Training Clinicians in Implementation Research to Improve Alcohol-related Care

 描述（由申请人提供）：布拉德利博士是设计和评价以患者为中心的循证医疗服务的专家。她是团体健康研究所（GHRI）的研究员，也是华盛顿大学医学和健康服务的副教授。她也是退伍军人事务部（VA）普吉特健全的医疗保健系统的副研究员。她进行了开创性的研究，旨在实施循证护理的风险饮酒和酒精使用障碍（AUD）在初级保健。她的成就包括在VA和非VA人群中验证3项AUDIT-C，并与VA的临床和质量领导者合作，在全国900多个VA站点实施酒精筛查和简短干预（BI）。她现在已经扩大了她的重点，包括在初级保健AUDs的管理。布拉德利博士目前资助的旨在改善酒精相关初级保健的研究包括：护士提供的合作护理AUD的选择试验（NIAAA R 01）;在25个初级保健诊所实施酒精筛查和BI以及AUD共同决策的务实试验（AHRQ R18）;以及一项研究，旨在开发一种决策辅助工具，以支持初级保健提供者及其AUD患者之间的共同决策（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名早期职业临床研究人员。拟议的K24将允许她招募和指导10-15名致力于以患者为中心的酒精相关实施研究的早期临床研究人员。职业发展：拟议的职业奖将支持布拉德利博士实现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最前沿; 2）开发新的专业知识，用于实施和评估初级保健中在线和移动的健康计划的“电子健康”干预措施; 3）指导下一代医疗环境中与酒精相关的研究创新者。研究人员：针对AUD的新电子健康干预措施正在快速开发，可能特别有利于不愿意接受治疗的AUD初级保健患者。然而，eHealth AUD计划在初级保健中的有效性未经测试。目标1将是设计一个战略，在初级保健中实施一个eHealth AUD计划-在线认知行为疗法（CBT）。目标2将是评估我们在目标1中设计的在线CBT的实施策略。这项研究将支持布拉德利博士和她的学员的培训，以及铺平道路的电子健康AUD计划在初级保健的务实试验。冲击拟议的职业奖将使布拉德利博士能够指导下一代领导人在医疗环境中创新酒精相关的实施研究，同时扩大她的研究计划，以评估电子健康计划在初级保健中的有效性。

 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.