Describing and Measuring Tobacco Treatment in Drug Treatment

描述（由申请人提供）：大多数接受药物滥用治疗的人吸烟，许多人将死于与烟草有关的疾病。一些设施开始提供烟草治疗，但对这些服务的普及程度或质量知之甚少。该项目的目的是更好地了解戒毒治疗机构目前如何处理烟草问题，并制定一项对变化敏感的有效烟草治疗措施。这是本申请的第二次修订。作为对第一轮审查的回应，该应用程序增加了一名量表开发专家，提供了有关定性方法的更多细节，并扩展了定性和定量分析。为了回应第二轮审查，这次修订扩大了美沙酮以外的研究，包括所有类型的门诊药物滥用治疗设施，限制第一阶段定性现场访问堪萨斯城药物滥用设施，争取组织管理研究人员的支持/专业知识，并扩大了使用的组织措施的阵列。这些变化增强了研究的普遍性，减少了第一年的成本和工作，并使研究与通过R21机制获得的资源保持一致。具体目标有三个：1。从工作人员和患者的角度确定为什么以及如何提供尼古丁依赖服务。将使用系统检查表和定性访谈在8-12个堪萨斯城地区药物治疗设施收集数据，这些设施代表了一系列治疗类型和烟草服务水平。2.开展烟草治疗调查（TTS），为烟草调整组织变革准备程度（ORC），并确定可能与烟草治疗服务提供相关的其他组织措施。这些措施将基于现场考察结果、概念框架和现有措施。3.测试和完善TTS，并与组织措施进行比较。TTS，ORC和其他组织措施将通过电话向120个药物滥用治疗中心进行抽样。将通过有效性分析完善TTS，并将其与ORC和其他组织措施进行比较，以确定与高和低服务提供率相关的设施气候和结构的潜在方面。该项目具有创新性，因为它采用了来自多个卫生保健机构的卫生服务和干预研究的方法。该应用程序将详细描述如何在设施中提供服务以及尼古丁依赖服务的有效措施。这些描述和措施将提供工具，以确定高和低服务设施，确定与提供服务有关的潜在组织因素，并支持未来对药物滥用治疗中的烟草治疗服务的研究。患有精神疾病的人，包括酒精和其他药物问题，吸烟占美国香烟消费量的70%。该项目的目的是更好地了解药物滥用治疗设施目前如何处理其病人中的烟草问题，并制定一个有效的衡量标准，衡量所提供服务的类型和质量。项目结果将支持今后的政策和研究，以加强药物滥用治疗中的烟草治疗服务。

DESCRIPTION (provided by applicant): Most people in treatment for drug abuse smoke cigarettes and many will die from tobacco-related illnesses. Some facilities are beginning to offer tobacco treatment, but little is known about the prevalence or quality of these services. The purpose of this project is to better understand how drug treatment facilities currently address tobacco and to develop a validated measure of tobacco treatment that is sensitive to change. This is the second revision to this application. In response to first-round reviewers, the application added an expert in scale development, provided more details on qualitative methods, and expanded qualitative and quantitative analyses. In response to second-round reviewers, this revision expands the study beyond methadone to include all types of outpatient substance abuse treatment facilities, restricts Phase I qualitative site visits to Kansas City substance abuse facilities, enlists the support/expertise of an organizational management researcher, and expands the array of organizational measures used. These changes enhance study generalizability, reduce year 1 costs and effort, and bring the study into line with the resources available through the R21 mechanism. There are three Specific Aims: 1. Identify why and how nicotine dependence services are offered, from the perspectives of staff and patients. Data will be collected using systems checklists and qualitative interviews at 8-12 Kansas City area drug treatment facilities representing a range of treatment types and levels of tobacco services. 2. Develop a Tobacco Treatment Survey (TTS), adapt for tobacco a measure of organizational readiness for change (ORC), and identify other organizational measures potentially related to tobacco treatment service provision. These measures will be based on site visit findings, a conceptual framework, and existing measures. 3. Test and refine the TTS and compare to organizational measures. The TTS, ORC, and other organizational measures will be phone-administered to a sample of 120 substance abuse treatment sites. The TTS will be refined through validity analyses and compared to the ORC and other organizational measures to identify potential aspects of facility climate and structure related to high and low rates of service provision. The project is innovative in that it adapts methods from health services and intervention research from multiple health care settings. This application will yield detailed descriptions of how services are offered in facilities and a validated measure of nicotine dependence services. These descriptions and measures will provide tools for identifying high- and low-service facilities, determine potential organizational factors related to service delivery, and support future research on tobacco treatment services in substance abuse treatment. People with mental illnesses, including alcohol and other drug problems, smoke 70% of the cigarettes consumed in the United States. The purpose of this project is to better understand how substance abuse treatment facilities currently address tobacco among their patients and to develop a validated measure of the types and quality of services provided. Project findings will support future policy and research to strengthen tobacco treatment services in substance abuse treatment.