Dissemination of a MI-Based Preparatory Procedure

传播基于 MI 的准备程序

• 批准号: 6920001
• 负责人: KIMBERLY S. WALITZER
• 金额: $ 60.28万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-12 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6920001
• 关键词: alcoholism /alcohol abuse; behavior therapy; behavioral /social science research tag; clinical research; cost effectiveness; data collection; human subject; human therapy evaluation; motivation; outpatient care; patient oriented research; questionnaires; therapy compliance; training

DESCRIPTION (provided by applicant): In the research field, we have little understanding of how alcoholism treatment strategies, shown to be efficacious through controlled clinical trials, operate and function in "real world" conditions. The gap between research and practice in addictions treatment has recently drawn considerable attention (e.g., Institute of Medicine, 1998). For example, as has been the case with many techniques and therapeutic strategies, widespread translation of motivational interviewing (MI) techniques from clinical trials to use in community-based treatment clinics has not occurred. Clinical trials have demonstrated that a single, MI-based preparatory session at the onset of alcoholism treatment reduces premature termination from treatment. The present application seeks to study the dissemination and "real world" effectiveness of a MI-based preparatory procedure designed to reduce early attrition from alcoholism outpatient treatment. In order to study dissemination and adoption, 150 New York State Office of Alcoholism and Substance Abuse Services (OASAS) alcoholism outpatient clinics will be randomly assigned to one of three dissemination conditions: (1) on-site delivery of the training manuals with a one-hour introductory presentation, (2) the manuals with a four-hour basic workshop, or (3) the manuals with the four-hour workshop and a four-hour MI-technique specific training. Measures of adoption will focus on both clinician and programmatic adoption, will be multifaceted, and will include assessment of partial adoption and modified adoption. In order to study the effectiveness of the MI-based preparatory procedure, we propose to examine clinic sites' rates of early treatment attrition and client treatment outcome prior to dissemination and following dissemination. Specifically, two cohorts of OASAS admissions will be followed for 12 months, one cohort prior to dissemination, the second cohort after dissemination. These are collected from standard OASAS admission and discharge reports on all clients treated in OASAS-licensed clinics and will be available to the research team. The monetary costs associated with delivery of each of the three dissemination strategies will be determined. Cost-effectiveness indices will then be calculated by associating dissemination costs with outcome variables and then compared and contrasted between the three dissemination strategies. These data will provide valuable information to governmental bodies and health care organizations interested in disseminating the MI preparatory technique.

描述（由申请人提供）：在研究领域，我们对通过对照临床试验证明有效的酗酒治疗策略如何在“现实世界”条件下运作和发挥作用知之甚少。成瘾治疗的研究与实践之间的差距最近引起了相当大的关注（例如，Institute of Medicine，1998）。例如，与许多技术和治疗策略的情况一样，动机访谈（MI）技术尚未从临床试验广泛转化为在社区治疗诊所中的使用。 临床试验表明，在酗酒治疗开始时进行一次基于 MI 的准备会议可以减少治疗提前终止的情况。本申请旨在研究基于 MI 的准备程序的传播和“现实世界”有效性，该程序旨在减少酗酒门诊治疗的早期损耗。 为了研究传播和采用，纽约州酒精中毒和药物滥用服务办公室 (OASAS) 的 150 个酗酒门诊将被随机分配到以下三种传播条件之一：(1) 现场提供培训手册并进行一小时的介绍性演示，(2) 手册进行四小时的基础研讨会，或 (3) 手册进行四小时的研讨会和四小时的培训 MI 技术特定培训。采用措施将侧重于临床医生和规划采用，将是多方面的，并将包括对部分采用和修改采用的评估。 为了研究基于 MI 的准备程序的有效性，我们建议在传播之前和传播之后检查诊所站点的早期治疗损耗率和客户治疗结果。 具体而言，将对两组 OASAS 入院情况进行为期 12 个月的跟踪，一组在发布前，另一组在发布后。这些数据是从 OASAS 许可诊所治疗的所有客户的标准 OASAS 入院和出院报告中收集的，并将提供给研究团队。 将确定与三种传播策略中每一种的实施相关的货币成本。 然后通过将传播成本与结果变量相关联来计算成本效益指数，然后对三种传播策略进行比较和对比。这些数据将为有兴趣传播 MI 准备技术的政府机构和医疗保健组织提供有价值的信息。