Screening for Substance Use with Computer Assisted Self Interview in Primary Care

项目摘要 我是一名医生和早期职业翻译研究者，研究重点是确定有效的 将药物滥用治疗纳入一般保健环境的方法。因为筛查 药物滥用的病人是耗时的临床医生的一部分，我建议研究，以解决 患者自我筛查的有效性。本研究的具体研究和培训目标是 围绕两个主要领域进行整合：行为研究方法（调查研究，定量 分析，定性方法）和实施研究。这些区域中的每一个都由 经验丰富的导师与相应的专业知识，并通过说教式的指导进一步发展 结合课程作业和指导性阅读以及研究经验。在我的赞助下， 主要导师Marc Gourevitch，医学博士，公共卫生硕士，我的研究和培训计划利用临床和学术 资源的纽约大学兰贡医学中心和贝尔维尤医院，其中药物滥用 治疗和研究一直是一个长期的重点领域。我提出的研究探索了一种创新的 提高初级保健中药物使用筛查率的方法，这是一个主要障碍， 一直缺乏一个简短的工具，可以准确，有效地识别患者的不健康 物质使用行为。被广泛接受和验证的“酒精、吸烟和物质参与 筛选测试（ASSIST）对于典型的医疗访问来说太长了，因此大大未得到充分利用。我 将调整ASSIST，这是设计和验证，以管理作为一个人的采访， 音频引导的计算机辅助自我访谈（ACASI），患者可以在他们的医疗访问之前完成。我 计划分3个阶段进行混合方法研究，以1）在城市安全中调整ACASI管理的ASSIST- 净初级保健诊所人口; 2）测试其有效性相对于传统的采访者管理 3）探讨医生对使用这些筛查结果来解决药物使用问题的态度。 初级保健办公室。

PROJECT SUMMARY I am a physician and early career translational investigator, with a research focus on identifying effective approaches for integrating substance abuse treatment into general healthcare settings. Because screening patients for substance abuse is time consuming on the part of clinicians, I propose research to address the validity of patient self-administered screening. The specific research and training aims of this study are integrated around two primary areas of focus: behavioral research methods (survey research, quantitative analysis, qualitative methods) and implementation research. Each of these areas is anchored by an experienced mentor with corresponding expertise, and further developed through didactic instruction combining coursework and directed readings as well as research experience. Under the sponsorship of my primary mentor Marc Gourevitch, MD, MPH, my research and training plans utilize the clinical and academic resources of New York University-Langone Medical Center and Bellevue Hospital, where substance abuse treatment and research has been a longstanding area of emphasis. My proposed study explores an innovative approach to improving rates of substance use screening in primary care, a major impediment to which has been the lack of a brief instrument that can accurately and efficiently identify patients with unhealthy substance use behaviors. The widely accepted and validated "Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is too lengthy for the typical medical visit, and greatly under-utilized as a result. I will adapt the ASSIST, which was designed and validated to be administered as an in-person interview, to an audio guided computer-assisted self interview (ACASI) that patients can complete prior to their medical visit. I plan a mixed methods study in 3 phases to 1) adapt the ASSIST for ACASI administration in an urban safety- net primary care clinic population; 2) test its validity relative to the traditional interviewer-administered ASSIST; and 3) explore physician attitudes to using these screening results to address substance use in the primary care office.