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

成瘾治疗中以患者为中心的电子医疗实施模型的测试

• 批准号: 10434016
• 负责人: DAVID H GUSTAFSON
• 金额: $ 58.5万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10434016
• 关键词: Address; Adopted; Adoption; Adult; Affect; Age; American; Car Phone; Caring; Cellular Phone; Client; Clinic; Clinical Protocols; Computer software; Cost Analysis; Cost Effectiveness Analysis; Country; Data Reporting; Discipline; Disease; Dissemination and Implementation; Educational Background; Engineering; Environment; Ethnic Origin; Evaluation Research; Gender; Health; Health Personnel; Health Technology; Health behavior; Healthcare; Individual; Instruction; Intervention; Iowa; Learning; Maintenance; Measures; Methods; Modality; Modeling; Monitor; Organizational Change; Organizational Models; Outcome; Outpatients; Patient Simulation; Patients; Phase; Pilot Projects; Population Heterogeneity; Positioning Attribute; Professional counselor; Public Health; Randomized; Reach Effectiveness Adoption Implementation and Maintenance; Readiness; Recovery; Recovery Support; Research; Research Personnel; Research Support; Rural Health; Site; Substance Use Disorder; Substance abuse problem; Support System; System; Techniques; Technology; Testing; Training; Treatment outcome; Universities; Use Effectiveness; Wisconsin; addiction; alcohol abstinence; alcohol use disorder; arm; base; college; compare effectiveness; eHealth; effective therapy; effectiveness testing; evidence base; experience; health information technology; health organization; healthspan; high risk drinking; implementation barriers; implementation framework; implementation process; implementation protocol; implementation science; improved; innovation; interest; medical specialties; mobile application; mobile computing; new technology; opioid use; organizational readiness; patient oriented; primary outcome; prospective; randomized trial; retention rate; service providers; technology validation; tool; treatment organization; treatment site; trend; two-arm study

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.

项目摘要/摘要 来自健康增强系统研究中心（中心）的研究人员团队 威斯康星州 - 麦迪逊工程学院和爱荷华州公共卫生系将测试 网络对改善成瘾​​治疗技术实施的有效性（niatx-- TI）实施Achess药物使用障碍（SUD）治疗和恢复应用程序的框架。 Achess使用智能手机技术来提供连续的泡沫护理，并改善了治疗 随机试验以及现实世界中的SUD治疗环境中的结果与阿片类药物和患者 酒精使用障碍。尽管有证据基础和74％的SUD治疗患者 智能手机，Achess目前用于提供SUD治疗的设置的<1％。成就不是唯一的 在这方面；通常，医疗保健以患者为中心的技术采用率低。这种低采用 突出显示了另一个实施差距以及对传播和实施领域的需求 开发方法以促进越来越多的循证电子健康技术清单。两个 NIATX-TI框架和产品培训是在增加实现时要测试的策略，遵循 通过持续的技术支持。我们中心开发的Niatx-Ti框架以我们的经验为基础 在3300多个组织中应用NIATX组织变革模型。 niatx-ti结合了 具有经过验证的技术的NIATX组织模型中嵌入的系统工程原理 采用技术。 Niatx-Ti在我们中心的7州项目中成功驾驶，“促进使用 改善治疗和恢复学习协作的技术，并导致客户增加了2倍 在试点研究期间接受距离治疗。 RE-AIM框架将用于测量影响 在爱荷华州n = 16个SUD组织中的2个干预措施中（每个手臂n = 8个组织）。定性 成本分析将用于更好地了解实施过程。爱荷华州是 由于其潜水者的服务提供商人口而被选为研究环境，因此 其他国家项目，强大的数据报告系统以及由于爱荷华州的滥用毒品财团 研究与评估将为这项研究提供强大的本地支持。爱荷华州的SUD治疗提供者和 全国各地需要有效的治疗支持，基于证据的移动技术可以提供 成功实施时。成就和其他承诺的基于证据的以患者为中心的技术 可以改变SUD治疗及其结果。通过测试NIATX-TI框架和典型 产品培训，该试验将对如何成功实施成就和 其他有前途的循证技术。

项目成果

Implementation of Smartphone Systems to Improve Quality of Life for People With Substance Use Disorder: Interim Report on a Randomized Controlled Trial.

• DOI: 10.2196/35125
• 发表时间: 2022-07-14
• 期刊: JMIR HUMAN FACTORS
• 影响因子: 2.7
• 作者: Gustafson, David Sr Sr;Horst, Julie;Boss, Deanne;Fleddermann, Kathryn;Jacobson, Nora;Roosa, Mathew;Ross, J. Charles;Gicquelais, Rachel;Vjorn, Olivia;Siegler, Tracy;Molfenter, Todd
• 通讯作者: Molfenter, Todd

Patient Preferences for Mobile Health Applications to Support Recovery.

• DOI: 10.1097/adm.0000000000001137
• 发表时间: 2023-07-01
• 期刊: Journal of addiction medicine
• 影响因子: 5.5

Organizational Facilitators and Barriers to Medication for Opioid Use Disorder Capacity Expansion and Use.

• DOI: 10.1007/s11414-020-09706-4
• 发表时间: 2020-10
• 期刊: The journal of behavioral health services & research
• 作者: Jacobson N;Horst J;Wilcox-Warren L;Toy A;Knudsen HK;Brown R;Haram E;Madden L;Molfenter T
• 通讯作者: Molfenter T

NIATx-TI versus typical product training on e-health technology implementation: a clustered randomized controlled trial study protocol.

• DOI: 10.1186/s13012-020-01053-4
• 发表时间: 2020-10-23
• 期刊: Implementation science : IS
• 作者: White VM;Molfenter T;Gustafson DH;Horst J;Greller R;Gustafson DH Jr;Kim JS;Preuss E;Cody O;Pisitthakarm P;Toy A
• 通讯作者: Toy A

Clinician Perspectives on Barriers and Facilitators to Implementing e-Health Technology in Substance Use Disorder (SUD) Treatment Facilities.

• DOI: 10.1177/11782218211053360
• 发表时间: 2021
• 期刊: Substance abuse : research and treatment
• 作者: Fleddermann K;Molfenter T;Jacobson N;Horst J;Roosa MR;Boss D;Ross JC;Preuss E;Gustafson DH
• 通讯作者: Gustafson DH