Telehealth-Clinical Advocacy Project (T-CAP)

总结/摘要 阿片类药物危机在美国已经达到流行病的程度。在伊利诺伊州，这个应用程序的重点， 与阿片类药物有关的死亡人数在过去一年增加了32%。作为国家回应的一部分，伊利诺伊州已经启动了一项 警察阿片类药物转移计划（ODP），个人自愿进入该计划，并寻求帮助， 药物治疗，不用担心被捕。拟议的远程保健-临床宣传项目（T-CAP） 干预的重点是通过（1）引入远程医疗模式，将参与者与 在整个干预过程中有一名训练有素的临床医生;（2）扩大社区治疗服务 基础设施（包括扩大疼痛管理的选择和增加获得医疗服务的机会， 可提供MAT）。志愿者研究参与者将被随机分配到两个条件之一：（1）“治疗为 通常”（TAU）对照组，他们将与研究助理（RA）会面，分三次完成调查 点，或（2）T-CAP干预组谁将完成调查，并接受七个远程医疗临床 会议具有简短的干预服务与动机面试（MI），“自信”转介，和三个 临床医生持续数月的临床支持和倡导。这一战略的新奇在于， 需要为参与者提供快速可用的专业水平的临床服务和支持， 警察分流计划，它扩大了服务基础设施，包括增加获得MAT 和替代性疼痛管理服务。研究的主要目的是（1）证明干预 通过测量研究参与者对远程医疗方法的接受度和利用率来评估可行性，以及（2）评估 拟议的T-CAP措施，以评估其在衡量远程医疗对物质使用的影响方面的表现 治疗启动、短期治疗保留和获得其他适当的治疗服务， 未来的大规模研究。如果这些改进是可行的，那么高度创新的 T-CAP干预将是主要的。这项研究有可能实现减少阿片类药物使用的更大目标， 相关的健康问题将对警察的分流政策和做法产生重大影响。

SUMMARY/ABSTRACT The opioid crisis has reached epidemic proportions across America. In Illinois, the focus of this application, opioid-related deaths have increased 32% in the past year. As part of a State response, Illinois has launched a police Opioid Diversion Program (ODP), where individuals voluntarily enter the program and ask for help with substance use treatment, without fear of arrest. The proposed Telehealth-Clinical Advocacy Project (T-CAP) intervention focuses on enhancing one Illinois ODP by (1) introducing a telehealth model to link participants to a trained clinician throughout the intervention process and (2) expanding the community treatment services infrastructure (including expanded options for pain management and increased access to medical services that can provide MAT). Volunteer study participants will be randomized to one of two conditions: (1) “treatment as usual” (TAU) comparison group who will meet with a research assistant (RA) to complete surveys at three time points, or (2) T-CAP intervention group who will complete surveys and receive seven telehealth clinical sessions featuring brief intervention services with Motivational Interviewing (MI), “assertive” referrals, and three months of on-going clinical support and advocacy from a clinician. The novelty of this strategy is that it focuses on the need to provide participants with rapidly available professional level clinical services and support as part of the police diversion program, and it expands the service infrastructure to include increased access to MAT and alternative pain management services. The primary study aims are (1) to demonstrate intervention feasibility by measuring study participant receptivity and utilization of the telehealth approach and (2) evaluate the proposed T-CAP measures to assess their performance in gauging the impact telehealth on substance use treatment initiation, short-term treatment retention, and access to other appropriate treatment services for future large-scale research. If the enhancements are feasible, the potential impact of the highly innovative T-CAP intervention will be major. The study’s potential to achieve the larger goal of reducing opioid use and related health problems will have major implications for police diversion policy and practice.