An innovative platform and smartphone app to deliver tailored interventions and facilitate completed referrals related to substance use.

摘要 此快速通道SBIR建议的目标是提高患者对SBIRT相关建议的依从性 由初级保健提供者(PCP)为患者提供的服务。SBIRT的成功(筛查、短暂干预和 转诊到治疗)在初级保健环境中的患者通过 关于治疗转介建议，平均低至10%。由于各种原因，许多患者， 无论其具体疾病如何，都不要很好地遵守临床建议。一种改进的方法 坚持根据每个人的需求个性化推荐，特别是使用数字 技术，如应用程序。NIDA的目标是开发一个复杂的基于智能手机的工具来改进 因此，患者对SBIRT建议的随访是有充分理由的。 Chess Health已经开发了一个自动化数字工具(EIntervative)，需要关键元素 通过这个RFA。电子干预旨在鼓励患者遵守以下PCP建议 SBIRT。使用RFA所需的各种功能，电子干预旨在促进和激励 一旦患者被SBIRT确定为使用了某种物质，即可进入治疗 紊乱(SUD)或处于这样的风险中。电子干扰是商业上可用的，开发于 对客户的要求作出回应。但是，电子干预并不包含所要求的所有功能 NIDA在这个RFA中，我们没有数据来验证疗效。这样的验证对于支持Wide非常重要 传播传播。我们建议通过以下新功能来增强我们现有的电子干预解决方案 解决本RFA中提出的要求，并进行疗效的随机研究。 在第一阶段，我们的具体目标是评估我们提高对SBIRT依从性的计划的可行性 儿科医生对患者的建议。这一具体目标将通过两项任务实现： 任务1：向我们的原型添加满足RFA中概述的大多数需求的功能。 任务2：演示原型电子干预的可接受性、可行性和初步效果 改善患者与指定的后续专科SUD护理的联系和参与度。 如果证明是可行的，在第二阶段，我们的具体目标是评估接近商业质量的产品， 包含RFA所需的所有功能。具体目标将分两个阶段完成： 任务1：修改程序(1-3个月)。 任务2：随机临床试验，比较SBIRT/TAU和SBIRT/E干预的疗效。 成功标准：我们的目标是将目前的后续专科SUD护理比率提高一倍(例如，从~17%提高到 达标率~35%)，影响很大。所有患者，包括那些被确定为有风险的患者，必须 显示物质使用的减少。患者和初级保健医生必须对该计划进行平均3.5分的评分 5分利克特评分，衡量可用性、满意度和再次使用程序的意愿。

Abstract The goal of this fast-track SBIR proposal is to increase patient adherence to SBIRT-related recommendations given to patients by a primary care provider (PCP). The success of SBIRT (Screening, Brief Intervention, and Referral to Treatment) in the primary care setting has been inconsistent in terms of patients following through on treatment referral recommendations, with averages as low as 10%. For a variety of reasons, many patients, irrespective of their specific disease, do not adhere well to clinical recommendations. One way to improve adherence has been to personalize the recommendations for each individual’s needs, especially using digital technology, such as apps. The aim of NIDA to develop a sophisticated smart phone based tool for improving patient follow up to SBIRT recommendations is therefore well justified. CHESS Health has already developed an automated digital tool (eIntervention) with key elements requested by this RFA. eIntervention is designed to encourage patient adherence to PCP recommendations following SBIRT. Using a variety of the RFA required functionalities, eIntervention is designed to facilitate and motivate each patient to enter treatment, once that patient has been identified by SBIRT as having a substance use disorder (SUD) or as being at risk of such. eIntervention is commercially available and was developed in response to customer requests. However, eIntervention does not contain all of the functionalities requested by NIDA in this RFA and we do not have data to validate efficacy. Such validation is important for supporting wide spread dissemination. We propose to enhance our existing eIntervention solution with new functionalities that address the requirements set forth in this RFA and carry out a randomized study of efficacy. In Phase I, our Specific Aim is to evaluate feasibility of our program for improving adherence to SBIRT recommendations to patients from PCPs. This Specific Aim will be accomplished in two Tasks: Task 1: Add functionality to our prototype that address most requirements outlined in the RFA. Task 2: Demonstrate acceptability, feasibility, and preliminary efficacy of the prototype eIntervention in improving patient linkage to and engagement in indicated follow-up specialty SUD care. If shown to be feasible, in Phase II, our Specific Aim is to evaluate a near commercial quality product that contains all of the features required by the RFA. The Specific Aim will be accomplished in two Tasks: Task 1: Modifications to the program (months 1-3). Task 2: The randomized clinical trial to test efficacy of SBIRT/eIntervention compared to SBIRT/TAU. Criteria for Success: We aim to double the current rate of follow-up specialty SUD care (e.g. go from ~17% to an achieved rate of ~35%), a highly impactful effect. All patients, including those identified as at risk, must show a reduction in substance use. Patients and PCPs must rank the program with an average of 3.5 on a five-point Likert scale for usability, satisfaction, and willingness to use with the program again.