Screening for Substance Use with Computer Assisted Self Interview in Primary Care

项目总结 我是一名内科医生和职业生涯早期的翻译调查员，研究重点是确定有效的 将药物滥用治疗纳入普通医疗保健环境的方法。因为筛选 对于临床医生来说，药物滥用的患者是很耗时的，我建议进行研究来解决 患者自我筛查的效度。这项研究的具体研究和培训目标是 围绕两个主要重点领域进行整合：行为研究方法(调查研究、定量研究 分析、定性方法)和实施研究。这些区域中的每一个都由 经验丰富的导师，具有相应的专业知识，并通过教学进一步发展 将课程作业和定向阅读以及研究经验相结合。在我的赞助下 首席导师Marc Gourevch，医学博士，公共卫生硕士，我的研究和培训计划利用临床和学术 纽约大学朗格尼医学中心和贝尔维尤医院的资源，在那里药物滥用 治疗和研究一直是一个重点领域。我提出的研究探索了一种创新的 提高初级保健药物使用筛查率的办法，这是实现这一目标的一个主要障碍 一直缺乏一种简单的工具来准确有效地识别不健康的患者 物质使用行为。被广泛接受和验证的“酒精、吸烟和物质参与” 筛查测试(辅助)对于典型的就诊来说太长了，因此大大地没有得到充分利用。我 将把设计和验证为以面谈形式管理的协助调整为 音频引导的计算机辅助自访(ACASI)，患者可以在就诊前完成。我 计划分3个阶段进行混合方法研究，以1)使ACASI在城市安全管理中的辅助- 净初级保健门诊人群；2)检验其相对于传统面试者管理的有效性 协助；以及3)探索医生对使用这些筛查结果来解决药物使用问题的态度 初级保健办公室。

PROJECT SUMMARY I am a physician and early career translational investigator, with a research focus on identifying effective approaches for integrating substance abuse treatment into general healthcare settings. Because screening patients for substance abuse is time consuming on the part of clinicians, I propose research to address the validity of patient self-administered screening. The specific research and training aims of this study are integrated around two primary areas of focus: behavioral research methods (survey research, quantitative analysis, qualitative methods) and implementation research. Each of these areas is anchored by an experienced mentor with corresponding expertise, and further developed through didactic instruction combining coursework and directed readings as well as research experience. Under the sponsorship of my primary mentor Marc Gourevitch, MD, MPH, my research and training plans utilize the clinical and academic resources of New York University-Langone Medical Center and Bellevue Hospital, where substance abuse treatment and research has been a longstanding area of emphasis. My proposed study explores an innovative approach to improving rates of substance use screening in primary care, a major impediment to which has been the lack of a brief instrument that can accurately and efficiently identify patients with unhealthy substance use behaviors. The widely accepted and validated "Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is too lengthy for the typical medical visit, and greatly under-utilized as a result. I will adapt the ASSIST, which was designed and validated to be administered as an in-person interview, to an audio guided computer-assisted self interview (ACASI) that patients can complete prior to their medical visit. I plan a mixed methods study in 3 phases to 1) adapt the ASSIST for ACASI administration in an urban safety- net primary care clinic population; 2) test its validity relative to the traditional interviewer-administered ASSIST; and 3) explore physician attitudes to using these screening results to address substance use in the primary care office.