Telehealth-Clinical Advocacy Project (T-CAP)

摘要/摘要 阿片类药物危机已经达到了全美流行的程度。在伊利诺伊州，这项申请的重点， 在过去的一年里，与阿片类药物相关的死亡人数增加了32%。作为州政府回应的一部分，伊利诺伊州发起了一项 警察阿片类药物转移计划(ODP)，个人自愿进入该计划并请求帮助 物质使用治疗，不用担心被捕。拟议的远程健康-临床倡导项目(T-CAP) 干预的重点是通过(1)引入远程医疗模式，将参与者链接到 在整个干预过程中配备训练有素的临床医生；(2)扩大社区治疗服务 基础设施(包括扩大疼痛管理选项和增加获得医疗服务的机会 可以提供垫子)。志愿者研究参与者将被随机分成以下两种情况之一：(1) 通常“(TAU)对照小组，将与一名研究助理(RA)会面，分三次完成调查 积分，或(2)T-CAP干预组，将完成调查并接受7个远程医疗临床 会议以简短的干预服务为特色，包括动机访谈(MI)、“果断”推荐和三项 临床医生持续数月的临床支持和宣传。这一策略的新奇之处在于它将重点放在 需要向学员提供迅速获得的专业级临床服务和支持，作为一部分 警察分流方案，并扩大了服务基础设施，包括增加进入垫子的机会 和替代的疼痛管理服务。研究的主要目的是(1)论证干预措施 通过测量研究参与者的接受度和远程保健方法的使用来衡量可行性，以及(2)评估 拟议的T-CAP措施，以评估其在衡量远程保健对物质使用的影响方面的表现 开始治疗、短期治疗保留和获得其他适当的治疗服务 未来的大规模研究。如果增强是可行的，高度创新的潜在影响 T-CAP的干预将是主要的。这项研究实现减少阿片类药物使用和 相关的健康问题将对警察分流政策和实践产生重大影响。

SUMMARY/ABSTRACT The opioid crisis has reached epidemic proportions across America. In Illinois, the focus of this application, opioid-related deaths have increased 32% in the past year. As part of a State response, Illinois has launched a police Opioid Diversion Program (ODP), where individuals voluntarily enter the program and ask for help with substance use treatment, without fear of arrest. The proposed Telehealth-Clinical Advocacy Project (T-CAP) intervention focuses on enhancing one Illinois ODP by (1) introducing a telehealth model to link participants to a trained clinician throughout the intervention process and (2) expanding the community treatment services infrastructure (including expanded options for pain management and increased access to medical services that can provide MAT). Volunteer study participants will be randomized to one of two conditions: (1) “treatment as usual” (TAU) comparison group who will meet with a research assistant (RA) to complete surveys at three time points, or (2) T-CAP intervention group who will complete surveys and receive seven telehealth clinical sessions featuring brief intervention services with Motivational Interviewing (MI), “assertive” referrals, and three months of on-going clinical support and advocacy from a clinician. The novelty of this strategy is that it focuses on the need to provide participants with rapidly available professional level clinical services and support as part of the police diversion program, and it expands the service infrastructure to include increased access to MAT and alternative pain management services. The primary study aims are (1) to demonstrate intervention feasibility by measuring study participant receptivity and utilization of the telehealth approach and (2) evaluate the proposed T-CAP measures to assess their performance in gauging the impact telehealth on substance use treatment initiation, short-term treatment retention, and access to other appropriate treatment services for future large-scale research. If the enhancements are feasible, the potential impact of the highly innovative T-CAP intervention will be major. The study’s potential to achieve the larger goal of reducing opioid use and related health problems will have major implications for police diversion policy and practice.