Implementing contingency management in opioid treatment centers across New England: A hybrid type 3 trial
在新英格兰各地的阿片类药物治疗中心实施应急管理:一项混合 3 型试验
基本信息
- 批准号:10665470
- 负责人:
- 金额:$ 72.23万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-08-01 至 2024-07-31
- 项目状态:已结题
- 来源:
- 关键词:AbstinenceAchievementAddressAdoptionBehavior TherapyBehavioralBiologicalClimateCluster randomized trialCombined Modality TherapyCompetenceComputerized Medical RecordCoupledDataData CollectionEducational workshopEffectivenessElementsEpidemicEvidence based practiceExperimental DesignsFDA approvedFeedbackFormulationFundingGoalsHybridsIncentivesKnowledgeLeadershipLearningLettersMeasurementMeasuresMediatingMethodsModelingMotivationNational Institute of Drug AbuseNew EnglandOpioidOutcomeOutcome StudyPatient Outcomes AssessmentsPatient Self-ReportPatient-Focused OutcomesPatientsPerformancePharmaceutical PreparationsPharmacological TreatmentPharmacotherapyPhasePilot ProjectsPlacebosProceduresPsychological reinforcementPublic HealthQuality of CareRandomizedResearchRewardsSamplingSiteTechnology TransferTestingTimeTrainingUnited StatesUnited States National Institutes of HealthUnited States Substance Abuse and Mental Health Services AdministrationUrineWorkaddictionbaseblindcommunity settingcontingency managementdesigneffectiveness testingevidence baseexperimental studyfollow-upimplementation barriersimplementation effortsimplementation evaluationimplementation measuresimplementation outcomesimplementation strategyimprovedimproved outcomeinnovationnovelnovel strategiesopioid overdoseopioid use disorderoverdose deathpilot trialpractice settingpublic health emergencypublic health relevanceresponsetreatment centertrial comparinguptake
项目摘要
Project Description
Overdoses and deaths due to opioid use disorders (OUDs) have been declared a public health emergency in
the United States, bringing to light an urgent need for highly effective OUD treatments. There are currently five
FDA-approved medication formulations, which relative to placebo have demonstrated effectiveness in helping
patients attain abstinence from opioids. Nonetheless, patients' opioid abstinence rates are sub-optimal: even
when treated with the newest extended-release formulations only about 40% of patients maintain abstinence
during the first 6-months of treatment. Contingency management (CM; i.e., motivational incentives for
achieving pre-defined treatment goals) is one of the only behavioral interventions shown to improve patient
abstinence from opioids when combined with FDA-approved pharmacotherapy. Unfortunately, however,
uptake of CM in OUD treatment centers remains low. In response to the urgent need for evidence-based
behavioral OUD treatments, we propose a large-scale type 3 hybrid trial comparing two comprehensive
strategies to promote CM implementation as an adjunct to pharmacotherapy within OUD centers. The control
condition is the staff training strategy used by the SAMHSA-funded network of Addiction Technology Transfer
Centers (ATTC; i.e., didactic workshop + performance feedback + staff coaching). The experimental condition
is the ATTC strategy enhanced by external leadership coaching (ELC; i.e., leadership coaching focused on
sustainment planning) and pay-for-performance (P4P; i.e., monetary bonuses for achieving pre-defined
implementation goals), which we refer to hereafter as E-ATTC. Elements of E-ATTC were informed by our
team's prior NIH-funded work evaluating organization-level implementation strategies. Using a cluster
randomized design, 30 OUD treatment centers across New England will be randomized to one of the two
implementation conditions (ATTC vs. E-ATTC) over the 5 year project. At each OUD treatment center, data will
be collected at multiple intervals from two CM staff (n=60), two organizational leaders (n=60), and 25 newly
admitted patients (n=750). Additionally, 25 patient charts per center (n=750) will be randomly selected for
review to examine sustainment. Data collection will use rigorous, replicable procedures including electronic
medical record review, ratings of audio recordings by staff blind to condition, well-validated measures, and
biological verification of abstinence. Specific Aims of the study are to experimentally compare the effect of the
two conditions on implementation outcomes (Primary Aim) and on patient outcomes (Secondary Aim). An
Exploratory Aim is to test whether two organization-level variables (i.e., implementation climate, leadership
engagement) partially mediate the relationship between implementation condition and the key study outcomes.
