MI-SMART: Methods for Optimizing Multilevel Adaptive Implementation Strategies to Promote the Adoption of Effective SUD and HIV Services

MI-SMART：优化多级自适应实施策略以促进采用有效 SUD 和 HIV 服务的方法

• 批准号: 10640291
• 负责人: Daniel Almirall
• 金额: $ 37.5万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10640291
• 关键词: Address; Adoption; Applet; Behavioral; Clinic; Code; Collaborations; Computer software; Data; Data Analyses; Death Rate; Development; Dose; Educational workshop; Electronic Health Record; Ensure; Evidence based practice; Experimental Designs; Feedback; Generations; Goals; Guidelines; HIV; Heterogeneity; Individual; Intervention; Methodology; Methods; Motivation; Opioid; Patients; Policies; Primary Care; Process; Publishing; Randomized; Risk; Sample Size; Scientist; Sequential Multiple Assignment Randomized Trial; Services; Speed; Substance Use Disorder; System; Techniques; Technology; Time; Training; Update; Urine; Work; Writing; design; drug testing; evidence base; implementation strategy; improved outcome; individualized prevention; non-cancer chronic pain; peer coaching; prescription opioid; prevention service; primary care patient; recovery services; service uptake; skills; substance use; theories; tool; treatment services; trial design; user friendly software; user-friendly; webinar

PROJECT SUMMARY: PROJECT 1 Evidence-based prevention, treatment, and recovery services for substance use disorders (SUDs) and HIV often fail to be implemented or sustained due to barriers at multiple levels, such as lack of time and skills at the practitioner level; lack of support or established processes at the clinic level; or lack of effective technological tools, financing, and policies at the system level. The long-term goal of this project is to develop a new generation of effective, replicable multi-level strategies for implementing evidence-based SUD/HIV services in real-world settings, thus improving the outcomes of individuals with or at risk for SUD or HIV. To achieve this long-term goal, we will: (Aim 1) Develop principles for the design of Multi-level Adaptive Implementation Strategies (MAISYs) to guide how best to adapt (e.g., augment, intensify) implementation strategies based on the context and needs at multiple levels (e.g., clinic, practitioner); and develop a new experimental design—the Multi-level Implementation Sequential, Multiple Assignment, Randomized Trial (MI-SMART), in which sequences of randomizations occur at multiple levels—to inform the construction of optimized MAISYs; (Aim 2) Develop new data analysis methods for use with longitudinal data in an MI-SMART to address a suite of questions about the construction of a MAISY; (Aim 3) Develop sample size calculators for MI-SMARTs to enable SUD/HIV implementation scientists to plan and calculate statistical power for different types of MI- SMART designs; and (Aim 4) Work with the Dissemination and Training Core to disseminate the developed methods so that they can be readily applied by SUD/HIV scientists. This includes the development of webinars, workshops, tutorials, and free, user-friendly software for SUD/HIV scientists.

项目摘要：项目 1 针对药物滥用障碍 (SUD) 和艾滋病毒的循证预防、治疗和康复服务 由于多个层面的障碍，例如缺乏时间和技能，往往无法实施或维持 从业者水平；缺乏诊所层面的支持或既定流程；或缺乏有效的技术 系统层面的工具、融资和政策。该项目的长期目标是开发一种新的 制定有效的、可复制的多层次战略，以实施基于证据的 SUD/HIV 服务 现实世界的环境，从而改善患有 SUD 或 HIV 或有风险的个体的结果。为了实现这一目标 长期目标，我们将：（目标 1）制定多级自适应实施的设计原则 指导如何最好地适应（例如，增强、强化）实施策略的策略（MAISY） 多个层面（例如诊所、从业者）的背景和需求；并开发了一种新的实验设计—— 多级实施顺序、多重分配、随机试验（MI-SMART），其中 随机化序列发生在多个级别——为构建优化的 MAISY 提供信息； （目标2） 开发新的数据分析方法，用于 MI-SMART 中的纵向数据，以解决一系列问题 有关 MAISY 建设的问题； （目标 3）为 MI-SMART 开发样本量计算器 使 SUD/HIV 实施科学家能够规划和计算不同类型 MI 的统计功效 智能设计； （目标 4）与传播和培训核心合作，传播已开发的 方法，以便 SUD/HIV 科学家可以轻松应用它们。这包括网络研讨会的发展， 为 SUD/HIV 科学家提供研讨会、教程和免费、用户友好的软件。