Testing of a patient-centered e-health implementation model in addiction treatment

项目概要/摘要 一组来自健康增强系统研究中心（中心）的研究人员在大学 威斯康星-麦迪逊工程学院和爱荷华州公共卫生部将测试 改善成瘾治疗技术实施网络（NIATx- TI）框架，以实施ACHESS物质使用障碍（SUD）治疗和康复应用程序。 ACHESS使用智能手机技术提供持续的SUD护理，并改善了治疗效果 在一项随机试验中以及在阿片类药物患者的真实SUD治疗环境中的结局， 酒精使用障碍尽管其证据基础和74%的SUD治疗患者具有 在智能手机上，ACHESS目前在不到1%的提供SUD治疗的环境中使用。ACHESS并非独一无二 在这方面，一般而言，卫生保健以病人为中心的技术采用率较低。这种低采用率 强调了另一个执行差距，以及传播和执行领域需要 制定各种办法，促进采用越来越多的循证电子保健技术。两 在增加ACHESS使用方面有待测试的策略是NIATx-TI框架和产品培训， 持续的技术支持。我们中心开发的NIATx-TI框架建立在我们在以下方面的经验之上： NIATx组织变革模型应用于3,300多个组织。NIATx-TI结合了 系统工程原理嵌入NIATx组织模型，并采用经过验证的技术 采用技术。NIATx-TI在我们中心的7个州项目中成功试点，“促进使用 技术，以改善治疗和恢复学习协作，”并导致客户增加了2倍 在试点研究期间接受远程治疗。RE-AIM框架将用于衡量影响 爱荷华州n=16个SUD组织的2项干预措施（每组n=8个组织）。了质的 将利用成本分析更好地了解执行进程。爱荷华州是 选择作为研究环境是因为其服务提供者的多样性， 其他国家项目，强大的数据报告系统，因为爱荷华州药物滥用联合会 研究和评估将为研究提供强有力的本地支持。爱荷华州的SUD治疗提供者和 需要基于证据的移动的技术所能提供的有效治疗支持 如果成功实施。ACHESS和其他有前景的以患者为中心的循证技术 可以改变SUD治疗及其结果。通过测试NIATx-TI框架和典型 产品培训，本试验将使您更深入地了解如何成功实施ACHESS， 其他有前途的循证技术。

Project Summary/Abstract A team of researchers from the Center for Health Enhancement Systems Studies (the Center) at University of Wisconsin–Madison College of Engineering and the Iowa Department of Public Health will test the effectiveness of the Network for the Improvement of Addiction Treatment-Technology Implementation (NIATx- TI) framework in implementing the ACHESS substance use disorder (SUD) treatment and recovery app. ACHESS uses smartphone technology to provide continual access to SUD care and has improved treatment outcomes in a randomized trial as well as in real-world SUD treatment settings with patients with opioid and alcohol use disorders. Despite its evidence base and 74% of SUD treatment patients possessing a smartphone, ACHESS is currently used in <1% of settings that provide SUD treatment. ACHESS is not unique in this regard; health care, in general, has low patient-centered technology adoption rates. This low adoption highlights yet another implementation gap and the need for the dissemination and implementation field to develop approaches to facilitate adoption of the growing list of evidence-based e-health technologies. The two strategies to be tested in increasing ACHESS use are the NIATx-TI framework and product training, followed by ongoing technical support. The NIATx-TI framework developed by our Center builds on our experience in applying the NIATx organizational change model in more than 3,300 organizations. NIATx-TI combines the systems engineering principles embedded in the NIATx organizational model with validated technology adoption techniques. NIATx-TI was piloted successfully in our Center's 7-state project, “Promoting the Use of Technology to Improve Treatment and Recovery Learning Collaborative,” and led to a 2-fold increase in clients receiving distance treatment during the pilot study. The RE-AIM framework will be used to measure the impact of the 2 interventions in n=16 SUD organizations in Iowa (with n=8 organizations per each arm). A qualitative and cost analysis will be used to develop a better understanding of the implementation process. Iowa was selected as a research setting because of its diverse population of service providers, high participation rates in other national projects, strong data reporting systems, and because the Iowa Consortium for Substance Abuse Research & Evaluation will provide strong local support for the study. SUD treatment providers in Iowa and across the country need the effective treatment supports that evidence-based mobile technologies can provide when successfully implemented. ACHESS and other promising evidence-based patient-centered technologies are positioned to alter SUD treatment and its outcomes. Through testing the NIATx-TI framework and typical product training, this trial will yield a deeper understanding of how to successfully implement ACHESS and other promising evidence-based technologies.