Achievement of the Study Aims will address critical public health needs by (a) informing how evidence-based
practice is implemented in OUD treatment centers, (b) improving the outcomes of OUD patients on
pharmacotherapy, and (c) advancing knowledge about why and how implementation strategies work.
项目说明
年,阿片类药物使用障碍(ODS)导致的过量和死亡已被宣布为公共卫生紧急情况
美国,揭示了对高效OUD治疗的迫切需求。目前有五个
FDA批准的药物配方,相对于安慰剂,已证明在帮助
患者获得阿片类药物的戒断。尽管如此,患者的阿片类药物戒断率并不理想:甚至
当使用最新的缓释制剂治疗时,只有大约40%的患者保持禁欲
在治疗的前6个月。应急管理(CM;即激励激励
实现预先定义的治疗目标)是仅有的可改善患者的行为干预措施之一
与FDA批准的药物治疗相结合时,戒除阿片类药物。然而,不幸的是,
乌德治疗中心对CM的摄取率仍然很低。为了应对以证据为基础的迫切需要
我们提出了一项大规模的3型杂交试验,比较了两种全面的
促进将中药作为药物治疗的辅助手段在大学中心内实施的策略。该控件
条件是SAMHSA资助的成瘾技术转移网络使用的工作人员培训战略
中心(ATTC;即教学研讨会+绩效反馈+员工培训)。实验条件
ATTC战略是否通过外部领导培训(ELC;即专注于以下方面的领导培训
维持规划)和绩效工资(P4P;即实现预定目标的货币奖金
实施目标),以下我们将其称为E-ATTC。E-ATTC的要素由我们的
团队之前由美国国立卫生研究院资助的工作,评估组织级别的实施战略。使用集群
随机设计,新英格兰的30个OUD治疗中心将随机分为两个
五年项目的实施条件(ATTC与E-ATTC)。在每个OUD治疗中心,数据将
以多个间隔从两名CM工作人员(n=60)、两名组织领导人(n=60)和25名新员工那里收集
住院患者750例。此外,每个中心(n=750)将随机选择25个患者图表用于
审查以检查维持情况。数据收集将使用严格的、可复制的程序,包括电子
医疗记录审查,对状况视而不见的工作人员对录音的评级,经过充分验证的措施,以及
禁欲的生物验证。这项研究的具体目的是通过实验比较
实施结果(主要目标)和患者结果(次要目标)的两个条件。一个
探索性目标是测试两个组织级别的变量(即实施环境、领导力
参与)部分调节了实施条件和关键研究结果之间的关系。
研究目标的实现将通过以下方式解决关键的公共卫生需求:(A)告知如何以证据为基础
在乌德治疗中心实施实践,(B)改善乌德患者的预后
药物疗法,以及(C)增进关于执行战略为什么和如何奏效的知识。
项目成果
期刊论文数量(7)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Sustainment of Contingency Management within Opioid Treatment Programs: COVID-Related Barriers and Innovative Workflow Adaptations.
阿片类药物治疗计划中应急管理的维持:与新冠病毒相关的障碍和创新工作流程调整。
- DOI:10.1016/j.dadr.2021.100003
- 发表时间:2021
- 期刊:
- 影响因子:0
- 作者:Becker,SaraJ;Bowen,CaitlynA;Reed,EllainaN;Lang,Sharon;Correia,Nicholas;Yermash,Julia;Yap,KimberlyR;Rash,CarlaJ;Garner,BryanR
- 通讯作者:Garner,BryanR
Virtual Training Is More Cost-Effective Than In-Person Training for Preparing Staff to Implement Contingency Management.
在培训员工实施应急管理方面,虚拟培训比面对面培训更具成本效益。
- DOI:10.1007/s41347-022-00283-1
- 发表时间:2022-10-12
- 期刊:
- 影响因子:0
- 作者:
- 通讯作者:
Early COVID-Related pandemic impacts and subsequent opioid outcomes among persons receiving medication for opioid use disorder: a secondary data analysis of a Type-3 hybrid trial.
- DOI:10.1186/s13722-023-00409-7
- 发表时间:2023-09-13
- 期刊:
- 影响因子:3.7
- 作者:Janssen, Tim;Garner, Bryan R.;Yermash, Julia;Yap, Kimberly R.;Becker, Sara J.
- 通讯作者:Becker, Sara J.
