Implementing a patient navigation intervention across a health system to address treatment entry inequities

在整个卫生系统中实施患者导航干预,以解决治疗进入不平等问题

基本信息

  • 批准号:
    10812628
  • 负责人:
  • 金额:
    $ 94.68万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2023
  • 资助国家:
    美国
  • 起止时间:
    2023-09-30 至 2025-08-31
  • 项目状态:
    未结题

项目摘要

Project Summary/Abstract Opioid agonist treatment (OAT) is protective against overdose, yet less than 20% of people with opioid use disorder (OUD) engage in such treatment. Hospital utilization is high among people with OUD and can be a ‘reachable moment’ to initiate OAT. However, most hospitals lack the capacity to follow up with patients after discharge. Theory-based, empirically supported patient navigator (PN) interventions following hospital discharge reduce inequities in accessing community-based OAT by helping patients navigate complex systems of care. However, challenges persist in implementing PN interventions on a wide scale, as they require coordination across institutions, data sharing, dedicated personnel, and community resources. This is especially true in settings that reach diverse, resource-challenged communities. To bring these interventions to scale, strategies are needed to assess factors that influence PN implementation in hospitals to increase feasibility, reach, and sustainability. Testing innovative implementation strategies for PN interventions has the potential for significant impact, as it will demonstrate implementation success of an intervention that can address the opioid epidemic in real-world settings and close the research-to-practice translation gap. The proposed study is a type II hybrid implementation-effectiveness trial of Navigation Services To Avoid Rehospitalization (NavSTAR). Our research team showed in a single-site randomized trial with 400 participants that NavSTAR significantly increased OAT entry, reduced readmissions, and was highly cost- effective compared to treatment as usual. The present study will test an Implementation Facilitation (IF) strategy following Proctor’s conceptual model using an external facilitator and an internal local clinical champion to provide training, resources, and performance feedback to implement NavSTAR in four hospitals. We hypothesize that engaging stakeholders (including patients, clinicians, and community leaders) in an IF strategy will create and test an implementation process that is feasible, acceptable, and effective in expanding access to OAT post-discharge. The R61 phase will conduct process mapping to identify existing hospital workflow and then refine an IF strategy through sequential pilot trials at 4 hospital sites in preparation for the R33 phase. The team’s NavSTAR operations manual will be adapted to the sites to train the existing staff. R61 milestones include the creation of an implementation toolkit and data sharing agreements. During the R33 phase, we will conduct a type II hybrid-implementation-effectiveness trial (N=720) of NavSTAR using a randomized stepped-wedge design with augmented inverse probability weighting to compare outcomes pre- and post-implementation. This study will develop an effective IF strategy to increase the reach and sustainability of NavSTAR and provide a path to scale-up this intervention to address the opioid epidemic.
项目摘要/摘要 阿片类激动剂治疗(OAT)对过量用药有保护作用,但只有不到20%的阿片类药物使用者 失调症从事这样的治疗。医院利用率在有尿毒症的人中很高,可能是 “触手可及的时刻”来发起燕麦片。然而,大多数医院缺乏对患者进行事后随访的能力 出院。基于理论、经验支持的医院后患者导航仪(PN)干预 出院通过帮助患者在复杂的系统中导航来减少获得基于社区的OAT的不平等 关爱。然而,如所需,在大规模实施个人卫生干预措施方面仍然存在挑战 跨机构协调、数据共享、专职人员和社区资源。这是 尤其是在触及多元化、资源匮乏的社区的环境中。将这些干预措施带到 需要规模、策略来评估影响医院实施PN的因素以增加 可行性、覆盖范围和可持续性。测试PN干预的创新实施战略具有 可能产生重大影响,因为这将表明干预措施的实施成功, 解决现实世界中阿片类药物的流行问题,缩小研究与实践之间的翻译差距。这个 拟议的研究是一项第二类混合实施-导航服务有效性试验,以避免 再次住院(Navstar)。我们的研究团队在一项单一地点的随机试验中显示, 与会者表示,Navstar显著增加了燕麦片的入院人数,减少了再入院人数,并且成本高昂- 与常规治疗相比有效。本研究将测试执行便利化(IF) 遵循普罗科特概念模型的战略,使用外部促进者和内部本地临床 冠军提供培训、资源和绩效反馈,以便在四家医院实施Navstar。 我们假设在IF中让利益相关者(包括患者、临床医生和社区领袖)参与进来 战略将创建并测试可行、可接受且在扩展方面有效的实施流程 出院后获取燕麦片的途径。R61阶段将进行流程映射,以确定现有医院 工作流程,然后通过在4个医院站点进行顺序试点试验来细化IF策略,为 R33期。该小组的Navstar操作手册将根据这些地点进行调整,以培训现有工作人员。R61 里程碑包括创建执行工具包和数据共享协议。在R33期间 阶段,我们将进行Navstar的第二类混合实施有效性试验(N=720),使用 增加逆概率加权的随机步进楔形设计比较治疗前结果 和实施后。这项研究将制定有效的IF战略,以扩大覆盖范围并 Navstar的可持续性,并提供了一条扩大这一干预措施以应对阿片类药物流行的途径。

