Micro-targeted Computerized Alcohol Misuse Intervention System for Health Care

用于医疗保健的微目标计算机酒精滥用干预系统

• 批准号: 8715016
• 负责人: Diana Howard Caldwell
• 金额: $ 51.09万
• 依托单位: RESEARCH CIRCLE ASSOCIATES, LLC
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8715016
• 关键词: Administrator; Adopted; Adoption; Age; Alcohol abuse; Alcohol consumption; Alcohols; Algorithms; Architecture; Attention; Attitude; Award; Behavioral Risk Factor Surveillance System; Characteristics; Clinic; Clinical; Clinical Services; Code; Community Health Centers; Complex; Computer software; Computers; Cost Savings; Data; Data Set; Development; Disease; Drug usage; Effectiveness; Effectiveness of Interventions; Electronic Health Record; Ensure; Epidemiology; Ethnic Origin; Feedback; Focus Groups; Gender; Generic Drugs; Genetic Crossing Over; Grant; Health; Health Promotion; Health behavior; Health education; Healthcare; Healthcare Systems; Industry; Intervention; Left; Mainstreaming; Marketing; Maryland; Mediator of activation protein; Medical; Motivation; National Ambulatory Medical Care Survey; Participant; Patients; Peer Review; Penetration; Phase; Physicians; Pilot Projects; Placebo Control; Population; Positioning Attribute; Prevention strategy; Preventive; Primary Health Care; Provider; Public Health; Questionnaires; Race; Randomized Controlled Trials; Readiness; Research; Review Literature; Risk Behaviors; Services; Site; Small Business Technology Transfer Research; Societies; Staging; Survey Methodology; Surveys; System; Target Populations; Thinking; Treatment Efficacy; United States; Update; Variant; Visit; Visual; Work; alcohol intervention; alcohol misuse; alcohol screening; alcohol screening and brief intervention; base; behavior change; binge drinking; brief intervention; commercialization; computerized; cost; design; drinking; drinking behavior; economic impact; evidence base; health economics; health record; improved; informant; information gathering; intervention effect; motivational enhancement therapy; multi-component intervention; normative feedback; novel; prevent; primary care setting; programs; prototype; public health relevance; reduced alcohol use; routine care; screening; screening and brief intervention; screening, brief intervention, referral, and treatment; social; therapy design; therapy development; usability

DESCRIPTION (provided by applicant): Alcohol misuse continues to pose a major burden for public health. Screening and brief intervention for alcohol misuse in primary care settings has been recommended for decades, and the evidence base supporting it in primary care is robust. However, many primary care providers do not intervene in alcohol misuse, and those that do often fail to do so systematically or in accordance with best-evidence standards. Computerization of screening and brief intervention for alcohol misuse holds the promise of alleviating many of the barriers that have prevented its adoption into routine care, and also offers new opportunities for optimizing the effectiveness of brief interventions. This Phase 2 STTR project follows up on Research Circle Associates' successful proof- of-concept work done under Phase 1, which led to the development of a versatile software platform (Interventionaire(c)) to support computerized alcohol misuse screening and brief intervention using evidence- based strategies including motivational interviewing and normative feedback. Our computerized alcohol misuse intervention includes a normative feedback component that is unique in its micro-targeting of alcohol use feedback based on participant demographic characteristics (race/ethnicity, gender, and age), drawing population normative data from the National Surveys on Drug Use and Health. This represents a novel use of epidemiological data to inform clinical services. The Phase 2 project is designed to answer a number of important research questions and prepare the product for successful commercialization. Specifically, during Phase 2 we intend to implement several refinements into the (Interventionaire(c)) platform that will increase its usability and streamline the creation of complex content with tailored feedback. We will also upgrade the software to make it compatible with a major electronic health record system used by our clinical partner site. This will increase the reach of the product and ensure maximum readiness for deployment into the modern healthcare marketplace, a dynamic and rapidly evolving industry. We will also conduct a study at our clinical partner site using qualitative key informant, focus group, and survey methodologies to investigate barriers to adopting computerized alcohol screening and brief intervention systems. A critical question is whether the computerized alcohol misuse intervention is effective in changing drinking behavior. To answer this question, we will conduct a cross-over randomized controlled trial examining the short-term impact of the computerized alcohol misuse intervention with micro-targeted normative feedback and motivational messaging compared to an "attention-control" (placebo) generic health promotion message. This trial will help to establish the short- term efficacy of the intervention and set the stage for larger trials and adoption of the product i healthcare settings. Finally, we will conduct a projection analysis of the economic and health impacts of the intervention under a variety of assumptions regarding intervention effect size, target population, and product penetration. Satisfying these Phase 2 objectives will leave RCA well-poised to deploy the product commercially, which will leverage the power of the market to improve clinical service delivery and promote public health.

描述(申请人提供)：酒精滥用仍然是公共健康的主要负担。几十年来，一直建议在初级保健环境中对酒精滥用进行筛查和短暂干预，并且在初级保健中支持这一建议的证据基础是强有力的。然而，许多初级保健提供者并不干预酒精滥用，而那些这样做的人往往没有系统地或根据最佳证据标准进行干预。酒精滥用筛查和短暂干预的计算机化有望缓解阻碍其进入常规护理的许多障碍，也为优化短暂干预的有效性提供了新的机会。这一第二阶段的STTR项目是继Research Circle Associates在第一阶段完成的成功的概念验证工作之后进行的，这项工作导致开发了一个多功能软件平台(Intervenonaire(C))，以支持计算机化的酒精滥用筛查和使用基于证据的策略(包括激励访谈和规范反馈)进行的短暂干预。我们的计算机化酒精滥用干预包括一个规范反馈部分，其独特之处在于根据参与者的人口统计特征(种族/民族、性别和年龄)对酒精使用进行微目标反馈，从全国药物使用和健康调查中提取人口规范数据。这代表了流行病学数据为临床服务提供信息的一种新用途。第二阶段项目旨在回答一些重要的研究问题，并为产品的成功商业化做好准备。具体地说，在第二阶段，我们打算在(Intervenonaire(C))平台中实施几项改进，以提高其可用性，并简化具有定制反馈的复杂内容的创建。我们还将升级软件，使其与我们的临床合作伙伴网站使用的主要电子健康记录系统兼容。这将扩大产品的覆盖范围，并确保最大限度地准备好部署到现代医疗保健市场，这是一个充满活力和快速发展的行业。我们还将在我们的临床合作伙伴现场进行一项研究，使用定性的关键信息者、焦点小组和调查方法来调查采用计算机化酒精筛查和简短干预系统的障碍。一个关键的问题是，计算机化的酒精滥用干预在改变饮酒行为方面是否有效。为了回答这个问题，我们将进行一项交叉随机对照试验，检查带有微目标规范反馈和激励性信息的计算机化酒精滥用干预的短期影响，并将其与“注意控制”(安慰剂)一般健康促进信息进行比较。这项试验将有助于确定干预的短期效果，并为更大规模的试验和产品I保健环境的采用奠定基础。最后，我们将在各种关于干预效果大小、目标人群和产品渗透率的假设下，对干预的经济和健康影响进行预测分析。满足这些第二阶段目标将使RCA做好充分准备，将该产品商业化部署，这将利用市场的力量来改善临床服务提供和促进公众健康。