Implementation of Alcohol Screening and Brief Intervention in a Health System: Sustainability, Fidelity and Patient Outcomes

在卫生系统中实施酒精筛查和短暂干预:可持续性、忠诚度和患者结果

基本信息

项目摘要

ABSTRACT Hazardous drinking is a significant public health problem, affecting approximately 20% of U.S. adult primary care patients, contributing to about 65,000 deaths and costing the US health system more than $250 billion annually. Clinical trials have documented the efficacy and cost-effectiveness of Alcohol Screening and Brief Intervention (ASBI), including in the health system studied here, and it is now a widely-endorsed approach to identification and early intervention for hazardous use. However, relatively few studies have examined real-world ASBI implementation and, its long-term sustainability, and their relationship to patient outcomes, utilization and cost. This study will take advantage of an ongoing health system-wide ASBI initiative in a large, heterogeneous health care delivery system, Kaiser Permanente Northern California, which in 2013 incorporated ASBI into its adult primary care workflow and conducts an average of 145,000 screenings and 9,500 brief intervention (BIs) monthly for adult primary care patients. Using a theory-driven conceptual framework, this innovative study will rigorously examine the factors which facilitate or impede successful real- world ASBI implementation and long-term sustainability. Guided by the PRISM (Practical, Robust Implementation and Sustainability Model) framework, this mixed-methods study will use electronic health record (EHR) data from 1/1/2014 to 12/31/2021, along with primary care provider surveys, patient telephone interviews, and qualitative key informant interviews to examine ASBI implementation (1/1/2014 – 12/31/2015), short-term sustainability (1/1/2016-12/31/2018) and long-term sustainability (1/1/2019 – 12/31/2021) outcomes (screening and BI rates); patient outcomes (heavy drinking days and typical drinking quantity and frequency, health services utilization and costs); and the fidelity and quality of BIs. We will use the PRISM domains to enhance our understanding of ASBI implementation and long-term sustainability. First, we will employ indirect standardization (observed-to-expected ratios) methodology to benchmark ASBI implementation, short- and long-term sustainability performance over 8 years and examine associating factors. Second, we will conduct multi-level models analyses to determine whether and how ASBI implementation and sustainability are related to patient drinking outcomes and use of health services and costs. Finally, we will measure BI fidelity and quality by asking patients and PCPs about their experiences receiving and delivering BIs, and examine how they are related to patient outcomes. Results will provide concrete, pragmatic guidance on factors which facilitate successful ASBI implementation and long-term sustainability that can be used widely by this and other health systems to improve how we identify and treat the full spectrum of unhealthy alcohol use, and how we implement, sustain and study population-based responses to it.
抽象的 有害饮酒是一个重大的公共卫生问题,影响着大约 20% 的美国成年人 初级保健患者,造成约 65,000 人死亡,美国卫生系统损失超过 250 美元 每年亿。临床试验记录了酒精筛查和酒精筛查的功效和成本效益 简短干预(ASBI),包括这里研究的卫生系统,它现在是一种得到广泛认可的方法 危险用途识别和早期干预的方法。然而,相对较少的研究 研究了现实世界中 ASBI 的实施及其长期可持续性及其与患者的关系 结果、利用率和成本。这项研究将利用正在进行的整个卫生系统 ASBI 计划 在一个大型、异构的医疗保健提供系统中,北加州凯撒医疗机构 (Kaiser Permanente Northern California) 于 2013 年 将 ASBI 纳入其成人初级保健工作流程,并平均进行 145,000 次筛查和 每月为成年初级保健患者提供 9,500 次简短干预 (BI)。使用理论驱动的概念 框架,这项创新研究将严格审查促进或阻碍成功现实的因素 世界 ASBI 实施和长期可持续性。以 PRISM(实用、稳健 实施和可持续性模型)框架,这项混合方法研究将使用电子健康 2014年1月1日至2021年12月31日的记录(EHR)数据,以及初级保健提供者调查、患者电话 访谈和定性关键知情人访谈,以检查 ASBI 实施情况(2014 年 1 月 1 日 – 12/31/2015)、短期可持续性(1/1/2016-12/31/2018)和长期可持续性(1/1/2019 – 2021 年 12 月 31 日)结果(筛查和 BI 率);患者结果(酗酒日和典型饮酒 数量和频率、卫生服务利用和成本);以及 BI 的保真度和质量。我们将使用 PRISM 领域,以增强我们对 ASBI 实施和长期可持续性的理解。第一的, 我们将采用间接标准化(观察与预期比率)方法来衡量 ASBI 实施情况、8 年的短期和长期可持续发展绩效,并检查相关因素。 其次,我们将进行多层次模型分析,以确定 ASBI 是否以及如何实施和 可持续性与患者饮酒结果以及卫生服务的使用和成本有关。最后,我们将 通过询问患者和 PCP 接受和交付的经历来衡量 BI 保真度和质量 BI,并检查它们与患者结果的关系。结果将提供具体、务实的指导 促进 ASBI 成功实施和长期可持续性的因素 被本卫生系统和其他卫生系统广泛采用,以改善我们识别和治疗各种不健康疾病的方式 饮酒,以及我们如何实施、维持和研究基于人群的饮酒应对措施。

