Leveraging virtual care strategies to improve access and treatment for individuals with alcohol use disorders
利用虚拟护理策略来改善酒精使用障碍患者的获取和治疗
基本信息
- 批准号:10615089
- 负责人:
- 金额:$ 70.19万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-05-01 至 2027-02-28
- 项目状态:未结题
- 来源:
- 关键词:AddressAdministratorAdoptionAdultAfrican AmericanAfrican American populationAlcohol consumptionAlcoholsBlack PopulationsBlack raceCOVID-19CaringChronicChronic CareClinicCognitive TherapyCommunitiesCoping SkillsCost MeasuresDataEnrollmentEthnic OriginFutureHealthHealth Services AccessibilityHealth systemHealthcare SystemsHeavy DrinkingImprove AccessIndividualInfrastructureInterventionInterviewLatinxLifeLocationMeasuresMediatorMental HealthModelingMotivationOutcomePatient-Focused OutcomesPatientsPersonsPharmaceutical PreparationsPhasePhototherapyPopulationPopulation HeterogeneityPsychotherapyPublic HealthRaceRandomizedReadinessReduce health disparitiesResource AllocationResourcesRisk FactorsSamplingSequential Multiple Assignment Randomized TrialStigmatizationSystemTelephoneTestingTherapeuticUnderrepresented PopulationsWomanWomen&aposs GroupWorkadaptive interventionaddictionalcohol abuse therapyalcohol use disorderbarrier to carecare deliverycare seekingcostdisparity reductiondrinkingeffectiveness/implementation trialefficacious treatmentevidence baseexperiencefuture implementationhealth care disparityhealth disparityhybrid type 1 designimplementation facilitatorsimprovedimproved outcomeinnovationmedical specialtiesmotivational enhancement therapynovelopioid misuseoutcome disparitiespatient engagementpatient populationpatient portalpreventrecruitreduced alcohol usesexsocial stigmasubstance usesuicidal risktelehealthtelephone sessiontheoriestreatment disparitytreatment programtrial designvideo sessionvirtualvirtual deliveryvirtual healthcare
项目摘要
Project Summary/Abstract
Despite the efficacy of psychotherapies, ~90% of people with alcohol use disorder (AUD) do not
receive treatment for this chronic condition and there are notable disparities in care. Access to and involvement
in efficacious AUD care is even lower for women, Black/African American individuals, and people from other
under-represented groups. Novel virtual care approaches (telephone, video, portal therapies) conceptually
rooted in efficacious therapies [e.g., motivational interviewing (MI), cognitive behavioral therapy (CBT)] and
theory can potentially improve treatment accessibility and appeal and reduce stigma. Virtual approaches have
had limited use in AUD care, recently increasing in COVID-19 to provide ongoing care (telephone/video
therapy) for current patients in specialty clinics, while treatment initiation remains low. There is an untapped
potential for virtual approaches to engage individuals across health systems, who otherwise do not receive
treatment, but could benefit. Virtual strategies, including telephone and video sessions and patient portals, are
promising for reaching and engaging substance-using populations, including under-represented individuals,
within health systems. Using a portal messaging system and phone calls to virtually engage patients in AUD
treatment outside of clinics and in their preferred locations is an innovative treatment model that can potentially
be implemented in health systems, but must be tested to inform broader dissemination.
We will use a sequential, multiple assignment randomized trial (SMART) to identify critical adaptive
intervention (AI) strategies for a virtually-delivered AUD engagement and care model. Adults with AUD (50%
women, 25% Black/African American, 5% Latinx) will be randomized to a 1st stage strategy for drinking
reduction and AUD care engagement integrating referral for AUD care: 1) a single telephone MI session (T-
engage), or 2) 4-weeks of a MI-focused portal messaging (P-engage). At 4 weeks, non-responders will be
randomized to a 2nd stage strategy: 1) step up to a video 8-session MI-CBT for AUD (phone delivery as
needed), or 2) continued 1st stage (i.e., 4 weeks of P-engage with greater depth, a second T-engage session
building on the first). Outcomes will be assessed at 4-, 8-, and 12-months. Aim 1 will compare 1st-stage
strategies (T-engage vs. P-engage) on alcohol outcomes and AUD treatment utilization. In Aim 2, among 1st-
stage non-responders, we will identify the most efficacious 2nd-stage strategy. Aim 3 includes an
implementation planning phase, with cost measures, and key stakeholder interviews and qualitative analysis of
barriers and facilitators to implementation and adoption of a virtual care model. Secondary aims include:
examining the moderating effects of race/ethnicity and sex on outcomes given our enriched sample and
examining the best sequence of AIs. Our proposed project will have high public health impact by evaluating a
novel virtual care model focused on increasing both treatment engagement and delivery that can be integrated
in health systems to increase AUD treatment appeal and accessibility and help address treatment disparities.