项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ monograph.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ sciAawards.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ conferencePapers.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ patent.updateTime }}

Karen Alexander其他文献

Karen Alexander的其他文献

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

{{ truncateString('Karen Alexander', 18)}}的其他基金

Mindfulness Based Stress Reduction Application for African American Caregivers
非裔美国护理人员基于正念的减压应用
  • 批准号:
    10325000
  • 财政年份:
    2021
  • 资助金额:
    $ 94.68万
  • 项目类别:
Mindfulness Based Stress Reduction App for African American Caregivers
针对非裔美国护理人员的基于正念的减压应用程序
  • 批准号:
    10760980
  • 财政年份:
    2021
  • 资助金额:
    $ 94.68万
  • 项目类别:

相似海外基金

WELL-CALF: optimising accuracy for commercial adoption
WELL-CALF:优化商业采用的准确性
  • 批准号:
    10093543
  • 财政年份:
    2024
  • 资助金额:
    $ 94.68万
  • 项目类别:
    Collaborative R&D
Investigating the Adoption, Actual Usage, and Outcomes of Enterprise Collaboration Systems in Remote Work Settings.
调查远程工作环境中企业协作系统的采用、实际使用和结果。
  • 批准号:
    24K16436
  • 财政年份:
    2024
  • 资助金额:
    $ 94.68万
  • 项目类别:
    Grant-in-Aid for Early-Career Scientists
Unraveling the Dynamics of International Accounting: Exploring the Impact of IFRS Adoption on Firms' Financial Reporting and Business Strategies
揭示国际会计的动态:探索采用 IFRS 对公司财务报告和业务战略的影响
  • 批准号:
    24K16488
  • 财政年份:
    2024
  • 资助金额:
    $ 94.68万
  • 项目类别:
    Grant-in-Aid for Early-Career Scientists
ERAMET - Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
ERAMET - 快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
  • 批准号:
    10107647
  • 财政年份:
    2024
  • 资助金额:
    $ 94.68万
  • 项目类别:
    EU-Funded
Assessing the Coordination of Electric Vehicle Adoption on Urban Energy Transition: A Geospatial Machine Learning Framework
评估电动汽车采用对城市能源转型的协调:地理空间机器学习框架
  • 批准号:
    24K20973
  • 财政年份:
    2024
  • 资助金额:
    $ 94.68万
  • 项目类别:
    Grant-in-Aid for Early-Career Scientists
Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
  • 批准号:
    10106221
  • 财政年份:
    2024
  • 资助金额:
    $ 94.68万
  • 项目类别:
    EU-Funded
Our focus for this project is accelerating the development and adoption of resource efficient solutions like fashion rental through technological advancement, addressing longer in use and reuse
我们该项目的重点是通过技术进步加快时装租赁等资源高效解决方案的开发和采用,解决更长的使用和重复使用问题
  • 批准号:
    10075502
  • 财政年份:
    2023
  • 资助金额:
    $ 94.68万
  • 项目类别:
    Grant for R&D
Engage2innovate – Enhancing security solution design, adoption and impact through effective engagement and social innovation (E2i)
Engage2innovate — 通过有效参与和社会创新增强安全解决方案的设计、采用和影响 (E2i)
  • 批准号:
    10089082
  • 财政年份:
    2023
  • 资助金额:
    $ 94.68万
  • 项目类别:
    EU-Funded
De-Adoption Beta-Blockers in patients with stable ischemic heart disease without REduced LV ejection fraction, ongoing Ischemia, or Arrhythmias: a randomized Trial with blinded Endpoints (ABbreviate)
在没有左心室射血分数降低、持续性缺血或心律失常的稳定型缺血性心脏病患者中停用β受体阻滞剂:一项盲法终点随机试验(ABbreviate)
  • 批准号:
    481560
  • 财政年份:
    2023
  • 资助金额:
    $ 94.68万
  • 项目类别:
    Operating Grants
Collaborative Research: SCIPE: CyberInfrastructure Professionals InnoVating and brOadening the adoption of advanced Technologies (CI PIVOT)
合作研究:SCIPE:网络基础设施专业人员创新和扩大先进技术的采用 (CI PIVOT)
  • 批准号:
    2321091
  • 财政年份:
    2023
  • 资助金额:
    $ 94.68万
  • 项目类别:
    Standard Grant
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了