Validation of the TAPS-Electronic Spanish Platform (TAPS-ESP): A Technology to Improve Access to Substance Use Screening and Reduce Behavioral Health Disparities in Hispanic Primary Care Patients

TAPS-电子西班牙语平台 (TAPS-ESP) 的验证：一种改善西班牙裔初级保健患者药物使用筛查并减少行为健康差异的技术

• 批准号: 10490979
• 负责人: Steven Bernard Carswell
• 金额: $ 86.99万
• 依托单位: COG ANALYTICS, LLC
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-19 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10490979
• 关键词: Address; Adult; Advisory Committees; Alcohols; Assessment tool; Awareness; Biological Markers; COVID-19; Client satisfaction; Clinic; Clinical; Clinical Trials Network; Detection; Development; Diagnosis; Diagnostic; Disease; Drug Prescriptions; Effectiveness; Elements; English Language; Epidemic; Evidence based practice; Federally Qualified Health Center; Funding; Health; Health Services; Health system; Healthcare; Healthcare Systems; Hispanic; Hispanic Americans; Hispanic Populations; Home; Illicit Drugs; Improve Access; Individual; Infrastructure; Internet; Intervention; Interview; Language; Limited English Proficiency; Linguistics; Liquid substance; Low income; Medical; Mental Health; Mental disorders; Minority Groups; National Institute of Drug Abuse; National Institute on Minority Health and Health Disparities; Oral; Outcome; Patient Care; Patient Education; Patients; Phase; Population; Preventive service; Primary Health Care; Provider; Public Health; Recommendation; Reference Standards; Research; Role; Saliva; Sampling; Screening procedure; Self Administration; Seminal; Small Business Innovation Research Grant; Small Business Technology Transfer Research; Social Problems; Substance Use Disorder; Surgeon; System; Tablets; Technology; Texas; Tobacco; Tobacco Use Disorder; Training; Underserved Population; United States National Institutes of Health; Update; Ursidae Family; Validation; Work; alcohol screening; behavioral health; burden of illness; care providers; clinically relevant; commercialization; comorbidity; design; drug testing; effectiveness implementation design; effectiveness implementation study; ethnic minority; evidence base; experience; health care quality; health care settings; health disparity; health disparity populations; health information technology; illicit drug use; implementation barriers; implementation facilitators; implementation trial; innovation; misuse of prescription only drugs; new technology; nonEnglish language; novel; opioid overdose; phase 2 study; physical conditioning; primary care setting; racial minority; screening; standard care; substance use; tobacco screening; tool; validation studies

ABSTRACT Language accessibility and cultural awareness are essential elements of quality healthcare. Individuals with limited English proficiency are less likely to self-identify a need for behavioral health services, which results in longer duration of untreated disorders. Accurate identification, diagnosis, and treatment are entirely dependent on a linguistically-accurate screening and assessment, especially for sensitive topics such as substance use. Substance use screening in primary care is now recommended as an evidence-based practice for all adults, but remains underutilized. The shortcomings of existing substance use screening tools led the NIH to develop and validate the “Tobacco, Alcohol, Prescription drug, and illicit Substance use Tool (TAPS Tool), a two-stage screening and brief assessment tool to detect substance use problems in primary care. As part of our Phase I NIMHD STTR project, our team led a research-driven adaptation of the TAPS Tool into a Spanish language version, and developed a mobile/tablet technology platform to support its deployment in healthcare settings (the TAPS-Electronic Spanish Platform, or TAPS-ESP). The current Phase II SBIR study builds on this effort. For Aim 1, we will integrate the TAPS-ESP into the existing health information technology infrastructure of Baylor Scott and White Health (BSWH), a large healthcare system in Texas that serves a large number of Spanish-speaking patients. For Aim 2, we will conduct a large-scale validation study of the TAPS-ESP against a widely-used diagnostic reference standard, other screening tools, and oral fluid/saliva drug testing in a large sample of 1,000 Spanish-speaking primary care patients. Separately, for Aim 3 we will conduct a real-world implementation trial in which 10 primary care providers receive training on the TAPS-ESP, incorporate it into standard care, and complete a qualitative interview on barriers and facilitators of implementation from a provider workflow perspective. To the best of our knowledge, this will be the largest validation study of a Spanish-language substance use screening tool in the US to date. The project could expand access to evidence-based, linguistically-accurate substance use screening and brief assessment for an underserved population that experiences significant behavioral health disparities. Thus, the project could have high scientific and public health impact, along with strong commercialization potential.

摘要 语言可获得性和文化意识是高质量医疗保健的基本要素。具有以下特征的个人 英语水平有限的人不太可能自我确认对行为健康服务的需求，这导致 未经治疗的疾病持续时间更长。准确的识别、诊断和治疗完全依赖于 对语言准确的筛选和评估，特别是对药物使用等敏感话题的筛查和评估。 初级保健中的物质使用筛查现在被建议作为所有成年人的循证做法， 但仍未得到充分利用。现有物质使用筛查工具的缺陷导致NIH开发了 和验证“烟草、酒精、处方药和非法物质使用工具”(TAPS工具)，这是一个两阶段的工具 筛选和简要评估工具，以发现初级保健中的物质使用问题。作为我们第一阶段的一部分 NIMHD STTR项目，我们的团队领导了一项由研究驱动的将TAPS工具改编成西班牙语的工作 版本，并开发了移动/平板电脑技术平台，以支持其在医疗保健环境中的部署 (TAPPS-西班牙语电子平台，或TAPS-ESP)。 目前的第二阶段SBIR研究建立在这一努力的基础上。对于目标1，我们将把TAPS-ESP整合到 贝勒·斯科特和怀特健康(BSWH)现有的医疗信息技术基础设施，是一家 德克萨斯州的医疗保健系统，为大量讲西班牙语的患者提供服务。对于目标2，我们将 对照广泛使用的诊断参考标准对TAPS-ESP进行大规模验证研究， 其他筛查工具，以及在1000名讲西班牙语的小学大样本中进行口腔液/唾液药物测试 照顾病人。另外，对于目标3，我们将进行一项现实世界的实施试验，其中10项初级保健 提供者接受有关TAP-ESP的培训，将其纳入标准护理，并完成定性 从提供商工作流程的角度对实施障碍和促进者进行访谈。 据我们所知，这将是对西班牙语物质使用情况进行的最大规模的验证研究 到目前为止在美国的筛查工具。该项目可以扩大以证据为基础的、语言上准确的 对服务不足的经历显著的人群进行物质使用筛查和简要评估 行为健康差异。因此，该项目可能会产生很高的科学和公共卫生影响，以及 很强的商业化潜力。