项目概要/摘要
尽管心理治疗有效,但约 90% 的酒精使用障碍 (AUD) 患者并没有
接受这种慢性病的治疗,并且护理方面存在显着差异。接触和参与
对于女性、黑人/非裔美国人和其他人来说,有效的 AUD 护理的比例甚至更低
代表性不足的群体。从概念上讲,新颖的虚拟护理方法(电话、视频、门户疗法)
植根于有效的疗法[例如动机访谈(MI)、认知行为疗法(CBT)]和
理论可以潜在地提高治疗的可及性和吸引力,并减少耻辱。虚拟方法有
在 AUD 护理中的使用有限,最近在 COVID-19 中增加以提供持续护理(电话/视频
治疗)目前在专科诊所的患者,但治疗启动率仍然很低。有一个未开发的
虚拟方法有可能让卫生系统中的个人参与进来,否则他们将无法接受
治疗,但可能会受益。虚拟策略,包括电话和视频会话以及患者门户,
承诺接触和吸引药物滥用人群,包括代表性不足的个人,
卫生系统内。使用门户消息系统和电话以虚拟方式让患者参与 AUD
在诊所外和他们喜欢的地点进行治疗是一种创新的治疗模式,有可能
在卫生系统中实施,但必须进行测试,以便为更广泛的传播提供信息。
我们将使用序贯、多重分配随机试验 (SMART) 来确定关键的适应性
虚拟交付的 AUD 参与和护理模型的干预 (AI) 策略。成人澳元 (50%
女性(25% 黑人/非裔美国人,5% 拉丁裔)将被随机分配到第一阶段饮酒策略
减少和 AUD 护理参与结合 AUD 护理转介:1) 一次电话 MI 会话 (T-
参与),或 2) 4 周以 MI 为中心的门户消息传递(P-engage)。 4 周后,无反应者将被
随机分配到第二阶段策略:1) 升级到 8 节视频 MI-CBT,费用为澳元(电话交付为
需要),或 2) 继续第一阶段(即 4 周更深度的 P-engage,第二次 T-engage 疗程)
建立在第一个的基础上)。结果将在 4 个月、8 个月和 12 个月时进行评估。目标 1 将比较第一阶段
关于酒精结果和 AUD 治疗利用率的策略(T-engage 与 P-engage)。在目标 2 中,第 1-
对于阶段无反应者,我们将确定最有效的第二阶段策略。目标 3 包括
实施规划阶段,包括成本衡量、关键利益相关者访谈和定性分析
实施和采用虚拟护理模式的障碍和促进因素。次要目标包括:
鉴于我们丰富的样本和结果,检查种族/民族和性别对结果的调节作用
检查 AI 的最佳序列。我们提出的项目将通过评估对公共健康产生重大影响
新颖的虚拟护理模式专注于增加可集成的治疗参与度和交付
提高 AUD 治疗的吸引力和可及性,并帮助解决治疗差异。
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)
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Erin E. Bonar其他文献
Daily patterns of substance use and sexual behavior among urban adolescents and emerging adults
- DOI:
10.1016/j.drugalcdep.2015.07.982 - 发表时间:
2015-11-01 - 期刊:
- 影响因子:
- 作者:
Erin E. Bonar;Maureen Walton;Elizabeth Austic;Frederic Blow;Brenda M. Booth;Anne Buu;R.M. Cunningham - 通讯作者:
R.M. Cunningham
Risky sexual behavior in Veterans seeking substance use and mental health treatment
- DOI:
10.1016/j.abrep.2024.100572 - 发表时间:
2024-12-01 - 期刊:
- 影响因子:
- 作者:
Joseph W. Tu;Rachael J. Shaw;Autumn Rae Florimbio;Kaitlyn McCarthy;Erin E. Bonar;Stephen T. Chermack;Jamie J. Winters;Maureen A. Walton;Minden B. Sexton - 通讯作者:
Minden B. Sexton
Transactional sex among an emergency department sample: Exploring gender, substance abuse and HIV risk
- DOI:
10.1016/j.drugalcdep.2014.02.480 - 发表时间:
2014-07-01 - 期刊:
- 影响因子:
- 作者:
Rikki Patton;F.C. Blow;Amy S. Bohnert;Erin E. Bonar;K.L. Barry;M.A. Walton - 通讯作者:
M.A. Walton
Energy drink use by adolescents and emerging adults seeking care in the emergency department: Alcohol, drugs, and other risk behaviors
- DOI:
10.1016/j.drugalcdep.2014.09.081 - 发表时间:
2015-01-01 - 期刊:
- 影响因子:
- 作者:
Erin E. Bonar;Rebecca M. Cunningham;Svitlana Polshkova;Stephen T. Chermack;Frederic C. Blow;Maureen A. Walton - 通讯作者:
