Using Technology to Scale Up the Evaluation of Motivational Interviewing

利用技术扩大动机访谈的评估

• 批准号: 9057931
• 负责人: David Charles Atkins
• 金额: $ 13.82万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-01 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9057931
• 关键词: Acoustics; Addictive Behavior; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Algorithmic Software; American; Applied Skills; Appointment; Area; Behavior Therapy; Behavioral; Cellular Phone; Client; Clinic; Clinical; Clinical Investigator; Code; Cognitive; Collaborations; Computer Simulation; Computer software; Computers; Data; Discipline; Electrical Engineering; Emerging Technologies; Empathy; Engineering; Evaluation; Feedback; Future; Goals; Grant; Group Psychotherapy; Health; Health Services; Healthcare; Healthcare Systems; Human; Individual; Institute of Medicine (U.S.); Interdisciplinary Study; Intervention; Intervention Studies; Judgment; K-Series Research Career Programs; Knowledge; Language; Life; Linguistics; Machine Learning; Mental Health; Mentors; Methods; Modeling; Monitor; Patient-Focused Outcomes; Pharmaceutical Preparations; Process; Professional counselor; Property; Psychologist; Psychotherapy; Reading; Records; Reporting; Research; Research Personnel; Role; Scientist; Semantics; Services; Signal Transduction; Societies; Software Tools; Speech; Substance Use Disorder; Supervision; System; Technology; Technology Assessment; Time; Training; Translating; Translations; United States; United States Department of Veterans Affairs; United States National Institutes of Health; United States Substance Abuse and Mental Health Services Administration; Vision; Visual; Work; alcohol intervention; alcohol related problem; alcohol use disorder; base; behavior change; career development; computer science; computerized tools; design; disease classification; drinking; economic cost; experience; global health; high risk; implementation science; improved; innovation; method development; mortality; motivational enhancement therapy; novel; scale up; signal processing; statistics; success; support tools; technology development; technology validation; text searching; theories; tool; visual feedback

 DESCRIPTION: Millions of Americans are receiving behavioral interventions for problematic alcohol use. In 2010, the Substance Abuse and Mental Health Services Administration documented over 1.8 million treatment episodes for drug and alcohol problems, many involving group or individual psychotherapy. What is the quality of these interventions? In truth, we have no idea. To evaluate the quality of behavioral interventions such as psychotherapy researchers rely on human evaluation through behavioral coding, which is a major impediment to scaling up and sustaining high-quality interventions for alcohol abuse in large-scale implementation. Human evaluation of behavioral interventions is a rate-limiting factor, and a technological solution is needed that incorporates human expertise but does not rely on human judgment as the evaluation tool. The current K02 career development proposal builds on interdisciplinary research focused on automating the evaluation of motivational interviewing (MI) fidelity for alcohol and substance use disorders. This collaborative research brings together speech signal processing experts from engineering and statistical text- mining experts from computer science with MI expert trainers and researchers. The work is currently supported by an R01 (AA018673) methods development grant and an R34 (DA034860) feasibility trial. Career development activities will encompass additional training, experience, and collaboration in three areas: 1) technical tools and methods (speech signal processing, statistical text-mining, and machine learning), 2) clinical process and change mechanisms of MI, and 3) large-scale implementation. A team of senior mentors, who are nationally and internationally recognized experts in each of the three core areas, will oversee the career development activities. These activities have been designed to deepen knowledge in key topics (course work, directed reading), develop applied skills (hands-on work with speech signal processing, statistical text-mining, and machine learning), advance integration of technology with clinical process (co- reviewing MI sessions from the view of computational tools and MI clinical theory), and prepare for large-scale implementation of automated MI fidelity coding and feedback (engage key stakeholders in large healthcare systems via the mental health research network). Research conducted during the K02 will: a) systematically explore how much and which portion(s) of MI sessions are needed for accurate fidelity assessment; b) conduct innovative process research on how tone and prosody of spoken language moderate the association of client change talk with patient outcome; and, c) incorporate cutting-edge visual design in developing an automated fidelity feedback report for MI therapists. This career development award will support, enhance, and move forward research developing automated clinical support tools to provide rapid feedback to MI therapists. The ultimate goal is to improve the quality of behavioral interventions for all Americans struggling with alcohol problems.

 数百万美国人正在接受有问题的酒精使用行为干预。2010年，药物滥用和精神卫生服务管理局记录了180多万次药物和酒精问题治疗，其中许多涉及团体或个人心理治疗。这些干预措施的质量如何？事实上，我们不知道。为了评估心理治疗等行为干预措施的质量，研究人员依赖于通过行为编码进行的人类评估，这是大规模实施中扩大和维持高质量酒精滥用干预措施的主要障碍。人类对行为干预的评估是一个限速因素，需要一种技术解决方案，该解决方案结合了人类的专业知识，但不依赖于人类的判断作为评估工具。 目前的K 02职业发展建议建立在跨学科研究的基础上，重点是自动评估酒精和物质使用障碍的动机面试（MI）保真度。这项合作研究汇集了来自工程和统计的语音信号处理专家，来自计算机科学的文本挖掘专家，以及MI专家培训师和研究人员。这项工作目前得到了R 01（AA 018673）方法开发资助和R34（DA 034860）可行性试验的支持。职业发展活动将包括三个领域的额外培训，经验和合作：1）技术工具和方法（语音信号处理，统计文本挖掘和机器学习），2）MI的临床过程和变化机制，以及3）大规模实施。一个由三个核心领域的国内和国际公认专家组成的高级导师小组将监督职业发展活动。这些活动旨在加深对关键主题的了解（课程作业，指导性阅读），培养应用技能（语音信号处理、统计文本挖掘和机器学习方面的实践工作），推进技术与临床流程的整合（从计算工具和MI临床理论的角度共同回顾MI会议），并为大规模实施自动化MI保真度编码和反馈做好准备（通过心理健康研究网络与大型医疗保健系统的关键利益相关者合作）。在K 02期间进行的研究将：a）系统地探索准确的保真度评估需要MI会话的多少和哪些部分; B）对口语的语调和韵律如何调节客户改变谈话与患者结局的关联进行创新过程研究;以及，c）在为MI治疗师开发自动保真度反馈报告时纳入尖端视觉设计。 该职业发展奖将支持，加强和推进自动化临床支持工具的研究，为MI治疗师提供快速反馈。最终目标是提高所有与酒精问题作斗争的美国人的行为干预的质量。