项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ monograph.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ sciAawards.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ conferencePapers.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ patent.updateTime }}

Stacy Ann Sterling其他文献

Stacy Ann Sterling的其他文献

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

{{ truncateString('Stacy Ann Sterling', 18)}}的其他基金

Virtual SBIRT for Pediatric Primary Care: Increasing Access to Screening, Brief Intervention and Referral to Treatment for Alcohol and Other Drug Use via Telehealth
儿科初级保健虚拟 SBIRT:通过远程医疗增加酒精和其他药物使用筛查、简短干预和转诊治疗的机会
  • 批准号:
    10706560
  • 财政年份:
    2022
  • 资助金额:
    $ 47.97万
  • 项目类别:
Virtual SBIRT for Pediatric Primary Care: Increasing Access to Screening, Brief Intervention and Referral to Treatment for Alcohol and Other Drug Use via Telehealth
儿科初级保健虚拟 SBIRT:通过远程医疗增加酒精和其他药物使用筛查、简短干预和转诊治疗的机会
  • 批准号:
    10606351
  • 财政年份:
    2022
  • 资助金额:
    $ 47.97万
  • 项目类别:
Addiction Telemedicine Consultation in Primary Care: Increasing Access to Pharmacotherapy and Specialty Treatment for Alcohol Problems
初级保健中的成瘾远程医疗咨询:增加酒精问题药物治疗和专业治疗的机会
  • 批准号:
    10212895
  • 财政年份:
    2020
  • 资助金额:
    $ 47.97万
  • 项目类别:
Addiction Telemedicine Consultation in Primary Care: Increasing Access to Pharmacotherapy and Specialty Treatment for Alcohol Problems
初级保健中的成瘾远程医疗咨询:增加酒精问题药物治疗和专业治疗的机会
  • 批准号:
    10616496
  • 财政年份:
    2020
  • 资助金额:
    $ 47.97万
  • 项目类别:
Addiction Telemedicine Consultation in Primary Care: Increasing Access to Pharmacotherapy and Specialty Treatment for Alcohol Problems
初级保健中的成瘾远程医疗咨询:增加酒精问题药物治疗和专业治疗的机会
  • 批准号:
    10397099
  • 财政年份:
    2020
  • 资助金额:
    $ 47.97万
  • 项目类别:
Implementation of Alcohol Screening and Brief Intervention in a Health System: Sustainability, Fidelity and Patient Outcomes
在卫生系统中实施酒精筛查和短暂干预:可持续性、忠诚度和患者结果
  • 批准号:
    10264654
  • 财政年份:
    2019
  • 资助金额:
    $ 47.97万
  • 项目类别:
Implementation of Alcohol Screening and Brief Intervention in a Health System: Sustainability, Fidelity and Patient Outcomes
在卫生系统中实施酒精筛查和短暂干预:可持续性、忠诚度和患者结果
  • 批准号:
    10413909
  • 财政年份:
    2019
  • 资助金额:
    $ 47.97万
  • 项目类别:
Implementation of Alcohol Screening and Brief Intervention in a Health System: Sustainability, Fidelity and Patient Outcomes
在卫生系统中实施酒精筛查和短暂干预:可持续性、忠诚度和患者结果
  • 批准号:
    10414232
  • 财政年份:
    2019
  • 资助金额:
    $ 47.97万
  • 项目类别:
Implementation of Alcohol Screening and Brief Intervention in a Health System: Sustainability, Fidelity and Patient Outcomes
在卫生系统中实施酒精筛查和短暂干预:可持续性、忠诚度和患者结果
  • 批准号:
    10630316
  • 财政年份:
    2019
  • 资助金额:
    $ 47.97万
  • 项目类别:
Population-based Screening and Brief Intervention in Primary Care: Health and Drinking Outcomes, Cost and Utilization
初级保健中基于人群的筛查和短期干预:健康和饮酒结果、成本和利用
  • 批准号:
    9355066
  • 财政年份:
    2017
  • 资助金额:
    $ 47.97万
  • 项目类别:

