The STop UNhealthy Substance Use Now Trial (STUN II)

立即停止使用不健康物质试验 (STUN II)

• 批准号: 10829018
• 负责人: Daniel E Jonas
• 金额: $ 62.5万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10829018
• 关键词: STop; UNhealthy; Substance; Use; Now

Project Summary/Abstract Background: Substance use disorders (SUDs), which can involve illicit drugs, prescription drugs, or alcohol, are common and result in substantial morbidity and mortality. Unhealthy alcohol and substance use are among the leading causes of preventable deaths in the US, are increasing, and are among the top causes of the shortening life expectancy in the US. Screening for unhealthy substance use is recommended by the US Preventive Services Task Force and other national groups because it can lead to improved health outcomes, yet most primary care practices do not have a system to screen for and manage SUDs. Objectives: (1) to determine if practice facilitation (PF) can achieve rapid implementation of patient-centered outcomes research findings to improve screening for and management of SUDs in primary care and (2) to compare whether learning collaboratives (LC), performance incentives (PI), or their combination can significantly improve the implementation of screening for and management of SUDs in primary care compared with PF alone. Methods: The STop UNhealthy Substance Use Now trial (STUN II) is a multisite 2x2 randomized comparative effectiveness trial that will enroll 48 primary care practices. STUN II will evaluate the comparative effectiveness of the following strategies for the implementation of screening and evidence-based interventions for SUDs in primary care: PF, PF plus LC, PF plus PI, and PF+LC+PI. Assessments will be conducted throughout a 12- month intervention period and at a 12-month post-intervention follow up, to assess sustainment. In addition, a mixed methods evaluation will assess the association between implementation effectiveness and putative moderators (e.g., organizational readiness for change) and mediators (e.g., implementation climate). Potential Impact: The study will produce fundamentally important evidence about the comparative effectiveness of PF, PF plus LC, PF plus PI, and PF+LC+PI on uptake of evidence-based screening and interventions for SUD when delivered to primary care practices. It will also generate scientific knowledge about how contextual factors influence the effectiveness of the various approaches in promoting clinical practice and office systems changes in primary care settings. The results will inform health systems, policymakers, and primary care practices about optimal strategies for implementation of screening for and management of SUDs in primary care.

项目摘要/摘要 背景：可能涉及非法药物，处方药或酒精的药物使用障碍（SUD）， 很常见，并导致大量发病率和死亡率。不健康的酒精和用途 美国可预防死亡的主要原因正在增加，并且是造成的最大原因之一 缩短美国的预期寿命。美国建议筛查不健康的药物使用 预防服务工作队和其他民族团体，因为它可以改善健康成果， 但是，大多数初级保健实践都没有用于筛选和管理SUDS的系统。 目标：（1）确定实践促进（PF）是否可以快速实施以患者为中心 结果研究结果，以改善基层医疗中SUD的筛查和管理以及（2） 比较学习协作（LC），绩效激励措施（PI）还是它们的组合可以 相比 独自与PF。 方法：停止不健康的物质使用现在试验（Stun II）是多站点2x2随机比较 有效性试验将招募48种初级保健实践。 Stun II将评估比较有效性 以下策略，用于实施筛查和基于证据的SUD干预措施 初级保健：PF，PF Plus LC，PF Plus PI和PF+LC+PI。评估将在整个12- 每月干预期，并在干预后的12个月后进行跟进，以评估维持。另外， 混合方法评估将评估实施效率与推定之间的关联 主持人（例如，变革的组织准备就绪）和调解人（例如，实施气候）。 潜在影响：该研究将产生有关比较的根本重要证据 PF，PF Plus LC，PF Plus PI和PF+LC+PI的有效性在摄取基于证据的筛查和 用于提供初级保健实践的SUD干预措施。它还将产生有关的科学知识 上下文因素如何影响各种方法在促进临床实践和 办公系统在初级保健环境中的变化。结果将为卫生系统，决策者和 有关实施SUD筛查和管理的最佳策略的初级保健实践 在初级保健中。