Web-based Biopsychosocial Assessment and Intervention for Alcohol Misuse

基于网络的酒精滥用生物心理社会评估和干预

• 批准号: 8061740
• 负责人: Andrew H. Soll
• 金额: $ 33.1万
• 依托单位: CPM SYSTEMS, INC.
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-05-01 至 2012-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8061740
• 关键词: Abbreviations; Address; Alcohols; Algorithms; Attitude; Automobile Driving; California; Caring; Clinic; Clinic Visits; Clinical; Comorbidity; Complex; Computers; Consensus; Data; Data Collection; Dependency; Development; Discipline; Early identification; Educational Intervention; Educational process of instructing; Elements; Ensure; Expert Opinion; Family; Feedback; Foundations; Funding; Goals; Health Care Costs; Healthcare; Home environment; Individual; Information Systems; Internet; Intervention; Interview; Investigation; Length; Medical; Mental Depression; National Institute on Alcohol Abuse and Alcoholism; Online Systems; Outcome; Paper; Pathway interactions; Patient Self-Report; Patients; Phase; Physicians; Policies; Primary Health Care; Process; Provider; Psychometrics; Psychosocial Assessment and Care; Psychosocial Influences; Quality of life; Questionnaires; Readiness; Recording of previous events; Reporting; Research; Research Infrastructure; Research Personnel; Research Support; Resistance; Resources; Review Literature; Risk; Screening procedure; Self Assessment; Site; Small Business Innovation Research Grant; Societies; Solutions; Symptoms; System; Testing; Time; Training; United States National Institutes of Health; Validation; Work; alcohol misuse; alcohol screening; behavioral health; biopsychosocial; brief intervention; clinically relevant; cost; cost effective; design; drinking; effective intervention; effective therapy; improved; insight; instrument; meetings; operation; patient oriented; psychologic; psychosocial; routine care; social; success; successful intervention; touchscreen; volunteer; wasting

DESCRIPTION (provided by applicant): Alcohol misuse (AMU) inflicts high costs on individuals and society. Timely intervention can be effective in reducing the impact, but AMU is rarely identified and treated in practice. Although AMU afflicts young, healthy people, it also frequently occurs superimposed on psychosocial problems, which are also frequently not identified. The common thread is that physicians lack the time and resources for a complete assessment and for appropriately treating biopsychosocial and health behavioral issues that are discovered. A central tenet of psychometrics is that if you want to know what is going on with the patient, you must ask the patient-not a provider and not the chart. If you want to know about AMU, patients must be asked directly; providers will not know and paper questionnaires cannot be scaled into an effective solution. SOLUTION: Our work builds on an operational, Web-based, patient self-assessment system called CarePrep that allows patients to easily enter and track symptom, psychosocial, and QOL data over the Internet from home or clinic. APPROACH: (1) We will deploy CarePrep in a primary care clinic, addressing any policy and procedural issues and fitting the system into the pathway of care, with the goal of assessing patients before their clinic visit. Patient testing will be conducted to identify and resolve problems with use and to start data collection for the Aim 2 validation. (2) Working with alcohol and psychometric experts, we will extend and validate CarePrep to screen for and assess AMU in the context of patients' bio-psychosocial issues. We will build on established instruments like the AUDIT and on established domains and items, focusing on early identification and assessment of dependency and consequences from AMU. High priority is placed upon generating value in medical settings, so that the system gets used. Clinical relevance and construct validity will be assessed. We will assess feasibility and acceptance by providers and patients. IMPACT: (1) Initial development and validation of an online resource capable of identifying and assessing AMU in the context of relevant biopsychosocial issues. (2) A integrated intervention that embeds screening and a brief intervention for AMU into the pathway of routine medical care, creating value for providers and patients so that the system gets used. (3) The core of a consensus resource for research that turns routine clinical encounters into research opportunities and supports relevant, transparent investigation of AMU. PUBLIC HEALTH RELEVANCE: This work adapts a web-based, patient self-assessment system that is now in operation in clinic to identify and assess alcohol misuse in medical settings in the context of the patients' medical and psychosocial issues. Since medical physicians frequently do not have the time to assess and provide brief interventions and continuing care, the online system will be developed to operate as independently as possible to support care, informing the clinician of the patient's status and problems. We propose to develop the questions for the assessment and then to test their validity with patients and whether use is acceptable to patients and physicians. Long-range goals are to establish that this approach improves care for alcohol misuse.

描述（由申请人提供）：酒精滥用 (AMU) 给个人和社会造成高昂成本。及时干预可以有效减少影响，但实践中很少发现和治疗 AMU。尽管 AMU 困扰着年轻、健康的人，但它也经常与心理社会问题同时发生，而这些问题也常常未被识别。共同点是医生缺乏时间和资源来进行完整的评估和适当地治疗发现的生物心理社会和健康行为问题。心理测量学的一个中心原则是，如果你想知道病人的情况，你必须询问病人，而不是询问提供者，也不要询问图表。如果想了解AMU，必须直接询问患者；提供商不会知道，纸质调查问卷也无法扩展为有效的解决方案。解决方案：我们的工作建立在名为 CarePrep 的可操作的、基于网络的患者自我评估系统的基础上，该系统允许患者从家里或诊所通过互联网轻松输入和跟踪症状、心理社会和生活质量数据。方法：(1) 我们将在初级保健诊所部署 CarePrep，解决任何政策和程序问题，并使系统融入护理路径，目标是在患者就诊前对其进行评估。将进行患者测试，以识别和解决使用问题，并开始收集 Aim 2 验证的数据。 (2) 与酒精和心理测量专家合作，我们将扩展和验证 CarePrep，以根据患者的生物心理社会问题筛查和评估 AMU。我们将以审计等既定工具以及既定领域和项目为基础，重点关注及早识别和评估 AMU 的依赖性和后果。我们高度重视在医疗环境中创造价值，以便系统得到使用。将评估临床相关性和结构有效性。我们将评估提供者和患者的可行性和接受度。影响：(1) 初步开发和验证在线资源，能够在相关生物心理社会问题的背景下识别和评估 AMU。 (2) 综合干预，将 AMU 筛查和简短干预纳入常规医疗护理路径，为提供者和患者创造价值，以便系统得到使用。 (3) 研究共识资源的核心，将常规临床遭遇转化为研究机会，并支持 AMU 的相关、透明调查。 公共健康相关性：这项工作采用了基于网络的患者自我评估系统，该系统现已在临床上运行，以根据患者的医疗和心理社会问题识别和评估医疗环境中的酒精滥用情况。由于医生经常没有时间评估和提供简短的干预措施和持续护理，因此将开发在线系统，使其尽可能独立运行以支持护理，告知临床医生患者的状况和问题。我们建议制定评估问题，然后测试患者的有效性以及患者和医生是否可以接受使用。长期目标是确定这种方法可以改善对酒精滥用的护理。