Evaluation of a Level I trauma center provider training in patient-centered alcohol brief interventions using the Behavior Change Counseling Index rated by standardized patients
Evaluation of a Level I trauma center provider training in patient-centered alcohol brief interventions using the Behavior Change Counseling Index rated by standardized patients
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DOI：
10.1136/tsaco-2019-000370
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发表时间：
2019-01-01
影响因子：
2
通讯作者：
Dunn, Christopher
中科院分区：
文献类型：
--
作者：
Darnell, Doyanne;Parker, Lea;Dunn, Christopher
背景需要住院治疗的创伤在美国很常见，而且经常与饮酒有关。美国外科医生学会要求I级和II级经认证的创伤中心对受伤患者实施普遍的酒精筛查和短暂干预。我们检查了I级创伤中心提供者在以患者为中心的酒精简短干预方面的技能在培训后是否有所提高，以及专业角色(如护理、社会工作)和教育是否与这些技能相关。方法我们将收集的评估数据作为酒精简短干预培训的一部分，嵌入针对创伤后应激障碍及其相关并发症的协作性护理干预的更大临床试验中。来自25个美国I级创伤中心的65名提供者参加了为期1天的研讨会，其中2个小时专门针对以患者为中心的酒精干预进行培训，然后在协作护理模式下进行6个月的每周培训。提供者在研讨会培训前和培训后6个月完成标准化的患者角色扮演。标准化患者参与者在每次角色扮演后立即使用行为改变咨询指数(Becci)对提供者的酒精质量简短干预进行评级。行为改变咨询指数(Becci)是一种旨在评估行为改变咨询质量的实用指标，适用于关于行为改变的简短医疗咨询。结果72%的提供者完成了两种标准化的患者角色扮演评估。在那些拥有术后数据的提供者中，观察到总体BECCI评分有统计学意义的改善(t(41)=-2.53，p=0.02，Cohen‘s d=-0.39)。提供者的专业角色与培训前的Becci得分相关(F(3，58)=11.25，p
BackgroundTraumatic injury requiring hospitalization is common in the USA and frequently related to alcohol consumption. The American College of Surgeons requires that Level I and II verified trauma centers implement universal alcohol screening and brief intervention for injured patients. We examined whether Level I trauma center provider skill in patient-centered alcohol brief interventions improved after training and whether professional role (eg, nursing, social work) and education were associated with these skills.MethodsWe present evaluation data collected as part of training in alcohol brief interventions embedded within a larger clinical trial of a collaborative care intervention targeting posttraumatic stress disorder and related comorbidities. Sixty-five providers from 25 US Level I trauma centers engaged in a 1-day workshop, with 2 hours dedicated to training in patient-centered alcohol brief interventions followed by 6 months of weekly coaching in a collaborative care model. Providers completed standardized patient role-plays prior to and 6 months after the workshop training. The standardized patient actors rated provider quality of alcohol brief interventions immediately after each role-play using the Behavior Change Counseling Index (BECCI), a pragmatic measure designed to assess the quality of behavior change counseling, an adaptation of motivational interviewing suitable for brief healthcare consultations about behavior change.ResultsSeventy-two percent of providers completed both standardized patient role-play assessments. A statistically significant improvement in overall BECCI scores (t(41)=-2.53, p=0.02, Cohen's d=-0.39) was observed among those providers with available pre-post data. Provider professional role was associated with BECCI scores at pre-training (F(3, 58)=11.25, p