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

项目总结：项目1 物质使用障碍(SUDS)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 从业者层面；缺乏临床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。这个项目的长期目标是开发一种新的 制定有效、可复制的多层次战略，以便在#年实施循证的性病/艾滋病毒服务 在现实世界的环境中，从而改善患有或有感染SUD或艾滋病毒风险的个人的结果。要做到这一点 长期目标，我们将：(目标1)制定多层次自适应实施的设计原则 战略(MAISY)，以指导如何最好地适应(例如，增强、强化)基于以下方面的实施战略 多个层面的背景和需求(例如，诊所、从业者)；并开发新的实验设计- 多层次实施顺序、多分配、随机试验(MI-SMART)，其中 在多个层面上进行随机化序列--为优化MAISY的构建提供信息；(目标2) 开发新的数据分析方法，用于MI-SMART中的纵向数据，以解决一套 关于MAISY结构的问题；(目标3)为MI-Smarts开发样本量计算器，以 使SUD/HIV实施科学家能够规划和计算不同类型MI的统计能力- 智能设计；以及(目标4)与传播和培训核心合作，传播已开发的 方法，以便于SUD/HIV科学家使用。这包括开发网络研讨会， 为SUD/HIV科学家举办的研讨会、教程和免费的用户友好软件。

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.