Multiple Behavior SBIRT Model of Drug Abuse Among Emerging Adults in Primary Care

本研究的主要目的是开发和评估一种创新的多重行为筛查、短暂干预和转诊治疗（MB-SBIRT）模型的有效性，该模型使用社会和自我形象来同时联系和减少处方和其他药物滥用以及其他共同发生的风险行为，这些行为发生在初级保健机构中，服务于种族和经济多样化的社区。这项研究的长期目标是成本有效地减少处方和非法药物滥用，以及酒精和烟草消费和艾滋病毒/艾滋病风险行为，并改善在干预研究和服务中经常被忽视的高风险新兴成年人的健康相关生活质量。新兴成人的处方、非法和合法药物消费量是全国所有年龄组中最高的。这项工作是建立在一个名为“行为-形象模型”（BIM）的新兴概念框架上的，该框架认为，针对突出的社会和自我形象的简短干预可以耦合并同时影响多种健康行为。拟议的研究将包括两个主要阶段。第一阶段将包括形成性研究活动，包括使用专家小组、目标受众调查和试点测试。将进行一项随机对照先导试验，以检验MB-SBIRT模式的两种社区友好型计算机技术交付形式对四家参与的初级保健诊所的年轻成年患者的可接受性、质量、可行性和短期（3个月）效果。将对所有医务人员进行培训，以提高对MB-SBIRT模式的接受度和利用率，并定期向医务人员提供关于感知患者质量、利用率和有效性的简短计算机生成总结报告，以提高参与的初级保健诊所拟议的SBIRT模式的可持续性。拟议研究设计和方法的第二阶段将涉及一项纵向随机临床试验（RCT），以评估修订后的MB-SBIRT模型的效果。这一阶段对于确定在佛罗里达州东北部不同社区参加初级卫生诊所的年轻人中创新型MB-SBIRT模式的短期（3个月）和长期（1年）有效性、成本和成本效益至关重要。第二阶段的研究还将确定基线药物使用、性别、种族和临床环境在两个随访数据收集点作为MB-SBIRT模型效应调节因子的作用。此外，我们建议评估社会和自我形象以及其他基于理论的风险因素在处方和非法药物使用和问题、酒精和烟草使用、艾滋病毒/艾滋病风险行为、与健康相关的生活质量以及在两个后续数据收集点寻求药物滥用和艾滋病毒/艾滋病治疗和检测的尝试方面的变化。项目

The primary purpose of this research is to develop and evaluate the effectiveness of an innovative multiple behavior screening, brief intervention and referral to treatment (MB-SBIRT) model using social and self-image to simultaneously link and reduce prescription and other drug abuse and other co-occurring risk behaviors among emerging adults in primary care settings serving racially and economically diverse communities. The long term objective of this research is to cost-effectively reduce prescription and illicit drug abuse, along with alcohol and tobacco consumption and HIV/AIDS risk behaviors, and improve health-related quality of life among high-risk emerging adults often ignored in intervention research and services. Emerging adults have the highest levels of prescription, illicit and licit drug consumption of any age group in the nation. This work is founded on an emerging conceptual framework titled the Behavior-Image Model (BIM), which posits that multiple health behaviors can be coupled and simultaneously influenced with brief interventions targeting salient social and self-images. The proposed research will involve two primary phases. The first phase will consist of formative research activities involving the use of expert panels, target audience surveys, and pilot testing. A randomized controlled pilot test will be conducted examining the acceptability, quality, feasibility, and short-term (3-month) effects of two community-friendly computer technology delivery formats of the MB-SBIRT model for young adult patients attending four participating primary care clinics. Training of all medical personnel will be conducted to increase acceptance and utilization of the MB-SBIRT model, and brief computer-generated summary reports on perceived patient quality, utilization and effectiveness will be provided to medical staff on a regular basis to enhance sustainability of the proposed SBIRT model within participating primary care clinics. The second phase of the proposed research design and methods will involve a longitudinal randomized clinical trial (RCT) of the effects of the revised MB-SBIRT model. This phase is essential to determining the short (3-month) and long-term (1-year) effectiveness, costs, and cost-effectiveness of the innovative MB-SBIRT model among young adults attending participating primary health clinics in diverse communities in northeast Florida. This second phase of research will also determine the role of baseline drug use, gender, race, and clinic setting as moderators of the MB-SBIRT model effects at both follow-up data collection points. In addition, we propose to evaluate social and self-image and other theory-based risk factors as mediators of change on prescription and illicit drug use and problems, alcohol and tobacco use, HIV/AIDS risk behaviors, health-related quality of life, and attempts to seek drug abuse and HIV/AIDS treatment and testing at both follow-up data collection points. Project