SBIRT in New Mexico

新墨西哥州的 SBIRT

• 批准号: 8314100
• 负责人: ROBERT P SCHWARTZ
• 金额: $ 48.23万
• 依托单位: FRIENDS RESEARCH INSTITUTE, INC.
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8314100
• 关键词: Absenteeism at work; Accident and Emergency department; Address; Adopted; Adoption; Adult; Advisory Committees; Affect; Age; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; American; Area; Behavior; Behavioral; Biological; Biological Assay; Categories; Characteristics; Clinic; Clinical Research; Collaborations; Community Health; Computers; Counseling; Data; Data Analyses; Dependence; Detection; Development; Disclosure; Drug usage; Effect Modifiers (Epidemiology); Effectiveness; Effectiveness of Interventions; Employment Status; Environment; Ethnic Origin; Federal Government; Frequencies; Friends; Gender; HIV; Hair; Health; Healthcare; Hospitalization; Human Resources; Illicit Drugs; Immunoassay; Income; Individual; Injury; Intervention; Investigation; Investments; Knowledge; Literature; Marital Status; Measures; Medical Staff; Methodology; Methods; Mexican Americans; Minority; Modeling; New Mexico; Outcome; Outcome Measure; Participant; Patient Self-Report; Patients; Persons; Physicians; Policy Maker; Population; Preventive; Primary Health Care; Public Health; Race; Radio; Randomized; Randomized Controlled Trials; Recommendation; Reimbursement Mechanisms; Relative (related person); Research; Research Institute; Resources; Risk; Risk Behaviors; Role; Sampling; Science; Screening procedure; Self-Administered; Services; Site; Standardization; Substance of Abuse; System; Testing; Time; Tobacco; Treatment Effectiveness; Treatment outcome; United States Substance Abuse and Mental Health Services Administration; Visit; Work; base; brief intervention; clinical care; clinical practice; compare effectiveness; computerized; cost; drug of abuse; evidence base; expectation; experience; high risk; improved; innovation; intervention effect; meetings; misuse of prescription only drugs; motivational enhancement therapy; post intervention; pressure; primary outcome; programs; psychological distress; screening and brief intervention; screening, brief intervention, referral, and treatment; secondary outcome; tool; treatment site; working group

DESCRIPTION (provided by applicant): A firm evidence base has emerged supporting screening and brief intervention for alcohol use in healthcare settings. However, important gaps exist in the evidence for screening and brief intervention for illegal drug use. Rigorous research is needed that tests the effectiveness of screening and brief intervention for illegal drug use. In the proposed project, Friends Research Institute is partnering with Sangre de Cristo Community Health Partnership, the organization responsible for implementing the SAMHSA Screening, Brief Intervention, Referral, and Treatment (SBIRT) Initiative at over 35 primary care sites throughout the State of New Mexico since 2003. The proposed study will use a randomized controlled trial to compare the effectiveness of a standardized interpersonal brief intervention (IBI) based on motivational interviewing (currently used in the New Mexico SBIRT initiative) with a promising computerized brief intervention (CBI) in reducing illegal drug use and its associated health consequences. In addition, the study will assess whether patients' computer experience differentially moderates the effectiveness of the two interventions. The study will take place at two large primary care clinics in New Mexico. All patients will complete a screening for substance use via the Alcohol, Tobacco, and Substance Involvement Screening Tool (ASSIST) as part of regular clinical care. Patients who score in a moderate-risk category for illegal drug use (n = 360, 180 at each site) will be randomized within their respective clinics to the IBI or CBI condition. Patients with high-risk drug use will be referred for more intensive services as per standard clinical practice. Primary outcomes include drug use levels for major substances of abuse as measured by radio immunoassay analysis of hair samples, as well as global illicit drug risk ASSIST scores. Secondary outcomes include self-reported frequency of hospitalizations, emergency room utilization, injuries, psychological distress, HIV risk behaviors, arrests, missed work days, and earned income. Data analysis will be conducted using a Generalized Linear Mixed Model approach. An effective computerized brief intervention has the potential to make a substantial impact on SBIRT practice and improve public health. An effective CBI has the potential to offer a more acceptable format for addressing drug use behaviors than an interpersonal encounter, and has the expected advantages of having high reach and easy replication with comparatively lower investment of clinicians' time and resources. PUBLIC HEALTH RELEVANCE: The relevance of this research to public health will show that targeted screening in primary care health settings for moderate drug use will have a significant impact on public health by implementing brief interventions that target risky behaviors in moderate drug using individuals. This research, which also tests the differential effectiveness of two brief interventions for illegal drug use, has the potential to make a significant contribution to understanding the role that brief interventions have in reducing drug use and its associated consequences.

描述(由申请人提供)：已出现确凿的证据基础，支持在医疗保健环境中对酒精使用进行筛查和短暂干预。然而，在对非法药物使用进行筛查和短暂干预的证据方面存在重要差距。需要进行严格的研究，以测试对非法药物使用的筛查和短暂干预的有效性。在拟议的项目中，朋友研究所与Sangre de Cristo社区健康伙伴关系合作，该组织自2003年以来负责在新墨西哥州超过35个初级保健地点实施SAMHSA筛查、短暂干预、转诊和治疗(SBIRT)倡议。这项拟议的研究将使用随机对照试验来比较基于动机访谈的标准化人际短暂干预(IBI)(目前在新墨西哥州SBIRT计划中使用)与前景看好的计算机化短暂干预(CBI)在减少非法药物使用及其相关健康后果方面的有效性。此外，这项研究将评估患者的电脑体验是否会对这两种干预措施的有效性产生不同的影响。这项研究将在新墨西哥州的两家大型初级保健诊所进行。作为常规临床护理的一部分，所有患者都将通过酒精、烟草和涉及物质的筛查工具(ASSIST)完成物质使用筛查。在非法药物使用的中等风险类别中得分的患者(每个地点360人，180人)将在各自的诊所内被随机分配到IBI或CBI条件下。根据标准的临床做法，使用高风险药物的患者将被转介到更密集的服务中。主要结果包括通过头发样本的放射免疫分析测量的主要滥用物质的药物使用水平，以及全球非法药物风险辅助评分。次要结果包括自我报告的住院频率、急诊室使用情况、受伤、心理困扰、艾滋病毒危险行为、逮捕、错过工作天数和收入。将使用广义线性混合模型方法进行数据分析。有效的计算机化短暂干预有可能对SBIRT实践产生重大影响，并改善公众健康。与人际接触相比，有效的CBI有可能为解决药物使用行为提供一种更可接受的形式，并具有预期的优势，即具有高覆盖率和易于复制，而临床医生的时间和资源投入相对较低。公共卫生相关性：这项研究与公共卫生的相关性将表明，在初级保健卫生环境中对适度药物使用进行有针对性的筛查，通过实施针对中度药物使用个人危险行为的简短干预，将对公共健康产生重大影响。这项研究还测试了两种针对非法药物使用的短暂干预措施的不同效力，有可能对理解短暂干预措施在减少药物使用及其相关后果方面的作用作出重大贡献。