probation (OBP) is a new juvenile probation model that expands on adolescent development research by leveraging adolescents’ drive towards independence as well as their heightened receptivity to rewards. In collaboration with their probation officers, youth create meaningful goals and incentives that reward the development of prosocial behavior. Probation officers scaffold prosocial behavior by reinforcing success and constructively addressing probation violations and problem behaviors. OBP was originally developed through a collaboration between UW CoLab and juvenile court leadership in Pierce County, Washington with funding from the Annie E. Casey Foundation and is now being implemented, refined, and tested for acceptability, implementation, and preliminary effectiveness. In 2021, a second OBP site was started in Hartford County, Connecticut and is currently undergoing co-design and implementation efforts with an eye for eventual testing and expansion statewide.
National Institute on Alcohol Abuse and Alcoholism (NIAAA) Outreach Communications Support
This project focused on assessing college students’ understanding of commonly used terms related to alcohol use and related consequences. Further, our team worked to update NIAAA statistics related to college student drinking and propose additional options for ongoing updates to their findings.
Applying Critical Race Theory to investigate the impact of COVID-19-related policy changes on racial/ethnic disparities in medication treatment for opioid use disorder
With the rise in opioid use disorder (OUD) and overdose, racialized disparities in buprenorphine access and use are a significant concern nationally—studies estimate that Black patients with OUD are 50-60% less likely to access buprenorphine compared to White patients, and similar disparities have also been observed for Hispanic/Latinx patients. COVID-19-related policy changes increased flexibility in the provision of buprenorphine and other effective medications for OUD over telehealth and present an unprecedented opportunity to examine impacts of a structural intervention—relaxed MOUD restrictions—on disparities that result from structural racism and discrimination (SRD). The proposed study, guided by Public Health Critical Race Praxis, will use data from the nation’s largest provider of substance use care and quantitative and qualitative methods to examine the impact of these policy changes on racialized disparities for Black and Hispanic/Latinx patients to inform future policy and interventions to improve equitable care for OUD.
