Training Clinicians in Implementation Research to Improve Alcohol-related Care

 描述(申请人提供)：布拉德利博士是设计和评估以患者为中心的、以证据为基础的医疗机构中酒精滥用护理的专家。她是团体健康研究所(GHRI)的研究员，也是华盛顿大学医学和卫生服务系的副教授。她也是退伍军人事务部(退伍军人事务部)普吉特湾医疗保健系统的副研究员。她进行了开创性的研究，旨在对初级保健中的高风险饮酒和酒精使用障碍(AUD)实施循证护理。她的成就包括在退伍军人管理局和非退伍军人管理局人群中验证3项AUDIT-C，并与退伍军人管理局的临床和质量领导者合作，在全国900多个退伍军人管理局地点实施酒精筛查和简短干预(BIS)。她现在已经扩大了她的重点，将AUDS的管理包括在初级保健中。Bradley博士目前资助的旨在改善与酒精相关的初级保健的研究包括：AUDS护士提供协作护理的SELECT试验(NIAAA R01)；在25个初级保健诊所实施酒精筛查和BIS以及AUDS共同决策的务实试验(AHRQ R18)；以及开发决策辅助支持初级保健提供者与其AUDS患者共同决策的研究(NIAAA R21)。指导经验和计划指导：布拉德利博士是一位杰出的导师，他成功地指导了28名职业生涯早期的临床医生研究人员。拟议的K24将允许她招募和指导10-15名早期临床医生研究人员，他们在5年期奖项期间致力于以患者为中心的酒精相关实施研究。职业发展：拟议的职业发展奖将支持Bradley博士实现3个职业目标：1)保持在医疗环境中与酒精相关的实施研究的前沿；2)开发新的专业知识，以实施和评估针对AUDS的“eHealth”干预措施--在线和移动健康计划--在初级保健中；以及3)指导医疗环境中与酒精相关研究的下一代创新者。研究：针对AUDS的新的电子健康干预措施正在快速开发，可能特别有利于不愿接受治疗的AUDS初级保健患者。然而，eHealth AUD计划在初级保健方面的有效性尚未得到测试。目标1将是设计一种战略，在初级保健中实施一个电子健康AUD项目--在线认知行为疗法(CBT)。目标2将评估我们在目标1中设计的在线CBT的实施策略。这项研究将支持Bradley博士和她的学员的培训，并为电子健康AUD计划在初级保健中的实际试验铺平道路。冲击力。拟议的职业奖项将使布拉德利博士能够在医疗环境中指导与酒精相关的创新实施研究的下一代领导者，同时扩大她的研究计划，以评估初级保健中AUDS的电子健康计划的有效性。

 DESCRIPTION (provided by applicant): Dr. Bradley is an expert in design and evaluation of patient-centered, evidence- based care for alcohol misuse in medical settings. She is an Investigator at Group Health Research Institute (GHRI) and Affiliate Professor of Medicine and Health Services at University of Washington. She is also an Associate Investigator at Veterans Affairs (VA) Puget Sound Health Care System. She has conducted groundbreaking research aimed at implementation of evidence-based care for risky drinking and alcohol use disorders (AUDs) in primary care. Her achievements include validation of the 3-item AUDIT-C in VA and non- VA populations and collaboration with clinical and quality leaders in the VA to implement alcohol screening and brief interventions (BIs) in over 900 VA sites nationwide. She has now expanded her focus to include management of AUDs in primary care. Dr. Bradley's currently funded studies aimed at improving alcohol- related primary care include: the CHOICE trial of nurse-delivered collaborative care for AUDs (NIAAA R01); a pragmatic trial of implementation of alcohol screening and BIs, and shared decision-making for AUDs, in 25 primary care clinics (AHRQ R18); and a study to develop a decision aid to support shared decision-making between primary care providers and their patients with AUDs (NIAAA R21). MENTORING EXPERIENCE and PLANNED MENTORING: Dr. Bradley is an outstanding mentor who has successfully mentored 28 early career clinician investigators. The proposed K24 will allow her to recruit and mentor 10-15 early-stage clinician researchers committed to patient-centered alcohol-related implementation research during the 5-year award. CAREER DEVELOPMENT: The proposed career award will support Dr. Bradley in achieving 3 career objectives: 1) to remain at the forefront of alcohol-related implementation research in medical settings; 2) to develop new expertise for implementing and evaluating "eHealth" interventions for AUDs-online and mobile health programs-in primary care; and 3) to mentor the next generation of innovators in alcohol-related research in medical settings. RESEARCH: New eHealth interventions for AUDs are being developed at a rapid rate and might especially benefit primary care patients with AUDs who are unwilling to enter treatment. However, the effectiveness of eHealth AUD programs in primary care is untested. Aim 1 will be to design a strategy for implementing one eHealth AUD program--online cognitive behavioral therapy (CBT)-in primary care. Aim 2 will be to evaluate the implementation strategy for online CBT that we design in Aim 1. This research will support Dr. Bradley and her mentees' training, as well as pave the way for pragmatic trials of eHealth AUD programs in primary care. IMPACT. The proposed career award will allow Dr. Bradley to mentor the next generation of leaders in innovative alcohol-related implementation research in medical settings, while expanding her research program to evaluate the effectiveness of eHealth programs for AUDs in primary care.