Development of a Novel Peer-Narrated Virtual Patient Decision Aid for Entry into Alcohol Treatment for ICU Survivors with Alcohol Misuse

项目总结/摘要 酒精滥用，包括酒精使用障碍（AUD），存在于多达200万的患者中， 重症监护室（ICU）每年。ICU入院可能是一个“可教的时刻”，许多ICU幸存者 都想改变他们的饮酒习惯不幸的是，目前将重症监护室幸存者与酒精联系起来的模式 治疗无效。利用ICU患者的动机的独特挑战是酒精治疗 项目与急性护理环境分离。该提案描述了一个为期2年的研究奖学金 该计划将反复开发和试点一个关于ICU幸存者治疗的同行叙述虚拟之旅 与澳元，并将允许博士凯尔西希尔斯邓拉普发展在重症监护医学的学术生涯。 拟议的研究计划将为患有AUD的ICU幸存者开发第一个也是唯一一个虚拟干预措施 旨在增加进入酒精治疗，并将提供必要的研究技能，以进一步博士。 邓拉普朝着她的目标，成为一个独立的调查员，在酒精健康服务和重症监护 research.该计划将包括来自全国知名的当地多学科团队的直接指导 酒精和危重病专家，健康行为改变，决策辅助和定性方法。在 此外，一个正式的研究咨询委员会将确保本提案的目标和基准 得到满足。该计划还将包括临床科学，成瘾医学和医疗决策的课程 制作。这个有凝聚力的计划将帮助希尔斯-邓拉普博士学习和应用多种研究方法， 成瘾医学的基础知识，重点是AUD，并获得专业知识的发展， 对患有AUD的ICU幸存者实施决策辅助。 这项提案的总体研究目标是优化酒精治疗方案的交付方式 通过创建一个同伴讲述的虚拟旅游原型，介绍治疗 以同行叙述的虚拟游览形式提供的选择可能有助于克服急性护理与 环境和酒精治疗方案。Hills-Dunlap博士将首先进行半- 对患有AUD的ICU幸存者进行结构化访谈，以确定参观的内容。随后，她将 使用严格的开发和反馈过程来创建同行讲述的虚拟旅游的视频原型 依赖，成瘾和康复中心（CeDAR），一个全国公认的成瘾 科罗拉多大学安舒茨医学院的治疗中心，并将试点原型， 可接受性这将为NIAAA K23提交完成同行讲述的虚拟图尔斯之旅铺平道路， 丹佛地区的剩余治疗方案，并进行务实的有效性研究。一个同行叙述的 AUD ICU幸存者的虚拟之旅将有助于缩小大量患者的治疗差距， 一个他们有独特动机去改变的时期。

Project Summary / Abstract Alcohol misuse, which includes alcohol use disorder (AUD), is present in up to 2 million patients admitted to an intensive care unit (ICU) each year. The ICU admission may be a “teachable moment” and many ICU survivors are motivated to change their drinking. Unfortunately, the current paradigm for linking ICU survivors to alcohol treatment is ineffective. The unique challenge in harnessing an ICU patient’s motivation is that alcohol treatment programs are separated from the acute care environment. This proposal describes a 2-year research fellowship program that will iteratively develop and pilot a peer-narrated virtual tour regarding treatment for ICU survivors with AUD and will allow Dr. Kelsey Hills-Dunlap to develop an academic career in Critical Care Medicine. The proposed research program will develop the first and only virtual intervention for ICU survivors with AUD aimed at increasing entry to alcohol treatment and will provide the research skills necessary to further Dr. Hills- Dunlap toward her goal of becoming an independent investigator in alcohol health services and critical care research. The program will consist of direct mentoring from a multidisciplinary team of nationally renowned local experts in alcohol and critical illness, health behavior change, decision aids, and qualitative methodology. In addition, a formalized research advisory committee will ensure that the goals and benchmarks of this proposal are met. The program will also include coursework in clinical sciences, addiction medicine and medical decision making. This cohesive program will help Dr. Hills-Dunlap learn and apply multiple research methods, acquire foundational knowledge of addiction medicine focusing on AUD, and gain expertise in the development and implementation of decision aids for ICU survivors with AUD. The overall research goal of this proposal is to optimize the way in which alcohol treatment options are delivered to ICU survivors with AUD through the creation of a peer-narrated virtual tour prototype. Presenting treatment options in the form of a peer-narrated virtual tour may help overcome the separation between the acute care environment and alcohol treatment programs. Dr. Hills-Dunlap will build this prototype by first conducting semi- structured interviews in ICU survivors with AUD to determine the content of the tour. Subsequently, she will use a rigorous process of development and feedback to create a video prototype of a peer-narrated virtual tour of the Center for Dependency, Addiction and Rehabilitation (CeDAR), a nationally recognized addiction treatment center at the University of Colorado Anschutz Medical Campus, and will pilot the prototype for acceptability. This will pave the way for a NIAAA K23 submission to complete peer-narrated virtual tours for the remaining treatment options in the Denver area and conduct a pragmatic effectiveness study. A peer-narrated virtual tour for ICU survivors with AUD would help to close the treatment gap for a large population of patients at a time when they are uniquely motivated to change.