A Virtual Learning Collaborative for Alcohol Screening, Brief Intervention and Treatment in Primary Care

摘要 这项申请建立在南卡罗来纳医科大学(MUSC)研究人员之前的研究基础上。 这导致了酒精筛查和短暂干预方面的显著改善，并适度 在初级保健实践中采用药物治疗酒精障碍的情况有所改善 美国。而PPRNet在交叉随机试验中完成了这些改进，有效 仍然需要制定战略，以更广泛地传播所使用的调查结果和方法，并制定 在通过和有效执行《国家IAAA》方面产生更大国家影响的机制 推荐的临床指南。拟议的R25教育计划实施了创新的虚拟 传播证据、指导方针和实施战略的协作学习(VLC)方法 筛查、简短干预和转介治疗(SBIRT)给初级保健临床医生、护士和其他人员 参与PPRNet的全国临床工作人员，PPRNet是一个基于实践的研究网络，已有15年的历史 将研究转化为实践的经验(TRIP)。拟议中的项目测试了比较 参与ALC-TRIP的有效性(酒精学习合作-将研究转化为实践) 与没有参与此次VLC的实践相比。这项研究将是首次使用一种创新的 VLC，让学员参与基于网络的讨论/规划，以改进酒精筛查和 初级保健的干预，有可能在全国范围内开展大量初级保健实践 我们。该酒精教育项目提案的主要目的是：1)开发和实施ALC-Trip，a 旨在教育初级保健人员和临床医生制定实践方法的多组件VLC 改进酒精使用障碍的酒精筛查、短期干预和酒精药物治疗；2) 比较参加ALC-Trip酒精筛查、短期干预和 使用酒精药物疗法来不参与这项合作学习，在全国范围内抽样调查10人 在每个小组中进行实践；以及3)对该协作学习进行过程评估，以检查 从以下角度来看，这种方法的优势、劣势、机会和威胁 利益相关者。该项目的发现将推进NIAAA的教育使命，并为未来 酒精SBIRT的传播和实施方案。如果ALC-TRIP比被动更有效 通过教育网络研讨会和季度实践报告传播指导方针，VLC可能会发挥 在以初级保健为重点的酒精和非法药物使用倡议中发挥关键作用。

ABSTRACT This application builds upon previous studies by investigators at Medical University of South Carolina (MUSC) that resulted in significant improvements in alcohol screening and brief interventions, and modest improvements in adoption of pharmacotherapy for alcohol disorders in primary care practices across the United States. While PPRNet accomplished these improvements in a crossover randomized trial, effective strategies are still needed to more widely disseminate findings and approaches practices used, and develop mechanisms to make a larger national impact in the adoption of and effective implementation of the NIAAA recommended clinical guidelines. The proposed R25 education program implements an innovative virtual learning collaborative (VLC) approach to disseminating evidence, guidelines and strategies for implementation of screening, brief intervention, and referral to treatment (SBIRT) to primary care clinicians, nurses and other clinical staff nationwide that participate in PPRNet, a practice based research network with 15 years of experience in translating research into practice (TRIP). The proposed project tests the comparative effectiveness of participating in ALC-TRIP (Alcohol Learning Collaborative–Translating Research into Practice) compared to practices that have not participated in this VLC. This study will be the first use of an innovative VLC that involves learner participation in web-based discussions/planning to improve alcohol screening and intervention in primary care, with the potential to reach a large number of primary care practices throughout the US. The primary aims of this alcohol education project proposal are to: 1) Develop and implement ALC-TRIP, a multi-component VLC designed to educate primary care staff and clinicians to develop practice approaches to improve alcohol screening, brief intervention and alcohol pharmacotherapy for alcohol use disorders; 2) Compare the effectiveness of practice participation in ALC-TRIP on alcohol screening, brief intervention and use of alcohol pharmacotherapy to non-participation in this learning collaborative, in a nationwide sample of 10 practices in each group; and 3) Conduct a process evaluation of this learning collaborative to examine the strengths, weaknesses, opportunities and threats related to this approach from the perspective of the stakeholders. Findings from this project will advance the educational mission of the NIAAA and inform future dissemination and implementation programs for alcohol SBIRT. If ALC-TRIP is more effective than passive dissemination of guidelines through an educational webinar and quarterly practice reports, VLCs might play a critical role in primary care-focused alcohol and illicit drug use initiatives.