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

项目摘要/摘要 酒精滥用，包括酒精使用障碍(AUD)，存在于多达200万名住院的患者中 每年的重症监护病房(ICU)。ICU入院可能是一个“有教益的时刻”，许多ICU幸存者 有动力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在一起的范例 治疗无效。在利用ICU患者的动机方面唯一的挑战是酒精治疗 方案与急性护理环境是分开的。这份提案描述了为期两年的研究奖学金。 该计划将反复开发和试点关于ICU幸存者治疗的同行讲述的虚拟旅游 与澳大利亚大学合作，并将允许凯尔西·希尔斯-邓拉普博士在重症监护医学领域发展学术生涯。 拟议的研究计划将为患有澳门氏症的ICU幸存者开发第一个也是唯一一个虚拟干预 旨在增加酒精治疗的门槛，并将提供必要的研究技能，以促进希尔斯博士- 邓拉普朝着成为酒精健康服务和重症监护领域的独立调查员的目标前进 研究。该计划将包括一个由全国知名的当地居民组成的多学科团队的直接指导 酒精与危重疾病、健康行为改变、辅助决策和定性方法方面的专家。在……里面 此外，一个正式的研究咨询委员会将确保该提案的目标和基准 都相遇了。该项目还将包括临床科学、成瘾医学和医学决策方面的课程。 制作。这个连贯的项目将帮助希尔斯-邓拉普博士学习和应用多种研究方法，获得 对成瘾药物的基础知识，重点是AUD，并在开发和获得专业知识 为患有澳门氏症的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选择的交付方式 通过创建同行讲述的虚拟旅游原型，向患有澳元病的重症监护室幸存者提供帮助。提出治疗方案 以同行讲述的虚拟旅游形式的选项可能有助于克服急性护理之间的分离 环境和酒精治疗方案。希尔斯-邓拉普博士将通过首先进行半 对ICU幸存者进行结构化访谈，以确定旅行的内容。随后，她将 使用严格的开发和反馈流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)的成员，这是一种国家公认的成瘾 科罗拉多大学安舒茨医学院的治疗中心，并将为 可接受性。这将为NIAAA K23提交完成同行讲述的虚拟之旅铺平道路 在丹佛地区进行剩余的治疗选择，并进行务实的有效性研究。同辈叙事者 为患有AUD的ICU幸存者提供的虚拟旅行将有助于缩小大量患者的治疗差距 这是一个他们有独特动力去改变的时代。

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.