Brief Intervention in the ER in Poland

对波兰急诊室的简短干预

• 批准号: 7371147
• 负责人: CHERYL J CHERPITEL
• 金额: $ 16.62万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-05 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7371147
• 关键词: Accident and Emergency department; Address; Affect; Age; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcohol or Other Drugs use; Alcoholic beverage heavy drinker; Alcohols; American College of Surgeons; Analysis of Variance; Applications Grants; Biological; Blinded; Caring; Charge; Cities; Consent; Consumption; Country; Cultural Characteristics; Data; Data Collection; Development; Disease regression; Early identification; Effectiveness; Effectiveness of Interventions; Emergency Medicine; Environment; Equation; Esthesia; European; Evaluation; Event; Feasibility Studies; Funding; Geographic Locations; Guidelines; Health; Health Services Accessibility; Healthcare Systems; Heavy Drinking; Human Resources; Impulsivity; Injury; International; Intervention; Intervention Studies; Intervention Trial; Knowledge; Laboratories; Lead; Logistic Regressions; National Institute on Alcohol Abuse and Alcoholism; Neuro-Oncological Ventral Antigen 2; Numbers; Nurses; Outcome; Outcome Assessment; Patient Self-Report; Patients; Pattern; Physicians; Poland; Policies; Polishes; Population; Prevalence; Primary Health Care; Protocols documentation; Provider; Public Hospitals; Quality of life; Randomized; Rate; Readiness; Relative (related person); Research; Research Personnel; Risk; Risk-Taking; Sampling; Score; Screening procedure; Selection Bias; Services; Site; Staging; Standards of Weights and Measures; Substance of Abuse; System; Techniques; Testing; Thinking; Time; Training; Translating; Trauma; Treatment Protocols; Treatment outcome; United States Substance Abuse and Mental Health Services Administration; Visit; Week; alcohol abuse therapy; alcohol related problem; alcohol use disorder; breath alcohol measurement; care seeking; cost; day; drinking; early /brief intervention /therapy; follow-up; injured; motivational enhancement therapy; motivational intervention; problem drinker; programs; social; trauma centers; willingness

DESCRIPTION (provided by applicant): The aims of this Developmental Grant Proposal for Collaborative International Projects are to: 1) examine the effectiveness of Screening, Brief Intervention and Referral to Treatment (SBIRT) using a nurse-delivered motivational intervention, relative to standard care with and without assessment, on a reduction in heavy drinking (drinking days per week, number of drinks per day, maximum number of drinks on an occasion) and alcohol-related problems (RAPS4 and SIPS + 6) in the emergency room (ER) in Sosnowiec, Poland; and, 2) identify variables that are related to effectiveness of the intervention and that predict successful treatment outcome. We plan to translate motivational interventions that have been successful in primary care and which were recently implemented in the U.S. 14 Academic Emergency Medicine SBIRT study to a non-academic ER setting outside of the U.S. The SBIRT study, recently funded by NIAAA and SAMHSA, is the first multisite, collaborative study of screening, brief intervention and referral for at-risk and dependent drinking in the ER. We will conduct a blinded randomized brief motivational intervention trial in which both injured and noninjured patients over the aged of 18 will be screened for at-risk or dependent (using the RAPS4) drinking. Those screening positive will be asked to participate in the study. Consenting patients will be randomized into one of three groups: screened only, assessed, and brief intervention, with n=292 in each group. Intervention and assessment groups will be followed-up at 3 months and all three groups at 12 months. Modifying variables include drinking in the event, risk taking disposition and readiness and stage of change. Prior research in the ER in Sosnowiec and a pilot feasibility study of SBIRT in Sosnowiec suggest: 1) a large number of "at risk", heavy problem and dependent drinkers who meet screening criteria for brief intervention in a relatively short period of time; 2) a socialized health care system which provides equal access to care and is not subject to selection bias affecting patient access; 3) a patient sample covering a large geographic area; 4) a stable environment facilitating high follow-up rates post-intervention; and, 5) a well integrated referral system and high accessibility to alcohol treatment services. Outcome data will be analyzed using ANOVA, logistic regression and Generalized Estimating Equations. The interaction of modifying variables on outcomes will also be analyzed. The ER is an important setting for screening and brief intervention for those with alcohol-related problems in order to reduce subsequent alcohol-related ER visits and associated costs and increase quality of life. This project will inform the development and spread of more effective techniques and protocols for addressing at-risk and dependent drinking in the ER, and provide a better understanding of those factors that influence effectiveness of brief intervention and predict successful patient outcomes.

描述（由申请人提供）：本国际合作项目发展资助计划的目的是：1）检查筛查，简短干预和转诊治疗（SBIRT）的有效性，使用护士提供的动机干预，相对于标准护理，评估和不评估，减少大量饮酒（每周饮酒天数、每天饮酒次数、每次最大饮酒次数）和酒精相关问题（RAPS 4和SIPS + 6）在索斯诺维茨，波兰的急诊室（ER）;以及2）识别与干预的有效性相关并且预测成功的治疗结果的变量。我们计划将在初级保健中取得成功的动机干预措施转化为最近在美国14个学术急诊医学SBIRT研究中实施的非学术ER设置美国以外的SBIRT研究，最近由NIAAA和SAMHSA资助，是第一个多地点，合作研究筛查，短暂干预和转诊风险和依赖性饮酒的ER。我们将进行一项盲法随机简短的动机干预试验，其中18岁以上的受伤和未受伤患者都将接受风险或依赖性（使用RAPS 4）饮酒的筛查。筛选阳性者将被要求参加研究。将接受治疗的患者随机分为三组：仅筛选组、评估组和简短干预组，每组n=292。干预组和评估组将在3个月时随访，所有三组均在12个月时随访。 修改变量包括饮酒的事件，冒险的处置和准备和阶段的变化。先前在索斯诺维茨的急诊室进行的研究和在索斯诺维茨进行的SBIRT的试点可行性研究表明：1）大量“有风险”、严重问题和依赖性饮酒者，他们在相对较短的时间内符合短暂干预的筛查标准; 2）社会化的卫生保健系统提供平等的护理机会，不受影响患者获得服务的选择偏差的影响; 3）患者样本覆盖大的地理区域; 4）稳定的环境，有利于干预后的高随访率;以及5）整合良好的转诊系统和酒精治疗服务的高可及性。将使用ANOVA、logistic回归和广义估计方程分析结局数据。还将分析修正变量对结果的相互作用。急诊室是对酒精相关问题患者进行筛查和短暂干预的重要场所，以减少随后与酒精相关的急诊室就诊和相关费用，提高生活质量。该项目将为更有效的技术和方案的开发和传播提供信息，以解决急诊室中的风险和依赖性饮酒问题，并更好地了解影响短期干预有效性的因素，并预测成功的患者结局。