Organizational Change and Nicotine Dependence Treatment

组织变革和尼古丁依赖治疗

• 批准号: 7794870
• 负责人: Joseph R Guydish
• 金额: $ 55.13万
• 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 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7794870
• 关键词: Address; Adopted; Adoption; Client; Clinic; Clinical Trials Network; Dentistry; Drug abuse; Drug usage; Effectiveness; Effectiveness of Interventions; Evidence based practice; Exposure to; Faculty; Funding; General Population; Goals; Health; Health Knowledge, Attitudes, Practice; Health Services Research; Intervention; Measurement; Measures; Medicine; Modeling; Morbidity - disease rate; National Institute of Drug Abuse; New Jersey; Nicotine; Nicotine Dependence; Organizational Change; Outpatients; Persons; Pharmaceutical Preparations; Policies; Policy Developments; Population; Procedures; Public Health Schools; Research; Residential Treatment; Risk; Sampling; Services; Smoke; Smoking; Surveys; Technology; Telephone; Testing; Time; Tobacco; United States; Universities; addiction; burden of illness; design; economic cost; experience; follow-up; improved; intervention effect; mortality; nicotine abuse; post intervention; programs; response; shift work; therapy design; therapy development; treatment program

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的吸烟率是一般人群的3-4倍，公共资助方案的工作人员的吸烟率是一般人群的两倍。虽然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升高，但治疗计划很少解决尼古丁成瘾的共病问题。虽然治疗计划越来越认识到这一矛盾，但很少有模型可用于指导他们进行尼古丁依赖干预。本研究将测试手动通过组织变革解决烟草问题（ATTOC）干预在促进药物滥用和尼古丁依赖治疗整合方面的有效性。在多基线设计中，每个项目作为其自身的对照，三个住院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，尼古丁知识、态度、实践的员工水平变化，以及尼古丁依赖治疗暴露和利用的客户水平变化。在每个测量点（干预前、干预后和随访），50名机构工作人员的纵向样本将完成有关尼古丁相关知识、态度和做法的调查，50名机构客户的横向样本将参加有关他们接受的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的组织变革干预的有效性。调查团队将UMDNJ干预开发团队的优势与UCSF组织变革研究团队的优势结合起来，在干预和研究程序都已试行的背景下。该研究将在NIDA CTN平台上进行，并由国家认可和研究经验丰富的治疗诊所参与。短期目标是测试ATTOC干预措施在解决正在接受治疗的吸毒者的尼古丁依赖方面的有效性。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。