A suite of web apps for patients with alcohol & drug use problems in primary care

描述(由申请人提供)：在美国，大量饮酒每年的医疗成本估计为246亿美元(Bouchery等人，2011年)。有效地干预危险、危险和问题饮酒者将降低他们的发病率和医疗费用。解决问题饮酒者需求的一种方法是在初级保健中对他们进行筛查和干预。然而，让初级保健提供者提供这些服务是不可行的 服务。相反，医疗保健正朝着使用行为健康顾问将这些服务整合到初级保健中的方向发展。这种融合现在开始在新墨西哥州和全国范围内发生(克莱，2012)。尽管大多数心理健康顾问没有专业知识，但他们正在解决酒精和毒品问题。这个项目试图通过为他们提供一个经验支持的计划来帮助解决这个问题，该计划可能是他们努力的补充。该项目的总体目标是开发、评估和传播一个名为Check-Up and Choices(CC)的网络应用程序。CC将被开发用于初级保健。它将紧密结合对酗酒和吸毒的筛查，针对危险或重度饮酒者的简短动机干预，针对不太依赖的问题饮酒者的适度训练方案，以及针对更依赖的饮酒者和吸毒者的以禁欲为导向的方案。简短的激励性干预将根据患者的年龄量身定做。其目的将是激励有问题的饮酒者改变他们的饮酒方式。以行动为导向的节制和禁欲方案是认知行为干预(CBIS)，为患者提供了通过改变饮酒和/或药物使用来最大化成功机会的技能。我们已经开发了这些元素，但它们没有集成到单个程序中，它们之间有适当的分支。内容也没有针对初级保健的使用而量身定做。这种行为健康服务的整合被视为一种双赢，既能改善患者的健康，同时又能降低医疗成本。整合服务的举措也被视为有必要为2014年1月国家医疗改革实施过程中不断增长的服务需求做好准备。

DESCRIPTION (provided by applicant): The annual healthcare costs of heavy drinking in the U.S. are estimated to be $24.6 billion (Bouchery et al., 2011). Effectively intervening with hazardous, risky, and problem drinkers would reduce both their morbidity and their healthcare costs. One way to address the needs of problem drinkers is by screening for and intervening with them in primary care. It is not feasible, however, for primary care providers to provide these services. Instead, healthcare is moving towards the integration of these services into primary care using behavioral health counselors. This integration is starting to happen now both in New Mexico and nationally (Clay, 2012). Most mental health counselors though do not have expertise is addressing alcohol and drug issues. This project seeks to help address this problem by providing them with an empirically supported program that could be an adjunct to their efforts. The overall objective of this project is to develop, evaluate, and disseminate a web application called Check-up and Choices (CC). CC will be developed for use in primary care. It would tightly integrate screening for heavy drinking and drug use, a brief motivational intervention for hazardous or heavy drinkers, a moderation training protocol for less dependent problem drinkers, and an abstinence-oriented protocol for more dependent drinkers and drug abusers. The brief motivational intervention will be tailored to the patient's age. Its purpose wil be to motivate problem drinkers to change their drinking. The action-oriented moderation and abstinence protocols are cognitive-behavioral interventions (CBIs) that provide patients with the skills to maximize their chances of success with changing their drinking and/or drug use. We have already developed these elements but they are not integrated into a single program with appropriate branching between them. Nor has the content been tailored for use in primary care. This integration of behavioral health services is seen as a win-win that improves the health of patients while at the same time reduces healthcare costs. The move to integrate services is also seen as necessary to be ready for the increased demand for services that will accompany the implementation of national healthcare reform in January, 2014.