Study Overview

People with opioid use disorder (OUD) have a high co-occurrence of serious mental illness (SMI) and other chronic diseases, and are often challenged by their clinical symptoms and social vulnerabilities. While primary care settings frequently treat patients with OUD and SMI, primary care providers have few tools to support this population in self-managing these complex health conditions. The Chronic Disease Self-Management programs (CDSMP) can improve disease management skills and behaviors of people with chronic diseases but have not been adapted for primary care patients with OUD and SMI. Un-adapted versions might lack relevance to this population and setting. In this research project, Dr. Siantz will address this implementation gap through the following specific aims 

Aim 1: Adapt the CDSMP for adults with OUD, SMI, and chronic disease for implementation in primary care settings using the CIPF. With my mentors, I will develop a Community Advisory Board (CAB). We will collaboratively adapt the CDSMP to improve relevance for this population and setting by exploring contextual factors that impact program implementation. This Research Aim corresponds with my Career Aim 1: develop expertise in intervention adaptation especially as it relates to the OUD population and associated mental health and primary care needs. 

Aim 2: Test the feasibility, acceptability, and initial impact of adapted CDSMP for persons with SMI and OUD in a primary care setting. I will randomize patients at two primary care sites to receive adapted CDSMP or primary care treatment as usual, study feasibility (e.g., program attendance), acceptability (e.g., participant satisfaction), and initial outcomes (e.g., patient activation). This Aim corresponds with my Career Aim 2: ac-quire training in clinical trial design and management in real-world settings. 

Aim 3: Evaluate implementation process and context of the adapted CDSMP using RAPICE. I will conduct interviews with study participants and clinic staff to understand how the CDSMP compares to usual care, implementation barriers and facilitators, and how study site differences impacted implementation. This research Aim corresponds to my Career Aim 3: obtain advanced skills in intervention implementation qualitative evaluation methods, particularly the RAPICE method.