Systems science modeling for implementation research: An application to tobacco smoking cessation for persons with serious mental illness

Takeru Igusa, PhD
Johns Hopkins University

Elizabeth Stuart, PhD
Johns Hopkins University

Gail Daumit, MD, MHS
Johns Hopkins University

ABSTRACT:
Implementation researchers have sought ways to use simulations to support the core components of implementation, which typically include assessing the need for change, designing implementation strategies, executing the strategies, and evaluating outcomes. The goal of this presentation is to explain how methods in systems science, with an emphasis on agent-based simulations, could fulfill this role. The presentation will include a discussion on explainability, in which modeling results are formulated in terms of constructs used in implementation science frameworks to facilitate the engagement of practitioners in the design and use of the models. This is part of an ongoing project focused on scaling up evidence-based tobacco smoking cessation practices in community mental health clinics in Maryland.

Suicidal behaviors from adolescence through young adulthood: Developmental trajectories and intervention.

David Goldston, PhD
Duke University

ABSTRACT:
This PSMG presentation will provide an overview of a program of research focused on youth and young adult suicidal behavior. From a longitudinal study of youth followed through adulthood, data will be presented regarding proximal psychiatric disorders and developmental changes in psychiatric profiles of youth with suicidal behaviors over time, differing developmental trajectories of risk and their covariates, patterns of escalation, and implicit affective responses associated with suicidal thoughts and behaviors. Building on these findings, the presentation will describe several ongoing and recent intervention development studies and clinical trials for youth at risk for suicide.

Reducing Opioid Use Disorder and Overdose in the United States: Model Development and Policy Analysis

Mohammad Jalali, PhD
Harvard University

Wayne Wakeland, PhD
Portland State University

ABSTRACT:
The opioid crisis is one of the most pressing public health issues in the U.S. today. Opioid overdoses are the proverbial “tip of the iceberg,” arising within a complex adaptive system characterized by rapidly changing dynamics combined with significant time lags and large uncertainties in the data. System dynamics modeling is a critical tool to guide policymaking and avoid unintended consequences. We developed a simulation model of the opioid system, spanning from medical use of prescription opioids to opioid misuse and heroin use, use disorder, treatment, and remission. The model aims to help policymakers address the crisis by aiding in policy analysis and decision-making under uncertainty. We project the effects of several policies to reduce opioid use disorder and overdose, and analyze intended and unintended effects of the policies over the next 10 years. Model simulations suggest most policies implemented on their own will achieve only modest reduction in either fatal overdoses or prevalence of OUD.