Testing of a patient-centered e-health implementation model in addiction treatment

项目摘要/摘要 来自加州大学健康增强系统研究中心(该中心)的一组研究人员 威斯康星-麦迪逊工程学院和爱荷华州公共卫生部将测试 改进成瘾治疗网络的有效性--技术执行(NIATx- Ti)实施ACHESS物质使用障碍治疗和康复应用程序的框架。 ACHESS使用智能手机技术提供持续的SUD护理，并改进了治疗 在一项随机试验中的结果，以及在现实世界中使用阿片类药物和 酒精使用障碍。尽管它的证据基础和74%的SUD治疗患者拥有 在智能手机上，ACHESS目前用于1%的提供SUD治疗的设置。ACHESS不是唯一的 在这方面，医疗保健总体上以患者为中心的技术采用率较低。这一低采用率 强调另一个执行方面的差距，以及传播和执行领域需要 制定促进采用日益增多的循证电子健康技术清单的方法。两个人 在增加ACHESS使用方面需要测试的战略是NIATx-TI框架和产品培训，以下是 通过持续的技术支持。我们中心开发的NIATx-TI框架建立在我们在 在3,300多个组织中应用NIATx组织变革模型。NIATx-TI结合了 NIATx组织模型中嵌入的系统工程原则和经过验证的技术 领养技巧。NIATx-TI在我中心的7个州项目中成功地进行了试点， 改善治疗和康复的技术学习合作，并使客户数量增加了2倍 在先导研究期间接受远程治疗。将使用RE-AIM框架来衡量影响 在两项干预措施中，爱荷华州有n=16个南部非洲发展组织(每个分支有n=8个组织)。一种定性的 并将利用成本分析来更好地了解执行过程。爱荷华州是 之所以被选为研究环境，是因为它的服务提供商群体多样化，参与率高 其他国家项目，强大的数据报告系统，以及爱荷华州药物滥用联合会 研究与评估将为这项研究提供强有力的地方支持。爱荷华州和美国的SUD治疗提供者 全国各地都需要循证移动技术可以提供的有效治疗支持 当成功实施时。ACHESS及其他以患者为中心的循证技术 处于改变SUD治疗及其结果的地位。通过测试NIATx-TI框架和典型 产品培训，该试验将使您更深入地了解如何成功实施ACHESS和 其他前景看好的循证技术。

Project Summary/Abstract A team of researchers from the Center for Health Enhancement Systems Studies (the Center) at University of Wisconsin–Madison College of Engineering and the Iowa Department of Public Health will test the effectiveness of the Network for the Improvement of Addiction Treatment-Technology Implementation (NIATx- TI) framework in implementing the ACHESS substance use disorder (SUD) treatment and recovery app. ACHESS uses smartphone technology to provide continual access to SUD care and has improved treatment outcomes in a randomized trial as well as in real-world SUD treatment settings with patients with opioid and alcohol use disorders. Despite its evidence base and 74% of SUD treatment patients possessing a smartphone, ACHESS is currently used in <1% of settings that provide SUD treatment. ACHESS is not unique in this regard; health care, in general, has low patient-centered technology adoption rates. This low adoption highlights yet another implementation gap and the need for the dissemination and implementation field to develop approaches to facilitate adoption of the growing list of evidence-based e-health technologies. The two strategies to be tested in increasing ACHESS use are the NIATx-TI framework and product training, followed by ongoing technical support. The NIATx-TI framework developed by our Center builds on our experience in applying the NIATx organizational change model in more than 3,300 organizations. NIATx-TI combines the systems engineering principles embedded in the NIATx organizational model with validated technology adoption techniques. NIATx-TI was piloted successfully in our Center's 7-state project, “Promoting the Use of Technology to Improve Treatment and Recovery Learning Collaborative,” and led to a 2-fold increase in clients receiving distance treatment during the pilot study. The RE-AIM framework will be used to measure the impact of the 2 interventions in n=16 SUD organizations in Iowa (with n=8 organizations per each arm). A qualitative and cost analysis will be used to develop a better understanding of the implementation process. Iowa was selected as a research setting because of its diverse population of service providers, high participation rates in other national projects, strong data reporting systems, and because the Iowa Consortium for Substance Abuse Research & Evaluation will provide strong local support for the study. SUD treatment providers in Iowa and across the country need the effective treatment supports that evidence-based mobile technologies can provide when successfully implemented. ACHESS and other promising evidence-based patient-centered technologies are positioned to alter SUD treatment and its outcomes. Through testing the NIATx-TI framework and typical product training, this trial will yield a deeper understanding of how to successfully implement ACHESS and other promising evidence-based technologies.