MI-SMART: Methods for Optimizing Multilevel Adaptive Implementation Strategies to Promote the Adoption of Effective SUD and HIV Services

项目概要：项目1 药物使用障碍和艾滋病毒的循证预防、治疗和康复服务 由于在多个层面上的障碍，如缺乏时间和技能， 医生一级;在诊所一级缺乏支持或既定程序;或缺乏有效的技术 系统层面的工具、融资和政策。该项目的长期目标是开发一种新的 * 制定有效、可复制的多层次战略，在下列地区实施循证的可持续发展/艾滋病毒服务： 真实世界的环境，从而改善个人或有风险的SUD或艾滋病毒的结果。实现这一 长期目标，我们将：（目标1）制定多层次自适应实施的设计原则 指导如何最好地适应的战略（MAISY）（例如，增强、加强）执行战略， 多个级别的背景和需求（例如，临床，从业者）;并开发一种新的实验设计， 多水平实施序贯、多重分配、随机试验（MI-SMART），其中 随机化序列发生在多个级别上，以通知优化MAISY的构建;（目标2） 开发新的数据分析方法，用于MI-SMART中的纵向数据，以解决 （目标3）为MI-SMART开发样本量计算器， 使SUD/HIV实施科学家能够计划和计算不同类型MI的统计功效， （目标4）与传播和培训中心合作，传播已制定的 方法，以便它们可以很容易地应用于SUD/HIV科学家。这包括网络研讨会的发展， 研讨会，教程，和免费的，用户友好的软件，为SUD/HIV科学家。

PROJECT SUMMARY: PROJECT 1 Evidence-based prevention, treatment, and recovery services for substance use disorders (SUDs) and HIV often fail to be implemented or sustained due to barriers at multiple levels, such as lack of time and skills at the practitioner level; lack of support or established processes at the clinic level; or lack of effective technological tools, financing, and policies at the system level. The long-term goal of this project is to develop a new generation of effective, replicable multi-level strategies for implementing evidence-based SUD/HIV services in real-world settings, thus improving the outcomes of individuals with or at risk for SUD or HIV. To achieve this long-term goal, we will: (Aim 1) Develop principles for the design of Multi-level Adaptive Implementation Strategies (MAISYs) to guide how best to adapt (e.g., augment, intensify) implementation strategies based on the context and needs at multiple levels (e.g., clinic, practitioner); and develop a new experimental design—the Multi-level Implementation Sequential, Multiple Assignment, Randomized Trial (MI-SMART), in which sequences of randomizations occur at multiple levels—to inform the construction of optimized MAISYs; (Aim 2) Develop new data analysis methods for use with longitudinal data in an MI-SMART to address a suite of questions about the construction of a MAISY; (Aim 3) Develop sample size calculators for MI-SMARTs to enable SUD/HIV implementation scientists to plan and calculate statistical power for different types of MI- SMART designs; and (Aim 4) Work with the Dissemination and Training Core to disseminate the developed methods so that they can be readily applied by SUD/HIV scientists. This includes the development of webinars, workshops, tutorials, and free, user-friendly software for SUD/HIV scientists.