Decreasing the Engagement Gap for Addiction Treatment in Primary Care

项目摘要 意义酒精使用障碍（AUD）是常见的，昂贵的，危及生命的，但只有8/100 过去一年AUD的人接受治疗。大多数患有AUD的人都去初级保健， 在初级保健中接受AUD治疗。这是一个错失的机会。 职业发展计划。Glass博士是一名临床研究员，成功回答了重要问题 通过分析复杂的二级数据集来研究问题。他的长期目标是进行干预 在初级保健中进行试验，以扩大成瘾治疗的范围和影响。建议的K 01 职业发展奖将确保他获得指导，培训和研究经验 需要实现这一目标。因为新的移动的健康（mHealth）计划提供了一个相对新颖的， 潜在的成本效益和可扩展的方法，以增加有效的AUD治疗的范围， 在初级保健方面，Glass博士将把他的培训重点放在数据收集和准备一项有效性试验上。 为AUD患者提供有前景的移动健康干预。这将使他做好准备， 在初级保健中进行AUD干预试验，并确保他发挥其作为AUD研究领导者的潜力。 研究计划。格拉斯博士的研究计划将评估现有的 mHealth工具（Square 2）作为管理初级保健AUD的新选项。Square 2计划包括 用于成瘾治疗和相关并发症（抑郁症， 焦虑和烟草使用），旨在满足初级保健患者的需求， AUD严重性或准备改变。然而，Square 2尚未在初级保健中进行经验测试， 对于AUD治疗，需要进行发展研究，以确定参与治疗的最佳方法。 Square 2试验中AUD患者的可推广初级护理样本。拟议方案的具体目标 K 01是：（目的1）评估AUDs初级护理患者和护理他们的临床医生的需求， 使用mHealth作为AUD初级保健管理的一部分（n = 40）;（目的2）试验一项随机 对照试验（RCT），通过评估a）可行性和可接受性，为未来的有效性试验提供信息 在临床医生协助下在初级保健中提供平方2，和B）RCT设计的可行性（n = 60）。 指导和环境。初级保健AUD的专家研究者（初级导师布拉德利博士）; 移动健康（联合导师Marsch博士和麦克卢尔博士）;数据收集（联合导师Curran博士）;和务实的试验 （顾问西蒙博士）将支持这项研究。该研究将在集团健康研究中心进行。 研究所，一个创新的研究机构嵌入在一个大型初级保健系统在太平洋西北部。 公共卫生影响：拟议的活动将确保玻璃博士发展成为一个创新的 独立研究员。此外，拟议中的研究将为未来的移动健康R 01奠定基础 增加有效AUD治疗覆盖面的工具，从而改善AUD患者的结局。

Project Summary Significance. Alcohol use disorders (AUDs) are common, costly, and life-threatening, but just 8 in 100 people with a past-year AUD receive treatment. Most individuals with AUDs visit primary care and prefer to receive AUD treatment in primary care. This represents a missed opportunity. Career Development Plan. Dr. Glass is a clinician researcher who has successfully answered important research questions by analyzing complex secondary datasets. His long-term goal is to conduct intervention trials in primary care in order to increase the reach and impact of addiction treatment. The proposed K01 career development award will ensure that he receives the mentoring, training, and research experience needed to achieve this goal. Because new mobile health (mHealth) programs offer a relatively novel—and potentially cost-effective and scalable—approach to increasing the reach of effective AUD treatments into primary care, Dr. Glass will focus his training on data collection and preparing for an effectiveness trial of a promising mHealth intervention for patients with AUDs. This will prepare him to lead rigorous, state-of-the-art trials of AUD interventions in primary care, and ensure he reaches his potential as a leader in AUD research. Research Plan. Dr. Glass's proposed research will evaluate the feasibility and acceptability of an existing mHealth tool (Square2) as a new option for managing AUDs in primary care. The Square2 program includes several evidence-based electronic tools for addiction treatment and associated comorbidity (depression, anxiety and tobacco use), and is designed to address the needs of primary care patients irrespective of their AUD severity or readiness to change. However, Square2 has not yet been empirically tested in primary care or for AUD treatment, and developmental research is needed to identify the optimal approach to engaging a generalizable primary care sample of patients with AUDs in a trial of Square2. Specific aims for the proposed K01 are: (Aim 1) Assess the needs of primary care patients with AUDs, and clinicians who care for them, for use of mHealth as part of primary care management of AUDs (n = 40); and (Aim 2) Pilot a randomized controlled trial (RCT) to inform a future effectiveness trial by assessing a) the feasibility and acceptability of delivering Square2 in primary care with clinician assistance, and b) the feasibility of the RCT design (n = 60). Mentorship and Environment. Expert investigators in AUDs in primary care (Primary Mentor Dr. Bradley); mHealth (Co-Mentors Drs. Marsch and McClure); data collection (Co-Mentor Dr. Curran); and pragmatic trials (advisor Dr. Simon) will support this research. The research will be conducted at the Group Health Research Institute, an innovative research institution embedded in a large primary care system in the Pacific Northwest. Public Health Impact: The proposed activities will ensure the development of Dr. Glass into an innovative independent researcher. Moreover, the proposed research will lay the groundwork for future R01s of mHealth tools to increase the reach of effective AUD treatments, thereby improving outcomes for patients with AUDs.