Impacts of the COVID-19 pandemic on healthcare access among patients receiving medication for opioid use disorder.
- DOI:10.1016/j.drugalcdep.2021.108617
- 发表时间:2021-04-01
- 期刊:
- 影响因子:4.2
- 作者:Jacka BP;Janssen T;Garner BR;Yermash J;Yap KR;Ball EL;Hartzler B;Becker SJ
- 通讯作者:Becker SJ
Project MIMIC (Maximizing Implementation of Motivational Incentives in Clinics): A cluster-randomized type 3 hybrid effectiveness-implementation trial.
- DOI:10.1186/s13722-021-00268-0
- 发表时间:2021-10-12
- 期刊:
- 影响因子:3.7
- 作者:Becker SJ;Murphy CM;Hartzler B;Rash CJ;Janssen T;Roosa M;Madden LM;Garner BR
- 通讯作者:Garner BR
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Sara J. Becker其他文献
Evaluation of sex disparities in opioid use among ED patients with sickle cell disease, 2006-2015.
2006-2015 年镰状细胞病 ED 患者阿片类药物使用性别差异的评估。
- DOI:
- 发表时间:
2021 - 期刊:
- 影响因子:3.6
- 作者:
T. Wilson;Shih;Sara J. Becker;J. Schuur;F. Beaudoin - 通讯作者:
F. Beaudoin
Randomized Clinical Trials in Behavioral Medicine
行为医学随机临床试验
- DOI:
10.1007/978-0-387-93826-4_5 - 发表时间:
2018 - 期刊:
- 影响因子:0
- 作者:
K. Freedland;Sara J. Becker;J. Blumenthal - 通讯作者:
J. Blumenthal
Interventions for Substance Use Disorders in Adolescents: A Systematic Review
青少年药物使用障碍的干预措施:系统评价
- DOI:
- 发表时间:
2020 - 期刊:
- 影响因子:0
- 作者:
D. Steele;Sara J. Becker;Kristin J. Danko;E. Balk;I. Saldanha;G. Adam;S. Bagley;C. Friedman;A. Spirito;Kelli Scott;E. Ntzani;Imani Saeed;Bryant T. Smith;J. Popp;T. Trikalinos - 通讯作者:
T. Trikalinos
Proceedings of the 13th annual conference of INEBRIA
- DOI:
10.1186/s13722-016-0062-9 - 发表时间:
2016-09-01 - 期刊:
- 影响因子:3.200
- 作者:
Rod Watson;James Morris;John Isitt;Pablo Barrio;Lluisa Ortega;Antoni Gual;Kenneth Conner;Tracy Stecker;Stephen Maisto;Sophie Paroz;Caroline Graap;Véronique S Grazioli;Jean-Bernard Daeppen;Susan E Collins;Nicolas Bertholet;Jennifer McNeely;Vlad Kushnir;John A. Cunningham;Iain K Crombie;Kathryn B Cunningham;Linda Irvine;Brian Williams;Falko F Sniehotta;John Norrie;Ambrose Melson;Claire Jones;Andrew Briggs;Peter Rice;Marcus Achison;Andrew McKenzie;Elena Dimova;Peter W Slane;Véronique S. Grazioli;Susan E. Collins;Sophie Paroz;Caroline Graap;Jean-Bernard Daeppen;Stéphanie Baggio;Marc Dupuis;Joseph Studer;Gerhard Gmel;Molly Magill;Véronique S. Grazioli;Robert J. Tait;Lucinda Teoh;Erin Kelty;Elizabeth Geelhoed;David Mountain;Gary K. Hulse;Elina Renko;Shannon G. Mitchell;David Lounsbury;Zhi Li;Robert P. Schwartz;Jan Gryczynski;Arethusa S. Kirk;Marla Oros;Colleen Hosler;Kristi Dusek;Barry S. Brown;Deborah S. Finnell;Aisha Holloway;Li-Tzy Wu;Geetha Subramaniam;Gaurav Sharma;Sara Wallhed Finn;Sven Andreasson;Robert D. Dvorak;Matthew P. Kramer;Brittany L. Stevenson;Emily M. Sargent;Tess M. Kilwein;Sion K. Harris;Lon Sherritt;Sarah Copelas;John R. Knight;Noreen D Mdege;Jim McCambridge;Gallus Bischof;Anja Bischof;Jennis Freyer-Adam;Hans-Juergen Rumpf;Niamh