A Computer-based Intervention for Women with Substance Use and IPV in the ED

描述(申请人提供)：Esther K.Choo博士是布朗大学沃伦·阿尔伯特医学院急诊医学系的助理教授。她的长期目标是成为一名独立的调查员，专注于为患有药物使用障碍的高危女性开发有效的干预措施。Choo博士建议的总体目标是使用基于计算机的干预B-SAFER(针对女性在急诊室使用药物和滥用伴侣的短暂干预)，针对药物使用和亲密伴侣暴力(IPV)共存的问题。这项由K23指导的以患者为导向的职业发展奖提案符合NIDA的使命，通过一种可以迅速有效地传播到其他急诊科(ED)和其他临床环境的干预措施，具有显著改善药物滥用治疗的巨大潜力。物质使用和IPV具有密切的双向关系，共存的疾病使妇女处于心理和身体健康结果不佳的高风险中。教育署提供了一个很好的机会来干预这一群体，因为共存的问题非常普遍，而常规情况下并没有足够的评估、干预和转介。此外，教育署并无资源以综合方式处理药物使用和IPV的相关问题。作为一种基于计算机的干预，B-SAFER作为一种可行和可接受的ED资源具有很大的潜力。该研究项目分为两个阶段。开发阶段将使用焦点小组来通知和改进以计算机为基础的干预的发展，并将以一项小型公开试验结束。测试阶段将是在高容量城市ED中进行干预的试点RCT，检查物质使用和关系安全资源利用的主要结果。通过完成这项研究和相关的培训活动，周博士计划获得所需的技能、知识和经验，以成为以技术为基础的干预措施研究领域的全国领先者。她的目标是在以下方面获得技能：1)使用定性健康研究方法为干预措施的制定提供信息；2)开发和测试针对药物使用和IPV的计算机化干预措施；3)对药物使用和IPV干预措施进行临床试验；4)分析纵向数据；5)解决针对有药物使用和受害情况的个人使用计算机干预措施进行研究的伦理问题。 公共卫生相关性：该项目旨在解决同时使用药物和呈现给ED环境的IPV的妇女的保健问题，这些妇女是高危人群，有很高的卫生保健需求，但可用的资源很少。这项研究的结果可能有助于ED环境下的国家护理模式，并将为Choo博士提供机会，为在其他临床和社区环境中使用药物和IPV的女性开发、测试和传播类似的干预措施。

DESCRIPTION (provided by applicant): Dr. Esther K. Choo is Assistant Professor in the Department of Emergency Medicine at Warren Alpert Medical School of Brown University. Her long-term goal is to become an independent investigator with a focus on developing effective interventions for high-risk women with substance use disorders. The overall aim of Dr. Choo's proposal is to target co-occurring problems of substance use and intimate partner violence (IPV) using a computer-based intervention, B-SAFER (Brief intervention for Substance use and partner Abuse for Females in the Emergency Room). This K23 Mentored Patient-Oriented Career Development Award proposal is in keeping with NIDA's mission, with great potential to significantly improve treatment of drug abuse through an intervention that could be rapidly and effectively disseminated to other emergency departments (EDs) and to other clinical settings. Substance use and IPV have a close, bidirectional relationship, and the coexisting disorders place women at high risk for poor mental and physical health outcomes. The ED presents a great opportunity to intervene in this population, as coexisting problems are highly prevalent, while adequate assessment, intervention and referrals are not routinely available. Further, no resource is available in the ED to address related problems of substance use and IPV in an integrated manner. As a computer-based intervention, B-SAFER has great potential as a feasible and acceptable ED resource. The research project has two phases. The Development Phase will use focus groups to inform and refine the development of the computer-based intervention, and will conclude with a small open trial. The Testing Phase will be a pilot RCT of the intervention in a high-volume urban ED, examining primary outcomes of substance use and utilization of relationship safety resources. In completing this research and associated training activities, Dr. Choo plans to gain the skills, knowledge and experience needed to become a national leader in research on technology-based interventions for women with substance use. Her goals are to gain skills in: 1) using qualitative health research methodology to inform the development of interventions; 2) developing and testing computerized interventions for substance use and IPV; 3) conducting clinical trials of substance use and IPV interventions; 4) analyzing longitudinal data; and 5) addressing the ethical issues related to research using computerized interventions for individuals with substance use and victimization. PUBLIC HEALTH RELEVANCE: This project seeks to address the health care of women with coexisting substance use and IPV presenting to the ED setting, a population at high risk and with high health care needs and yet few available resources. The results of this research could contribute to national models of care in ED settings and will provide opportunities for Dr. Choo to develop, test and disseminate similar interventions for women with substance use and IPV in other clinical and community settings.