权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Translating Depression Guidelines in Substance Abuse Tx

将抑郁症指南转化为药物滥用德克萨斯州

基本信息

批准号：
7254763
负责人：
GEOFFREY M CURRAN
金额：
$ 13.79万
依托单位：
UNIV OF ARKANSAS FOR MED SCIS
依托单位国家：
美国
项目类别：
财政年份：
2003
资助国家：
美国
起止时间：
2003-09-30 至 2008-12-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7254763
关键词：
Adoption Agreement Alcohol or Other Drugs use Algorithms American Antidepressive Agents Area Attitude Behavior Belief Caring Clinical Cognitive Therapy Communities Continuity of Patient Care Data Depressive disorder Development Development Plans Diagnosis Diffusion Diffusion of Innovation Drug Metabolic Detoxication Eating Effectiveness Evaluation Foundations Funding Goals Guidelines Healthcare Individual Intervention K-Series Research Career Programs Learning Link Literature Major Depressive Disorder Medical Sociology Mental Depression Mentored Research Scientist Development Award Mentors Methods Organizational Change Organizational Policy Outcome Outcomes and Health Services Research Patients Persons Pharmaceutical Preparations Pharmacotherapy Practice Guidelines Preparation Protocols documentation Provider Psychotherapy Qualitative Methods Quality of life Recommendation Recording of previous events Reporting Research Services Structure Substance Use Disorder Substance abuse problem Symptoms System Technology Transfer Testing Training Translating Translations Treatment Protocols Treatment Step Veterans Week base career depressive symptoms emotional abuse experience health administration implementation research improved knowledge base medication compliance member programs psychosocial skills sobriety theories therapy design tool treatment program

项目摘要

DESCRIPTION (provided by applicant): The applicant is requesting five years of funding though the Mentored Career Development Award (K01) program to enhance his knowledge base and methodological skills for diffusion of renovation research-- specifically, to translate evidence-based care for depression into community substance use treatment settings. The applicant's strong background in medical sociology, the developmental course of substance use disorders, and health services/outcomes research is an ideal foundation for developing expertise in technology transfer in these settings. The proposed career development plan supports this goal by providing specific training in five areas: 1) organizational change theory and methods; 2) clinical provision of care for substance abuse and depression 3) the current organizational/policy structure of substance abuse and mental healthcare services, focusing on continuity of care within and across systems; 4) quantitative and qualitative methods pertinent to the proposed research plan; and 5) the ethical conduct of research. The research plan seeks to develop, implement, and test an organizational intervention in community substance abuse treatment settings to establish guideline-concordant treatment of comorbid depression. The intervention will assist programs in their own implementation of a guidelines-based treatment algorithm to improve the recognition of depression and initiation of pharmacotherapy. The algorithm will involve two assessment-to-treatment steps-- 1) early post-detoxification assessment of depressive symptoms plus a patient history of depression, with initiation of pharmacotherapy if the patient reports both current symptoms and a history of major depression during periods of sobriety; 2) assessment of depression symptoms at least 4 weeks post-detoxification, with initiation of pharmacotherapy if an independent diagnosis of depression is indicated. We know from previous guideline implementation research that the simple dissemination of guidelines does little to influence provider/system behavior. Rather, a multi-component diffusion of innovation intervention is necessary to maximize the adoption of guideline concordant behavior. Study 1 analyzes the barriers and facilitators to technology transfer of depression management in participating facilities. These data will inform the development of the technology transfer intervention, its implementation tools, and the depression algorithm. Study 2 implements and tests the intervention. The evaluation will examine program- and provider-level outcomes. Program level outcomes will include feasibility, extent of adoption of the algorithm, and provider/organizational attitudes and beliefs about the intervention's design and effectiveness. Patient-level outcomes will include depressive symptoms, substance use outcomes, medication adherence quality of life, and services use.

描述(由申请人提供)：申请者要求通过导师职业发展奖(K01)计划提供五年的资金，以增强他在传播创新研究方面的知识基础和方法技能--具体地说，将抑郁症的循证护理转化为社区药物使用治疗环境。申请者在医学社会学、物质使用障碍的发展过程和健康服务/结果研究方面的深厚背景是在这些环境中发展技术转让专业知识的理想基础。拟议的职业发展计划通过在五个领域提供具体培训来支持这一目标：1)组织变革理论和方法；2)药物滥用和抑郁的临床护理；3)药物滥用和精神保健服务的当前组织/政策结构，侧重于系统内和系统间护理的连续性；4)与拟议研究计划有关的定量和定性方法；以及5)研究的道德行为。该研究计划旨在开发、实施和测试社区药物滥用治疗环境中的组织干预，以建立符合指南的共病抑郁症治疗。这项干预将帮助项目自己实施基于指南的治疗算法，以提高对抑郁症的认识和药物治疗的启动。该算法将包括两个评估到治疗的步骤--1)戒毒后抑郁症状的早期评估加上患者的抑郁症病史，如果患者同时报告目前的症状和戒酒期间的严重抑郁症病史，则开始药物治疗；2)在戒毒后至少4周后评估抑郁症状，如果有独立的抑郁症诊断，则开始药物治疗。我们从以前的指南实施研究中了解到，简单地传播指南对提供商/系统行为的影响很小。相反，创新干预的多成分扩散是最大限度地采用指导方针一致性行为所必需的。研究一分析了参与设施抑郁症治理技术转移的障碍和促进者。这些数据将为技术转移干预的发展、其实施工具和抑郁算法提供信息。研究2实施并检验了干预措施。评估将检查计划和提供商级别的结果。计划层面的结果将包括可行性、采用算法的程度以及提供者/组织对干预的设计和有效性的态度和信念。患者水平的结果将包括抑郁症状、物质使用结果、服药依从性、生活质量和服务使用。