Training Clinicians in Implementation Research to Improve Alcohol-related Care

 描述（由申请人提供）：Bradley 博士是针对医疗环境中酗酒问题设计和评估以患者为中心、基于证据的护理方面的专家。她是群体健康研究所 (GHRI) 的研究员和华盛顿大学医学与健康服务学副教授。她还是退伍军人事务部 (VA) 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危险饮酒和酒精使用障碍 (AUD) 实施循证护理。她的成就包括在 VA 和非 VA 人群中验证了 3 项 AUDIT-C，以及与 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)。她现在将工作重点扩大到初级保健中 AUD 的管理。 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： 护士为 AUD 提供协作护理的 CHOICE 试验 (NIAAA R01)；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)；以及一项开发决策辅助工具的研究，以支持初级保健提供者与其 AUD 患者之间的共同决策（NIAAA R21）。指导经验和计划指导：Bradley 博士是一位杰出的导师，他已成功指导了 28 名早期职业临床医生研究人员。拟议的 K24 将使她能够招募和指导 10-15 名早期临床研究人员，致力于在 5 年奖励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）保持在医疗环境中酒精相关实施研究的前沿； 2) 开发新的专业知识，以实施和评估初级保健中 AUD 的“电子健康”干预措施（在线和移动医疗计划）； 3) 指导下一代医疗环境中酒精相关研究的创新者。研究：针对 AUD 的新电子健康干预措施正在快速开发，可能特别有利于那些不愿接受治疗的 AUD 初级保健患者。然而，eHealth AUD 计划在初级保健中的有效性尚未经过测试。目标 1 是设计一项在初级保健中实施 eHealth AUD 计划——在线认知行为治疗 (CBT) 的策略。目标 2 将评估我们在目标 1 中设计的在线 CBT 实施策略。这项研究将支持 Bradley 博士及其学员的培训，并为初级保健中 eHealth AUD 计划的务实试验铺平道路。影响。拟议的职业奖将使布拉德利博士能够指导下一代领导者在医疗环境中进行与酒精相关的创新实施研究，同时扩大她的研究计划，以评估初级保健中 AUD 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.