Organizational Change and Nicotine Dependence Treatment

组织变革和尼古丁依赖治疗

• 批准号: 7020821
• 负责人: Joseph R Guydish
• 金额: $ 63.69万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-20 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7020821
• 关键词: clinical research; nicotine

DESCRIPTION (provided by applicant): Nicotine dependence continues to be the single most preventable cause of morbidity and mortality in the United States. Persons entering drug abuse treatment smoke at 3-4 times the rate, and staff in publicly funded programs smoke at twice the rate, of the general population. Although the burden of illness and associated economic costs of nicotine addiction are elevated in the drug treatment population, treatment programs rarely address comorbid nicotine addiction. While treatment programs increasingly recognize this paradox, there are few models available to guide them in nicotine dependence intervention. This study will test the effectiveness of the manualized Addressing Tobacco Through Organizational Change (ATTOC) intervention in facilitating the integration of drug abuse and nicotine dependence treatments. In a multiple baseline design with each program acting as its own control, three residential treatment programs will participate in a 6 month intervention designed to support organizational changes in nicotine policies, staff - level changes in nicotine knowledge, attitudes, practices, and client-level changes in exposure to and utilization of nicotine dependence treatment. At each measurement point (pre-intervention, post-intervention, and follow-up), a longitudinal sample of 50 agency staff will complete surveys concerning nicotine-related knowledge, attitudes and practices, and a cross-sectional sample of 50 agency clients will participate in phone surveys concerning nicotine-related services they have received. This work shifts the focus of nicotine dependence intervention from the person level to the organizational level, and tests the effectiveness of an organizational change intervention designed to address nicotine dependence. The investigative team unites the strengths of the UMDNJ intervention development team with those of the UCSF organizational change study team, in a context where both the intervention and the research procedures have been piloted. The study will be conducted on the NIDA CTN platform with the participation of nationally recognized and research-experienced treatment clinics. The short term goal is to test the effectiveness of the ATTOC intervention in addressing nicotine dependence among drug using persons in treatment. The long term goal is to develop and disseminate organizational change technologies that can be applied broadly, beyond nicotine dependence, to support programs in adopting evidence based practices.

描述(由申请人提供)： 尼古丁依赖仍然是美国发病率和死亡率的唯一最可预防的原因。接受药物滥用治疗的人吸烟率是普通人群的3-4倍，公共资助项目的工作人员吸烟率是普通人群的两倍。尽管尼古丁成瘾的疾病负担和相关经济成本在药物治疗人群中有所增加，但治疗方案很少能解决并存的尼古丁成瘾问题。虽然治疗方案越来越多地认识到这一悖论，但几乎没有可用的模型来指导他们进行尼古丁依赖干预。这项研究将测试通过组织变革手动处理烟草(ATTOC)干预在促进药物滥用和尼古丁依赖治疗的整合方面的有效性。在一项多基线设计中，每个项目都作为自己的对照，三个住宅治疗项目将参与为期6个月的干预，旨在支持尼古丁政策的组织变化、员工水平的尼古丁知识、态度、做法以及客户水平的尼古丁依赖治疗暴露和利用的变化。在每个测量点(干预前、干预后和跟踪)，由50名机构工作人员组成的纵向样本将完成关于尼古丁相关知识、态度和行为的调查，而由50名机构客户组成的横断面样本将参与关于他们接受的与尼古丁相关服务的电话调查。这项工作将尼古丁依赖干预的重点从个人层面转移到组织层面，并测试了旨在解决尼古丁依赖问题的组织变革干预的有效性。调查小组将UMDNJ干预发展小组与加州大学旧金山分校组织变革研究小组的力量结合起来，在干预和研究程序都已试行的情况下进行。这项研究将在NIDA CTN平台上进行，国家认可的、有研究经验的治疗诊所将参与其中。短期目标是测试ATTOC干预措施在解决吸毒者在治疗中对尼古丁依赖的有效性。长期目标是开发和传播可广泛应用的组织变革技术，超越尼古丁依赖，以支持采用循证实践的计划。