Table 2.
Capacity by domain, activity type, general approach, and number of Clinical and Translational Science (CTSA) program hubs mentioning that domain among the 45 hubs that responded
| Capacity | Activity/topic | General approach examples | Number of hubs mentioning this |
|---|---|---|---|
| Pre-clinical | Chronic pain | Noninvasive neuromodulation techniques, Mu agonist delta antagonist opioids, mechanism of nociception induced by innocuous cold in trigeminal system, pain induction, G protein-coupled receptors and transient receptor potential ion channels, self-reported pain, pharmacological and non-pharmacological treatments, herbal remedies | 8 |
| Biomarkers/Imaging | Psychophysical and brain imaging techniques, functional magnetic resonance imaging (fMRI), magnetic resonance (PET/MR) imaging, blood oxygen level dependent (BOLD) fMRI, arterial spin labeling (ASL), integrated positron emission, imaging of novel compounds | 3 | |
| Novel approaches | Brain plasticity to mediate opioid seeking behavior in conditions of pain, microassays for use in infants and newborns, transcranial direct current stimulation (tDCS), and transcranial magnetic stimulation (TMS) in pain | 3 | |
| Genetics | Genomics, genetics of pain and opioid analgesia, gene therapy platforms | 2 | |
| Animal models | Brain–computer interface in animal models, animal models of pain in burns | 2 | |
| Clinical | Recruitment and retention/screening | Social media, community engagement, patient research partnership; rural research networks, electronic data warehouse (EDW), wearable technologies, health claims data, telehealth, retention efforts, dashboards to facilitate partnership with patients, social network analysis, electronic medical record (EMR) based screening/identification | 13 |
| Pain management | Emergency department (ED) initiated opioid and non-opioid prescribing patterns, perioperative pain management, cognitive behavioral therapy (CBT), multi-disciplinary pain rehabilitation, rural telehealth, opioid prescribing patterns; alternatives to opioids (ALTO): nutritional and herbal supplements, meditation, cognitive behavioral therapy (CBT) | 11 | |
| Medication-assisted treatment (MAT) | Outcomes of collaborative care models in primary care settings, suboxone clinics, methadone maintenance treatment, low dose naltrexone, buprenorphine/naloxone, specialty care | 5 | |
| Perinatal/Obstetrics | Perinatal and mother’s treatment programs, pregnant women with opioid use disorder (OUD), neonatal abstinence syndrome (NAS), rural telehealth | 3 | |
| HIV | Persons living with human immunodeficiency virus (PLWHIV), outcomes among human immunodeficiency virus (HIV) infected opioid-dependent patients receiving buprenorphine/naloxone | 1 | |
| Community engagement | Community networking | Community Advisory Boards (CABs) | Nearly all sites |
| Community academic partnerships | 3 | ||
| Social media/Machine learning | 3 | ||
| Traumatic brain injury (TBI) network | 1 | ||
| Health affairs blog | 1 | ||
| Local/Regional/National town hall meetings | Our community our health (national) | 1 + 22 CTSI sites | |
| Conference on opioids | 4, CDC, NIH | ||
| Science cafes | 1 | ||
| Community conversations about the opioid epidemic | 1 | ||
| Sharing of data with state, local, and government leaders | With Governor, President’s Opioid Task Force, Mayor, Department of Health (DOH), Surgeon General, Opioid Task Force, Medical Examiner, State Opioid Response, harm reduction | Nearly all sites | |
| Hot-spotting geospatial techniques to identify areas of risk | 5 | ||
| Community engagement programs | Community linkages | 2 | |
| Community engagement program with community health workers | 2 | ||
| Harm reduction community outreach program | Needle exchange | 2 | |
| Deterra deactivation pouch distribution | 2 | ||
| Narcan distribution | 2 | ||
| Needs assessments | “All of Us” | 3 | |
| Stakeholders, community members | 2 | ||
| Opioid risk tool – ED | 2 | ||
| Data science | Enterprise data warehouse | Data warehouse, i2b2 query to identify patients with opioid prescriptions | Nearly all sites |
| Health claims databases | Overdose data; analysis of electronic record data; prescribing studies of insurer databases | Nearly all sites | |
| Prescription drug monitoring program (PDMP) | Statewide effort | Nearly all sites | |
| Electronic health records data | Opioid prescription data, high-risk patients, natural language processing (NLP), epidemiology and rural service accessibility, telemedicine, registries, phenotypes | 11 | |
| Predictive modeling | Network-based models, machine learning, public–private access database | 11 | |
| Cloud-based technologies | Clinical data to address OUD | 1 | |
| Workforce development | Clinical training | Face to face, community-based learning, eHealth platform, virtual reality, collaboration with outside entities [e.g., Project Extension for Community Healthcare Outcomes (ECHO)]. Training on: MAT, prescribing, quality improvement (QI) projects, for clinicians, clinical staff, residents, dentists, nurses, pharmacists, pharmacy residents, community agencies, law enforcement, and students (dental, pharmacy, and public health | 27 |
| Clinical training and research training | Workshops, seminars, grand rounds, online training, decision support tools, web-based self-management and coaching, patient-centered educational programs to reduce the development of chronic pain and OUD | 12 | |
| Research training | Fellowship/certification programs; opioid use trends; student design competition | 9 |