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Dissemination of a MI-Based Preparatory Procedure

传播基于 MI 的准备程序

基本信息

批准号：
7456596
负责人：
KIMBERLY S. WALITZER
金额：
$ 38.53万
依托单位：
STATE UNIVERSITY OF NEW YORK AT BUFFALO
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-07-12 至 2011-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7456596
关键词：
Admission activity Adoption Alcohol or Other Drugs use Alcoholism Ambulatory Care Facilities Attention Characteristics Client Clinic Clinical Trials Communities Condition Controlled Clinical Trials Costs and Benefits Data Data Collection Early treatment Educational workshop Effectiveness Effectiveness of Interventions Frequencies Goals Heavy Drinking Hour Institute of Medicine (U.S.)Intervention Lead Length Licensing Manuals Measures Mechanics Monograph National Institute of Drug Abuse Nature New York Numbers Outcome Outpatients Principal Investigator Procedures Randomized Rate Relative (related person)Reporting Research Services Site Standards of Weights and Measures Substance abuse problem Techniques Therapeutic Time Training Translations Treatment outcome addiction alcohol abuse therapy base cohort cost cost effectiveness design efficacy trial health care service organization improved indexing interest motivational enhancement therapy programs research in practice skills therapy design treatment duration treatment program

项目摘要

DESCRIPTION (provided by applicant): In the research field, we have little understanding of how alcoholism treatment strategies, shown to be efficacious through controlled clinical trials, operate and function in "real world" conditions. The gap between research and practice in addictions treatment has recently drawn considerable attention (e.g., Institute of Medicine, 1998). For example, as has been the case with many techniques and therapeutic strategies, widespread translation of motivational interviewing (MI) techniques from clinical trials to use in community-based treatment clinics has not occurred. Clinical trials have demonstrated that a single, MI-based preparatory session at the onset of alcoholism treatment reduces premature termination from treatment. The present application seeks to study the dissemination and "real world" effectiveness of a MI-based preparatory procedure designed to reduce early attrition from alcoholism outpatient treatment. In order to study dissemination and adoption, 150 New York State Office of Alcoholism and Substance Abuse Services (OASAS) alcoholism outpatient clinics will be randomly assigned to one of three dissemination conditions: (1) on-site delivery of the training manuals with a one-hour introductory presentation, (2) the manuals with a four-hour basic workshop, or (3) the manuals with the four-hour workshop and a four-hour MI-technique specific training. Measures of adoption will focus on both clinician and programmatic adoption, will be multifaceted, and will include assessment of partial adoption and modified adoption. In order to study the effectiveness of the MI-based preparatory procedure, we propose to examine clinic sites' rates of early treatment attrition and client treatment outcome prior to dissemination and following dissemination. Specifically, two cohorts of OASAS admissions will be followed for 12 months, one cohort prior to dissemination, the second cohort after dissemination. These are collected from standard OASAS admission and discharge reports on all clients treated in OASAS-licensed clinics and will be available to the research team. The monetary costs associated with delivery of each of the three dissemination strategies will be determined. Cost-effectiveness indices will then be calculated by associating dissemination costs with outcome variables and then compared and contrasted between the three dissemination strategies. These data will provide valuable information to governmental bodies and health care organizations interested in disseminating the MI preparatory technique.

描述（由申请人提供）：在研究领域，我们对酒精中毒治疗策略如何在“真实的世界”条件下运作和发挥作用知之甚少，这些策略通过对照临床试验显示是有效的。成瘾治疗的研究和实践之间的差距最近引起了相当大的关注（例如，医学研究所，1998年）。例如，与许多技术和治疗策略一样，动机访谈（MI）技术从临床试验到社区治疗诊所的广泛翻译尚未发生。临床试验表明，在酒精中毒治疗开始时进行一次基于MI的预备会议可以减少治疗的过早终止。本申请寻求研究基于MI的准备过程的传播和“真实的世界”有效性，所述基于MI的准备过程被设计为减少来自酒精中毒门诊治疗的早期损耗。为了研究传播和采用，将150个纽约州酒精中毒和药物滥用服务办公室（OASAS）酒精中毒门诊诊所随机分配到三个传播条件之一：（1）现场提供培训手册，并提供一小时的介绍性介绍，（2）手册和四小时的基本讲习班，或（3）手册与四小时的研讨会和四小时的MI技术具体培训。采用措施将侧重于临床医生和程序采用，将是多方面的，并将包括部分采用和修改采用的评估。为了研究MI为基础的准备程序的有效性，我们建议检查诊所网站的早期治疗损耗率和客户端的治疗结果之前，传播和传播后。具体而言，将对两个OASAS入院队列进行为期12个月的随访，一个队列在传播前，第二个队列在传播后。这些是从标准OASAS入院和出院报告中收集的，这些报告是关于在OASAS许可诊所接受治疗的所有客户的，并将提供给研究小组。将确定与执行三项传播战略中的每一项战略有关的货币费用。然后将传播费用与结果变量联系起来计算成本效益指数，然后在三种传播战略之间进行比较和对照。这些数据将为有兴趣传播MI准备技术的政府机构和医疗保健组织提供有价值的信息。