Screening and Brief Intervention for Prescription Stimulant Misuse and Diversion: Refining and Piloting a Curriculum for College Health Providers

摘要 处方兴奋剂转移([PSD]，即共享、销售或交易处方兴奋剂)和 处方兴奋剂滥用([PSM]，即无处方使用、超过处方使用或用于 非医疗目的)是大学校园里相互关联和共同发生的问题。此外，PSD和 PSM并不局限于有兴奋剂处方的学生(Lam等人，2020；Garcia等人，2022)。因此， 有必要对这两种行为进行普遍的筛选和干预。先前的研究表明，大学 卫生服务提供者[CHP]担心PSM和PSD，但觉得他们缺乏应对策略的培训 这些行为(Loskutova等人，2020年)。因此，社区卫生专业人员是理想的培训和 实施PSM和PSD干预措施。为此，我们的团队开发了一项研究和理论- 有指导的PSM和PSD筛查和简短干预[SBI]课程将由社区卫生计划实施。 拟议的为期三年的R34研究的目的是让CHP和大学生参与炼油 以及试行履行机构，以解决私营部门和私营部门之间的矛盾。在完成启动活动后，提升内容有效性 面对有效性，我们提出了三项研究来实现我们的三个目标。在研究1中，地理位置不同的 从美国大学健康协会成员名录中招募的CHP样本将评估 课程内容的适当性和清晰度，以及对潜在实施的见解 障碍和克服障碍的策略。提供的反馈将用于改进现有的 试行测试之前的课程(目标1：通过让社区社区计划人员参与 开发过程)。试点测试将在一所不同大学的校园卫生中心完成 在PSD和PSM盛行的地方。学生将被随机分配到对照组、e-SBI或面对面的SBI 由训练有素的CHP提供。研究2将侧重于社区卫生计划；所有接受培训的社区卫生计划都将完成 对课程进行评价，执行履行机构的社区卫生计划将完成可行性指标， 可接受性和实施性(通过激励性访谈治疗诚信工具，定性 访谈和定量调查；目标2：试点试验的可行性、可接受性和实施 干预)。研究3将与研究2同时进行，重点将放在学生参与者身上。可接受性 将在参与(AIM 2)和对学生PSM的影响之后立即进行测量 将在一个月的随访中评估PSD的结果(目标3：评估 和PSD)。我们的目标是应用所获得的知识来提炼 可以广泛传播的课程。实现这一目标可以用来减少发病率和 病死率与PSM和PSD有关。 运用有关行为的基本知识来促进健康。

ABSTRACT Prescription stimulant diversion ([PSD] i.e., the sharing, selling, or trading of prescription stimulants) and prescription stimulant misuse ([PSM] i.e., use without a prescription, use in excess of a prescription, or use for nonmedical purposes) are inter-related and co-occurring problems on college campuses. In addition, PSD and PSM are not limited to students with a prescription for stimulants (Lam et al., 2020; Garcia et al., 2022). Thus, there is a need to universally screen and intervene upon both behaviors. Prior research has shown college health providers [CHPs] are concerned about PSM and PSD, yet feel they lack training in strategies to address these behaviors (Loskutova et al., 2020). As such, CHPs serve as ideal professionals for training and implementing PSM and PSD intervention efforts. To that end, our team has developed a research- and theory- guided PSM and PSD screening and brief intervention [SBI] curriculum to be implemented by CHPs. The purpose of the proposed, three-year, R34 study is to engage CHPs and college students in the refining and piloting of a SBI to address PSM and PSD. After completing start-up activities to promote content validity and face validity, we propose three studies to achieve our three aims. In Study 1, a geographically diverse sample of CHPs recruited from the American College Health Association member directory will assess the appropriateness and clarity of the curriculum content, as well as provide insights on potential implementation barriers and strategies to overcome barriers. The feedback provided will be used to refine the existing curriculum prior to pilot testing (AIM 1: Refine a novel PSM and PSD SBI curriculum by engaging CHPs in the development process). The pilot test will be completed at the campus health center of one diverse university where PSD and PSM are prevalent. Students will be randomized to control, e-SBI, or face-to-face SBI delivered by trained CHPs. Study 2 will focus on the CHPs; all CHPs who receive training will complete an evaluation of the curriculum, and CHPs who implement the SBI will complete indicators of feasibility, acceptability, and implementation (via the Motivational Interviewing Treatment Integrity tool, qualitative interview, and quantitative survey; AIM 2: Pilot test feasibility, acceptability, and implementation of the intervention). Study 3 will run concurrently with Study 2, and will focus on the student participants. Acceptability of the intervention will be measured immediately after participation (AIM 2) and impact on student PSM and PSD outcomes will be measured at one-month follow-up (AIM 3: Evaluate the short-term impact of the and PSD). Our goal is to apply the knowledge gained to refine a curriculum that can be widely disseminated. Attainment of this goal could be applied to reduce morbidity and mortality related to PSM and PSD. applying fundamental knowledge about behavior to promote health.