ORGANIZATIONAL CHANGE AND NICOTINE DEPENDENCE TREATMENT

组织变革和尼古丁依赖治疗

• 批准号: 7681745
• 负责人: Joseph R Guydish
• 金额: $ 6.97万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-01 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7681745
• 关键词: Adoption; Alcohol dependence; Attitude; Caring; Characteristics; Client; Clinic; Clinical; Clinical Trials; Complex; Control Groups; Data; Dimensions; Drug abuse; Educational Background; Exposure to; General Population; Goals; HIV; HIV Seropositivity; Health Care Costs; Health Knowledge, Attitudes, Practice; Individual; Intervention; Knowledge; Link; Maintenance; Measures; Morbidity - disease rate; Nicotine; Nicotine Dependence; Organizational Change; Patients; Provider; Rate; Readiness; Research; Resistance; Resources; Score; Screening procedure; Services; Smoke; Smoker; Substance abuse problem; Surveys; Testing; Time; Translational Research; cost; follow-up; improved; innovation; mortality; non-smoker; programs; response; treatment program

Alcohol dependent and HIV-positive individuals smoke at higher rates than the general population, and incur associated increases in smoking-related morbidity, mortality and healthcare costs. Substance abuse treatment and HIV care settings may be optimal venues for delivering nicotine dependence treatment, but structural and attitudinal barriers impede implementation. This Center component will investigate organizational changes that occur in clinics hosting each of the two TRC clinical trials of nicotine dependence treatment, compare observed changes with those in similar clinics not involved in the clinical trials, and assess maintenance of organizational change after the clinical trials are completed. Three clinics that host a TRC clinical trial of nicotine dependence treatment (intervention group) will be compared with two clinics that do not host a TRC clinical trial (control group) on staff knowledge, attitudes, and practices (KAP) related to nicotine dependence treatment. Data will be collected through a workforce survey conducted at each clinic at 4 time points: baseline, 18-months, 36-months and 45-months. The study will compare the KAP of individual service providers in the intervention clinics (n=77) with the KAP of those in the control clinics (n=43), with the hypotheses that clinical trial participation will produce increased knowledge of nicotine dependence and its treatment, more favorable attitudes towards nicotine dependence treatment, and improved clinical practices. This component extends the TRC clinical trials by assessing how the implementation of innovative client-level interventions may impact organizational-level attitudes and practices, and extends the scientific reach of the TRC into translational research. The long term goal is to improve the treatment of patients in complex settings by including organizational change to drive adoption of innovative interventions.

酒精依赖者和艾滋病毒阳性者的吸烟率高于一般人群，并导致与吸烟相关的发病率、死亡率和医疗费用的增加。药物滥用治疗和艾滋病毒护理机构可能是提供尼古丁依赖治疗的最佳场所，但结构和态度障碍阻碍了实施。该中心部分将调查主持两项 TRC 尼古丁依赖治疗临床试验的诊所发生的组织变化，将观察到的变化与未参与临床试验的类似诊所的变化进行比较，并评估组织的维持情况。 临床试验完成后发生变化。 举办尼古丁依赖治疗 TRC 临床试验的三个诊所（干预组）将与未举办 TRC 临床试验（对照组）的两家诊所在员工与尼古丁依赖治疗相关的知识、态度和实践 (KAP) 方面进行比较。数据将通过在每个诊所在 4 个时间点进行的劳动力调查来收集：基线、18 个月、36 个月和 45 个月。该研究将比较干预诊所 (n=77) 中个体服务提供者的 KAP 与对照诊所 (n=43) 中个体服务提供者的 KAP，并假设参与临床试验将增加对以下方面的了解： 尼古丁依赖及其治疗，对尼古丁依赖治疗持更有利的态度，并改进临床实践。 该部分通过评估创新客户层面干预措施的实施如何影响组织层面的态度和实践来扩展 TRC 临床试验，并将 TRC 的科学范围扩展到转化研究。长期目标是通过组织变革来推动创新干预措施的采用，从而改善复杂环境下患者的治疗。