Computer Based Training in CBT for Spanish-Speaking Substance Users

为西班牙语药物使用者提供基于计算机的 CBT 培训

• 批准号: 9231403
• 负责人: KATHLEEN M. CARROLL
• 金额: $ 60.57万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-03-15 至 2018-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9231403
• 关键词: Address; African American; Alcohol or Other Drugs use; Alcohols; Clinic; Clinical Research; Cognition; Cognitive Therapy; Computer Assisted; Computer-Assisted Therapy; Connecticut; Counseling; Decision Making; Dependence; Drug usage; E-learning; European; Evidence based practice; Evidence based treatment; Exercise; Frequencies; Goals; HIV risk; Hispanic Americans; Hispanics; Improve Access; Individual; Innovative Therapy; Institute of Medicine (U.S.); Intervention; Language; Latino; Mediator of activation protein; Mental Health; Methods; Minority Groups; Narration; Online Systems; Outcome; Outcome Measure; Outpatients; Participant; Pharmaceutical Preparations; Population; Problem Solving; Randomized; Randomized Clinical Trials; Risk Behaviors; Risk Reduction; Sampling; Services; Specimen; Substance Addiction; Substance abuse problem; Toxicology; Training; Training Programs; Translations; Underserved Population; United States; United States National Institutes of Health; Urine; Videotape; Voice; adverse outcome; bilingualism; community based treatment; comparative; coping; cost; craving; ethnic minority population; evidence base; experience; follow-up; health disparity; improved; literacy; meetings; mental health center; novel; primary outcome; programs; psychosocial; randomized trial; reduced substance use; secondary outcome; service utilization; skills; standard care; substance abuse treatment; substance abuser; treatment as usual; treatment effect; treatment program

DESCRIPTION (provided by applicant): Substance abuse is a significant problem among Hispanic Americans, who represent the largest ethnic minority group in the United States. Latino/as tend to be less likely to receive mental health and substance abuse treatment services than European and African Americans, experience disproportionate levels of adverse consequences of drug use, and yet are highly underrepresented in clinical and research samples. To address the issue of improving access to empirically validated therapies, we have developed a computer-assisted version of cognitive behavioral therapy (Computer Based Training for Cognitive Behavioral Therapy, CBT4CBT) and have demonstrated its efficacy and durability as an adjunct to standard outpatient substance abuse treatment. We now propose to adapt the CBT4CBT program for use with a broad range of substance abusers whose principal/preferred language is Spanish and to evaluate its efficacy in this population. If this Spanish version of CBT4CBT is found to be an effective adjunct to treatment, it would be comparatively inexpensive and straightforward to disseminate and implement in a wide range of programs. It would thus also represent a significant step in making evidence-based therapies more broadly available to this important and underserved population and hence to address a critical health disparity in the US and an NIH priority. We propose to, first, adapt our individualized, interactive, web-based training program (CBT4CBT) for Spanish- speaking substance users. Second, we propose to conduct an initial randomized trial evaluating the feasibility and efficacy of adding CBT4CBT-Spanish to treatment as usual in a community based treatment program in a population of 100 Spanish-speaking individuals who meet current criteria for substance abuse dependence. Participants will be randomized to one of two conditions: (1) standard treatment (ST) at the Hispanic Clinic of the Connecticut Mental Health Center, or (2) ST with access to the CBT4CBT-Spanish program as an adjunct to treatment. The long-term durability and/or delayed emergence of treatment effects will be evaluated through a six month follow-up. The primary outcome measures will be reduction in substance use, operationalized as reduction in the frequency of substance use by week confirmed by urine toxicology screens. Secondary outcomes will include HIV risk reduction, psychosocial functioning, and the participants' ability to demonstrate the skills targeted in the CBT4CBT intervention as a mediator of outcome.

描述（由申请人提供）：药物滥用是西班牙裔美国人中的一个严重问题，他们是美国最大的少数族裔群体。与欧洲人和非裔美国人相比，拉丁裔/亚裔往往不太可能接受心理健康和药物滥用治疗服务，他们经历的吸毒不良后果程度不成比例，但在临床和研究样本中的代表性却严重不足。为了解决改善获得经经验验证的疗法的问题，我们开发了一种计算机辅助版本的认知行为疗法（基于计算机的认知行为疗法训练，CBT4CBT），并证明了其作为标准门诊药物滥用治疗的辅助手段的有效性和持久性。我们现在建议调整 CBT4CBT 计划，以适用于主要/首选语言是西班牙语的广泛药物滥用者，并评估其在该人群中的功效。如果这种西班牙语版本的 CBT4CBT 被认为是一种有效的治疗辅助手段，那么在广泛的项目中传播和实施将相对便宜且直接。因此，这也代表着向这一重要且服务不足的人群更广泛地提供循证疗法的重要一步，从而解决美国严重的健康差距和 NIH 的优先事项。我们建议首先针对西班牙语药物使用者调整我们的个性化、交互式、基于网络的培训计划 (CBT4CBT)。其次，我们建议开展一项初步随机试验，评估在基于社区的治疗计划中像往常一样将 CBT4CBT-西班牙语添加到治疗中的可行性和有效性，该试验对 100 名符合当前药物滥用依赖标准的讲西班牙语的人进行。参与者将被随机分配接受以下两种情况之一：(1) 在康涅狄格州精神健康中心的西班牙裔诊所进行标准治疗 (ST)，或 (2) 接受 CBT4CBT-西班牙计划作为辅助治疗的 ST。将通过六个月的随访来评估治疗效果的长期持久性和/或延迟出现。主要成果指标将是减少物质使用，具体表现为通过尿液毒理学筛查证实每周物质使用频率减少。次要成果将包括艾滋病毒风险降低、心理社会功能以及参与者展示 CBT4CBT 干预中作为结果中介的技能的能力。