Maureen A. Walton
Including Community Partners in the Development and Adaptation of Intervention Strategies to Prevent Initiation or Escalation of Opioid Misuse
- DOI:
10.1007/s11121-023-01575-5 - 发表时间:
2023-08-01 - 期刊:
- 影响因子:2.700
- 作者:
Rebecca Perry;Elvira Elek;Elizabeth D’Amico;Daniel Dickerson;Kelli Komro;Maureen Walton;Erin Becker Razuri;Amy M. Yule;Juli Skinner;Tyra Pendergrass;Kaitlyn Larkin;Carrie Johnson;Erin E. Bonar;Barbara A. Oudekerk;Sara Hairgrove;Shirley Liu;Phillip Graham - 通讯作者:
Phillip Graham
Erin E. Bonar的其他文献
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{{ truncateString('Erin E. Bonar', 18)}}的其他基金
Leveraging virtual care strategies to improve access and treatment for individuals with alcohol use disorders
利用虚拟护理策略来改善酒精使用障碍患者的获取和治疗
- 批准号:
10369287 - 财政年份:2022
- 资助金额:
$ 70.19万 - 项目类别:
Harnessing telemedicine to improve alcohol use disorder outcomes in primary care patients
利用远程医疗改善初级保健患者酒精使用障碍的结果
- 批准号:
10491370 - 财政年份:2021
- 资助金额:
$ 70.19万 - 项目类别:
Harnessing telemedicine to improve alcohol use disorder outcomes in primary care patients
利用远程医疗改善初级保健患者酒精使用障碍的结果
- 批准号:
10276367 - 财政年份:2021
- 资助金额:
$ 70.19万 - 项目类别:
Harnessing telemedicine to improve alcohol use disorder outcomes in primary care patients
利用远程医疗改善初级保健患者酒精使用障碍的结果
- 批准号:
10628012 - 财政年份:2021
- 资助金额:
$ 70.19万 - 项目类别:
Optimized Interventions to Prevent Opioid Use Disorder among Adolescents and Young Adults in the Emergency Department
预防急诊科青少年和年轻人阿片类药物使用障碍的优化干预措施
- 批准号:
10397259 - 财政年份:2021
- 资助金额:
$ 70.19万 - 项目类别:
Optimized Interventions to Prevent Opioid Use Disorder among Adolescents and Young Adults in the Emergency Department
预防急诊科青少年和年轻人阿片类药物使用障碍的优化干预措施
- 批准号:
10212539 - 财政年份:2019
- 资助金额:
$ 70.19万 - 项目类别:
A social media intervention for high-intensity drinking in a national sample of emerging adults
对全国新兴成年人样本中高强度饮酒的社交媒体干预
- 批准号:
10006494 - 财政年份:2019
- 资助金额:
$ 70.19万 - 项目类别:
A social media intervention for high-intensity drinking in a national sample of emerging adults
对全国新兴成年人样本中高强度饮酒的社交媒体干预
- 批准号:
10241460 - 财政年份:2019
- 资助金额:
$ 70.19万 - 项目类别:
Social Media Intervention for Cannabis Use in Emerging Adults
针对新兴成年人吸食大麻的社交媒体干预
- 批准号:
9788380 - 财政年份:2018
- 资助金额:
$ 70.19万 - 项目类别:
Drug Use and Sexual Risk Behaviors Among Emerging Adults in the ER
急诊室新成人的吸毒和性危险行为
- 批准号:
9317453 - 财政年份:2013
- 资助金额:
$ 70.19万 - 项目类别:
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