Testing the implementation and sustainment facilitation (ISF) strategy as an effective adjunct to the Addiction Technology Transfer Center (ATTC) strategy: study protocol for a cluster randomized trial.
Testing the implementation and sustainment facilitation (ISF) strategy as an effective adjunct to the Addiction Technology Transfer Center (ATTC) strategy: study protocol for a cluster randomized trial.
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DOI：
10.1186/s13722-017-0096-7
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发表时间：
2017-11-17
影响因子：
3.7
通讯作者：
Ford JH 2nd
中科院分区：
文献类型：
--
作者：
Garner BR;Zehner M;Roosa MR;Martino S;Gotham HJ;Ball EL;Stilen P;Speck K;Vandersloot D;Rieckmann TR;Chaple M;Martin EG;Kaiser D;Ford JH 2nd
提高循证做法(EBP)--已被经验证明有效或有效的治疗--纳入常规做法的程度，是许多卫生领域都有充分证据证明的挑战。2014年，国家药物滥用研究所资助了一项名为药物滥用治疗到艾滋病毒护理(SAT2HIV)项目的第二类有效性-实施混合试验。SAT2HIV项目的目标1测试了以激励访谈为基础的短暂干预(MIBI)的有效性，作为其MIBI实验的一部分，该干预将物质使用作为艾滋病服务组织(ASOS)日常护理的辅助手段。SAT2HIV项目的目标2测试实施和维持便利(ISF)作为成瘾技术转移中心(ATTC)模式的辅助工具的有效性，作为其ISF实验的一部分，培训工作人员进行激励性面谈。本文介绍了ISF实验的研究方案。采用整群随机设计，来自美国39个ASO的病例管理和领导人员被随机接受ATTC策略(对照条件)或ATTC+ISF策略(实验条件)。ATTC战略以工作人员为重点，包括10个不同的战略(例如，提供集中技术援助、召开教育会议、提供持续咨询)。ISF战略以组织为重点，包括七个不同的战略(例如，使用实施顾问、组织实施团队会议、进行周期性的小规模变更测试)。在战略规划系统(exploration–preparation–implementation–sustainment)框架的基础上，通过三个工作人员层面的衡量标准来审查战略框架的有效性：(1)熟练掌握时间(即，准备阶段成果)；(2)实施成效(即，实施阶段成果)；(3)维持水平(即，维持阶段成果)。虽然不是没有局限性，但ISF实验有几个优点：高度严格的设计(随机、假设驱动)、高需求设置(ASOS)、大样本量(39个ASO)、大地理代表性(23个州和哥伦比亚特区)以及沿着EPIS连续体的多个阶段进行测试(准备、实施和维持)。因此，研究结果将显著提高关于沿着EPIS连续体推进EBPS的最佳准备、实施和维持战略的概括性知识。此外，提高ASO解决物质使用问题的能力可能会改善艾滋病毒护理的连续性。试验注册诊所Trials.gov：NCT03120598。本文的在线版本(10.1186/s13722-0170096-7)包含向授权用户提供的补充材料。
Improving the extent to which evidence-based practices (EBPs)—treatments that have been empirically shown to be efficacious or effective—are integrated within routine practice is a well-documented challenge across numerous areas of health. In 2014, the National Institute on Drug Abuse funded a type 2 effectiveness–implementation hybrid trial titled the substance abuse treatment to HIV Care (SAT2HIV) Project. Aim 1 of the SAT2HIV Project tests the effectiveness of a motivational interviewing-based brief intervention (MIBI) for substance use as an adjunct to usual care within AIDS service organizations (ASOs) as part of its MIBI Experiment. Aim 2 of the SAT2HIV Project tests the effectiveness of implementation and sustainment facilitation (ISF) as an adjunct to the Addiction Technology Transfer Center (ATTC) model for training staff in motivational interviewing as part of its ISF Experiment. The current paper describes the study protocol for the ISF Experiment. Using a cluster randomized design, case management and leadership staff from 39 ASOs across the United States were randomized to receive either the ATTC strategy (control condition) or the ATTC + ISF strategy (experimental condition). The ATTC strategy is staff-focused and includes 10 discrete strategies (e.g., provide centralized technical assistance, conduct educational meetings, provide ongoing consultation). The ISF strategy is organization-focused and includes seven discrete strategies (e.g., use an implementation advisor, organize implementation team meetings, conduct cyclical small tests of change). Building upon the exploration–preparation–implementation–sustainment (EPIS) framework, the effectiveness of the ISF strategy is examined via three staff-level measures: (1) time-to-proficiency (i.e., preparation phase outcome), (2) implementation effectiveness (i.e., implementation phase outcome), and (3) level of sustainment (i.e., sustainment phase outcome). Although not without limitations, the ISF experiment has several strengths: a highly rigorous design (randomized, hypothesis-driven), high-need setting (ASOs), large sample size (39 ASOs), large geographic representation (23 states and the District of Columbia), and testing along multiple phases of the EPIS continuum (preparation, implementation, and sustainment). Thus, study findings will significantly improve generalizable knowledge regarding the best preparation, implementation, and sustainment strategies for advancing EBPs along the EPIS continuum. Moreover, increasing ASO’s capacity to address substance use may improve the HIV Care Continuum. Trial registration ClinicalTrials.gov: NCT03120598. The online version of this article (10.1186/s13722-017-0096-7) contains supplementary material, which is available to authorized users.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
DOI：
10.1186/1748-5908-7-64
发表时间：
2012-07-11
期刊：
Implementation science : IS
影响因子：
--
作者：
Cully JA;Armento ME;Mott J;Nadorff MR;Naik AD;Stanley MA;Sorocco KH;Kunik ME;Petersen NJ;Kauth MR
通讯作者：
Kauth MR
影响因子：
3.3
作者：
Gaynes, Bradley N.;Pence, Brian Wells;Miller, William C.
通讯作者：
Miller, William C.
DOI：
10.1016/s0140-6736(10)60829-x
发表时间：
2010-07-31
期刊：
Lancet (London, England)
影响因子：
--
作者：
Altice FL;Kamarulzaman A;Soriano VV;Schechter M;Friedland GH
通讯作者：
Friedland GH
影响因子：
4.2
作者：
Azar, Marwan M.;Springer, Sandra A.;Meyer, Jaimie P.;Altice, Frederick L.
通讯作者：
Altice, Frederick L.