Fitzgerald;Lisa Schölin;Paul Toner;Jan R. Böhnke;Laura J. Veach;Olivia Currin;Leigh Z. Dongre;Preston R. Miller;Elizabeth White;Emily C. Williams;Gwen T. Lapham;Jennifer J. Bobb;Anna D. Rubinsky;Sheryl L. Catz;Susan Shortreed;Kara M. Bensley;Katharine A. Bradley;Joanna Milward;Paolo Deluca;Zarnie Khadjesari;Rod Watson;Stephanie Fincham-Campbell;Colin Drummond;Kathryn Angus;Linda Bauld;Sophie Baumann;Katja Haberecht;Inga Schnuerer;Christian Meyer;Hans-Jürgen Rumpf;Ulrich John;Beate Gaertner;Marion Barrault-Couchouron;Marion Béracochéa;Vincent Allafort;Valérie Barthélémy;Hervé Bonnefoi;Emmanuel Bussières;Véronique Garguil;Marc Auriacombe;Marianne Saint-Jacques;Michel Dorval;Katia M’Bailara;Lidia Segura-Garcia;Nuria Ibañez-Martinez;Juan Manuel Mendive-Arbeloa;Manel Anoro-Perminger;Pako Diaz-Gallego;Mª Angeles Piñar-Mateos;Joan Colom-Farran;Marianthi Deligianni;Bertrand Yersin;Angeline Adam;Constance Weisner;Felicia Chi;Wendy Lu;Stacy Sterling;Kevin L. Kraemer;Kathleen A. McGinnis;David A. Fiellin;Melissa Skanderson;Adam J. Gordon;Jonathan Robbins;Susan Zickmund;P. Todd Korthuis;E. Jennifer Edelman;Nathan B. Hansen;Christopher J. Cutter;James Dziura;Lynn E. Fiellin;Patrick G. O’Connor;Stephen A. Maisto;Roger Bedimo;Cynthia Gilbert;Vincent C. Marconi;David Rimland;Maria Rodriguez-Barradas;Michael Simberkoff;Amy C. Justice;Kendall J. Bryant;Anne H Berman;Gillian W Shorter;Jeremy W Bray;Carolina Barbosa;Magnus Johansson;Reid Hester;William Campbell;Maria Lucia O. Souza Formigoni;André Luzi Monezi Andrade;Laisa Marcorela Andreoli Sartes;Christopher Sundström;Niels Eék;Martin Kraepelien;Viktor Kaldo;Claudia Fahlke;Lynn Hernandez;Sara J. Becker;Richard N. Jones;Hannah R. Graves;Anthony Spirito;Silke Diestelkamp;Lutz Wartberg;Nicolas Arnaud;Rainer Thomasius;Jacques Gaume;Véronique Grazioli;Cristiana Fortini;Zelra Malan;Bob Mash;Katherine Everett-Murphy;Véronique S. Grazioli;Joseph Studer;M. Mohler-Kuo;Nicolas Bertholet;Gerhard Gmel;Lawrence Doi;Helen Cheyne;Ruth Jepson;Vanesa Luna;Leticia Echeverria;Silvia Morales;Teresa Barroso;Ângela Abreu;Cosma Aguiar;Duncan Stewart;Angela Abreu;Riany M. Brites;Rafael Jomar;Gerson Marinho;Pedro Parreira;J. Paul Seale;J. Aaron Johnson;Dena Henry;Sharon Chalmers;Freida Payne;Linda Tuck;Akula Morris;Cátia Gonçalves;Bettina Besser;Cristina Casajuana;Hugo López-Pelayo;María Mercedes Balcells;Lídia Teixidó;Laia Miquel;Joan Colom;Kimberly A. Hepner;Katherine. J. Hoggatt;Andy Bogart;Susan. M. Paddock;Sarah L Hardoon;Irene Petersen;Fiona L Hamilton;Irwin Nazareth;Ian R. White;Louise Marston;Paul Wallace;Christine Godfrey;Elizabeth Murray;Hana Sovinová;Ladislav Csémy - 通讯作者:
Ladislav Csémy
“Sounds like CSI:” How consumers of adolescent substance use disorder treatment perceive the term “evidence-based practice”
“听起来像犯罪现场调查:”青少年物质使用障碍的消费者如何看待“循证实践”一词的治疗
- DOI:
- 发表时间:
2015 - 期刊:
