Adolescent Primary Care Adoption of Substance Use SBI

青少年初级保健药物使用 SBI

• 批准号: 6952450
• 负责人: CHRISTOPHER P TOMPKINS
• 金额: $ 23.1万
• 依托单位: BRANDEIS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-30 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6952450
• 关键词: administrative personnel; adolescence (12-20); alcoholism /alcohol abuse; alcoholism /alcohol abuse therapy; clinical research; community health services; drug abuse therapy; health care policy; health care service organization; health services research tag; health surveys; human subject; information dissemination; managed care; marijuana abuse; public health; statistics /biometry; student health services; telecommunications; tobacco abuse

DESCRIPTION (provided by applicant): For adolescents (ages 12-24), use of marijuana and other drugs, alcohol, and tobacco is prevalent in the United States and associated with risks for negative outcomes. Although numerous initiatives have encouraged provision of screening for substance use and appropriate anticipatory guidance or brief interventions (SBI) in primary care settings, available research indicates adherence to these recommendations is inconsistent at best. Adoption of specific organizational policies procedures to support and monitor provision of SBI is among the major determinants of adherence. Currently, recommended SBI protocols differ in terms of their resource-use and other requirements for primary care settings. Parallel differences among new technologies introduced in other health care context have been shown to both influence organizational adoption and practitioner adherence. This study will apply a set of hypotheses derived from emerging models of diffusion of innovation to SBI adoption in primary care settings for adolescents. These hypotheses will be tested in a national telephone survey of the clinical directors of Community Health Centers and School Based Health Centers in 60 market areas (n=300). Our specific study aims are to: 1.Describe variations in adoption of protocols to support and monitor provision of SBI for marijuana and other drugs, alcohol, and tobacco to adolescents in public sector primary care settings; 2. Model the organizational and contextual factors associated with adoption of policies and procedures to support and monitor provision of substance use SBI in these settings; 3.Examine the characteristics of SBI protocols and dissemination strategies that increase clinical directors intentions to adopt marijuana and other drugs SBI protocols for adolescents in public sector primary care settings. Hypotheses will be tested using multivariate regression techniques. It is anticipated that SBI approaches with greater relative advantage, compatibility, complexity, and "observability" are more likely to be adopted, and that settings with more organizational and external supports for these innovations will show greater levels of adoption. Based on our modeling of prior adoption determinants and assessments of alternative SBI approaches, it will be possible to identify dissemination strategies that are most likely to be successful as substance use SBI evidence-based guidelines are further developed.

描述（由申请人提供）： 对于青少年（12-24岁），大麻和其他药物，酒精和烟草的使用在美国很普遍，并与负面结果的风险相关。尽管许多倡议鼓励在初级保健环境中提供物质使用筛查和适当的预期指导或简短干预（SBI），但现有研究表明，遵守这些建议充其量是不一致的。通过具体的组织政策和程序来支持和监督履行机构的提供，是遵守的主要决定因素之一。目前，建议SBI协议在其资源使用和其他要求的初级保健设置方面有所不同。在其他医疗保健环境中引入的新技术之间的平行差异已被证明既影响组织的采用和从业者的依从性。本研究将适用于一组假设来自新兴的模型的创新，SBI通过在初级保健环境中的青少年的扩散。这些假设将在全国电话调查的社区卫生中心和学校为基础的健康中心在60个市场领域（n=300）的临床主任进行测试。我们的具体研究目的是：1.描述通过协议的变化，以支持和监测提供大麻和其他药物，酒精和烟草的青少年在公共部门的初级保健设置; 2。模型的组织和背景因素与通过的政策和程序，以支持和监测提供物质使用SBI在这些设置; 3.检查SBI协议和传播策略，增加临床主任的意图，采用大麻和其他药物SBI协议的青少年在公共部门的初级保健设置的特点。将使用多元回归技术对假设进行检验。预计具有较大相对优势、兼容性、复杂性和“可观察性”的SBI方法更有可能被采用，而对这些创新有更多组织和外部支持的环境将显示出更高的采用水平。基于我们的模型先前采用的决定因素和替代SBI方法的评估，它将有可能确定传播策略，最有可能是成功的物质使用SBI循证指南的进一步发展。