An organizational readiness intervention and randomized controlled trial to test strategies for implementing substance use disorder treatment into primary care: SUMMIT study protocol.
An organizational readiness intervention and randomized controlled trial to test strategies for implementing substance use disorder treatment into primary care: SUMMIT study protocol.
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DOI：
10.1186/s13012-015-0256-7
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发表时间：
2015-05-08
期刊：
影响因子：
--
通讯作者：
Setodji CM
中科院分区：
文献类型：
--
作者：
Ober AJ;Watkins KE;Hunter SB;Lamp K;Lind M;Setodji CM
数百万需要治疗物质使用障碍（SUD）的人没有得到治疗。存在治疗SUD的循证实践，其中一些适合在专科护理环境之外提供。初级保健是一个提供SUD治疗的适当环境，因为许多人每年至少见一次初级保健提供者。此外，《患者保护和平价医疗法案》（PPACA）增加了SUD治疗的覆盖面，并增加了寻求初级保健服务的人数。在这篇文章中，我们提出了一项研究的协议测试的影响，组织准备和服务提供的干预措施，以增加在初级保健的SUD治疗的吸收和患者的结果。在一项随机对照试验中，我们测试了由实施工具和活动组成的组织准备干预和基于慢性护理模式的综合协作护理服务提供干预对服务系统的联合作用（以病人为中心的护理，物质使用障碍治疗的利用，卫生保健服务的利用以及循证实践的采用和可持续性）和病人（物质使用，使用的后果，健康和心理健康，以及对护理的满意度）结果。我们还使用了一个重复的措施设计，以测试整个研究中的组织变化，如可接受性，适当性和可行性的做法提供商，和提供商打算采用的做法。我们使用提供者焦点小组，提供者和患者调查以及管理数据来衡量结果。本研究回应了物质使用障碍患者医疗保健服务的关键差距，包括需要更多地获得SUD治疗和更多地采用循证实践在初级保健中。我们设计了一个多层次的研究，结合实施工具，以提高组织准备采用和维持循证实践（EBP）和测试的有效性，服务提供干预服务系统和患者的结果与SUD服务。当前对照试验：NCT 01810159本文的在线版本（doi：10.1186/s13012-015-0256-7）包含补充材料，可供授权用户使用。
Millions of people who need treatment for substance use disorders (SUD) do not receive it. Evidence-based practices for treating SUD exist, and some are appropriate for delivery outside of specialty care settings. Primary care is an opportune setting in which to deliver SUD treatment because many individuals see their primary care providers at least once a year. Further, the Patient Protection and Affordable Care Act (PPACA) increases coverage for SUD treatment and is increasing the number of individuals seeking primary care services. In this article, we present the protocol for a study testing the effects of an organizational readiness and service delivery intervention on increasing the uptake of SUD treatment in primary care and on patient outcomes. In a randomized controlled trial, we test the combined effects of an organizational readiness intervention consisting of implementation tools and activities and an integrated collaborative care service delivery intervention based on the Chronic Care Model on service system (patient-centered care, utilization of substance use disorder treatment, utilization of health care services and adoption and sustainability of evidence-based practices) and patient (substance use, consequences of use, health and mental health, and satisfaction with care) outcomes. We also use a repeated measures design to test organizational changes throughout the study, such as acceptability, appropriateness and feasibility of the practices to providers, and provider intention to adopt the practices. We use provider focus groups, provider and patient surveys, and administrative data to measure outcomes. The present study responds to critical gaps in health care services for people with substance use disorders, including the need for greater access to SUD treatment and greater uptake of evidence-based practices in primary care. We designed a multi-level study that combines implementation tools to increase organizational readiness to adopt and sustain evidence-based practices (EBPs) and tests the effectiveness of a service delivery intervention on service system and patient outcomes related to SUD services. Current controlled trials: NCT01810159 The online version of this article (doi:10.1186/s13012-015-0256-7) 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
影响因子：
3.4
作者：
Bonomi, AE;Wagner, EH;VonKorff, M
通讯作者：
VonKorff, M
影响因子：
5.5
作者：
Bouchery, Ellen E.;Harwood, Henrick J.;Brewer, Robert D.
通讯作者：
Brewer, Robert D.
DOI：
10.1023/b:mhsr.0000024351.12294.65
发表时间：
2004-06-01
期刊：
Mental health services research
影响因子：
--
作者：
Aarons, Gregory A
通讯作者：
Aarons, Gregory A
影响因子：
3.4
作者：
Cherpitel, Cheryl J.;Ye, Yu
通讯作者：
Ye, Yu