- 影响因子:3.7
- 作者:
Sara J. Becker;Miriam M Midoun;A. Spirito - 通讯作者:
A. Spirito
Sara J. Becker的其他文献
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{{ truncateString('Sara J. Becker', 18)}}的其他基金
HD2A RASC-SUD Implementation Support Core
HD2A RASC-SUD 实施支持核心
- 批准号:
10596437 - 财政年份:2022
- 资助金额:
$ 72.23万 - 项目类别:
HD2A RASC-SUD Implementation Support Core
HD2A RASC-SUD 实施支持核心
- 批准号:
10708983 - 财政年份:2022
- 资助金额:
$ 72.23万 - 项目类别:
C-DIAS RP 2: Implementing contingency management for stimulant use in specialty addiction treatment organizations
C-DIAS RP 2:在专业成瘾治疗组织中实施兴奋剂使用应急管理
- 批准号:
10668488 - 财政年份:2022
- 资助金额:
$ 72.23万 - 项目类别:
C-DIAS RP 2: Implementing contingency management for stimulant use in specialty addiction treatment organizations
C-DIAS RP 2:在专业成瘾治疗组织中实施兴奋剂使用应急管理
- 批准号:
10493960 - 财政年份:2022
- 资助金额:
$ 72.23万 - 项目类别:
Improving Outcomes of Adolescents in Residential Substance use Treatment via a Technology-Assisted Parenting Intervention
通过技术辅助育儿干预改善青少年住宅药物滥用治疗的结果
- 批准号:
10666175 - 财政年份:2021
- 资助金额:
$ 72.23万 - 项目类别:
Neighborhood perceptions and response to a technology-assisted parenting intervention for youth substance use
社区对针对青少年药物滥用的技术辅助育儿干预的看法和反应
- 批准号:
10836689 - 财政年份:2021
- 资助金额:
$ 72.23万 - 项目类别:
Implementing contingency management in opioid treatment centers across New England: A hybrid type 3 trial
在新英格兰各地的阿片类药物治疗中心实施应急管理:一项混合 3 型试验
- 批准号:
10400426 - 财政年份:2018
- 资助金额:
$ 72.23万 - 项目类别:
Implementing contingency management in opioid treatment centers across New England: A hybrid type 3 trial
在新英格兰各地的阿片类药物治疗中心实施应急管理:一项混合 3 型试验
- 批准号:
10215461 - 财政年份:2018
- 资助金额:
$ 72.23万 - 项目类别:
Adolescents with Substance Use Disorders Transitioning from Residential Treatment to the Community: Improving Outcomes via a Computer Assisted Parenting Program
患有药物滥用障碍的青少年从住院治疗过渡到社区:通过计算机辅助育儿计划改善治疗结果
- 批准号:
9034960 - 财政年份:2016
- 资助金额:
$ 72.23万 - 项目类别:
Adolescents with Substance Use Disorders Transitioning from Residential Treatment to the Community: Improving Outcomes via a Computer Assisted Parenting Program
患有药物滥用障碍的青少年从住院治疗过渡到社区:通过计算机辅助育儿计划改善治疗结果
- 批准号:
9263967 - 财政年份:2016
- 资助金额:
$ 72.23万 - 项目类别:
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Meta-Analysis of the Instructional-Relational Model of Student Engagement and Math Achievement: A Moderation and Mediation Approach
学生参与度和数学成绩的教学关系模型的元分析:一种调节和中介方法
- 批准号:
2300738 - 财政年份:2023
- 资助金额:
$ 72.23万 - 项目类别:
Standard Grant
Improving maths achievement in children with speech, language, and communication needs through 'collaborative vocabulary teaching'
通过“协作词汇教学”提高有言语、语言和交流需求的儿童的数学成绩
- 批准号:
2890475 - 财政年份:2023
- 资助金额:
$ 72.23万 - 项目类别:
Studentship
HSI Institutional Transformation Project: Retention and Achievement for Introductory STEM English Learners (RAISE)
HSI 机构转型项目:STEM 英语入门学习者的保留和成就 (RAISE)
- 批准号:
2225178 - 财政年份:2023
- 资助金额:
$ 72.23万 - 项目类别:
Continuing Grant