相似海外基金

Investigating the Adoption, Actual Usage, and Outcomes of Enterprise Collaboration Systems in Remote Work Settings.
调查远程工作环境中企业协作系统的采用、实际使用和结果。
  • 批准号:
    24K16436
  • 财政年份:
    2024
  • 资助金额:
    $ 47.97万
  • 项目类别:
    Grant-in-Aid for Early-Career Scientists
WELL-CALF: optimising accuracy for commercial adoption
WELL-CALF:优化商业采用的准确性
  • 批准号:
    10093543
  • 财政年份:
    2024
  • 资助金额:
    $ 47.97万
  • 项目类别:
    Collaborative R&D
Unraveling the Dynamics of International Accounting: Exploring the Impact of IFRS Adoption on Firms' Financial Reporting and Business Strategies
揭示国际会计的动态:探索采用 IFRS 对公司财务报告和业务战略的影响
  • 批准号:
    24K16488
  • 财政年份:
    2024
  • 资助金额:
    $ 47.97万
  • 项目类别:
    Grant-in-Aid for Early-Career Scientists
ERAMET - Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
ERAMET - 快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
  • 批准号:
    10107647
  • 财政年份:
    2024
  • 资助金额:
    $ 47.97万
  • 项目类别:
    EU-Funded
Assessing the Coordination of Electric Vehicle Adoption on Urban Energy Transition: A Geospatial Machine Learning Framework
评估电动汽车采用对城市能源转型的协调:地理空间机器学习框架
  • 批准号:
    24K20973
  • 财政年份:
    2024
  • 资助金额:
    $ 47.97万
  • 项目类别:
    Grant-in-Aid for Early-Career Scientists
Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
  • 批准号:
    10106221
  • 财政年份:
    2024
  • 资助金额:
    $ 47.97万
  • 项目类别:
    EU-Funded
De-Adoption Beta-Blockers in patients with stable ischemic heart disease without REduced LV ejection fraction, ongoing Ischemia, or Arrhythmias: a randomized Trial with blinded Endpoints (ABbreviate)
在没有左心室射血分数降低、持续性缺血或心律失常的稳定型缺血性心脏病患者中停用β受体阻滞剂:一项盲法终点随机试验(ABbreviate)
  • 批准号:
    481560
  • 财政年份:
    2023
  • 资助金额:
    $ 47.97万
  • 项目类别:
    Operating Grants
Our focus for this project is accelerating the development and adoption of resource efficient solutions like fashion rental through technological advancement, addressing longer in use and reuse
我们该项目的重点是通过技术进步加快时装租赁等资源高效解决方案的开发和采用,解决更长的使用和重复使用问题
  • 批准号:
    10075502
  • 财政年份:
    2023
  • 资助金额:
    $ 47.97万
  • 项目类别:
    Grant for R&D
Engage2innovate – Enhancing security solution design, adoption and impact through effective engagement and social innovation (E2i)
Engage2innovate — 通过有效参与和社会创新增强安全解决方案的设计、采用和影响 (E2i)
  • 批准号:
    10089082
  • 财政年份:
    2023
  • 资助金额:
    $ 47.97万
  • 项目类别:
    EU-Funded
Collaborative Research: SCIPE: CyberInfrastructure Professionals InnoVating and brOadening the adoption of advanced Technologies (CI PIVOT)
合作研究:SCIPE:网络基础设施专业人员创新和扩大先进技术的采用 (CI PIVOT)
  • 批准号:
    2321091
  • 财政年份:
    2023
  • 资助金额:
    $ 47.97万
  • 项目类别:
    Standard Grant
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了