Multidisciplinary Approach to Reduce Injury and Substance Abuse

项目摘要/摘要 美国外科医生学会(ACS)最近建立了I级创伤中心的要求，以 为酒精问题提供筛查和短暂干预(SBI)。这项任务的推动力是 支持对受伤患者进行短暂酒精干预对减少 酒精的使用和未来受伤的风险，以及节省成本。然而，缺乏证据表明， 履行机构在药物使用方面的有效性。此外，几乎没有证据表明药物SBI对 艾滋病毒风险和其他与吸毒密切相关的健康后果。 这项申请提出了一项随机临床试验，评估简明建议(BA)的有效性 带反馈的激励干预(BMI)和带反馈和助推器的简短激励干预 (BMI+B)在有药物问题的受伤患者中。环境是一个创伤中心，为大型和多样化的 病人群体。人们感兴趣的主要结果将是随后的药物使用。其他感兴趣的结果 包括：(A)与艾滋病毒有关的危险行为；(B)改善健康结果，包括减少伤害；(C)增加 就业，(D)减少从事非法行为(E)增加药物滥用治疗 (E)在3个月、6个月和12个月的随访中提高生活质量。 这项研究还将检验患者对变化的准备程度的潜在调节和调节作用， 使用经验和行为过程中的变化和决策平衡考虑。此外, 该项目将审查组织层面的实施因素和英航的成本效益， BMI和BMI+B。 拟议研究的经费将增加关于《简报》有效性的知识库 对有药物使用问题的受伤患者进行干预，从而为ACS和外地提供 药物使用问题筛查、短期干预和转诊的必要证据基础 在创伤护理环境中。

PROJECT SUMMARY/ABSTRACT The American College of Surgeons (ACS) recently established requirements for Level I Trauma Centers to provide screening and brief intervention (SBI) for alcohol problems. The impetus for this mandate was the evidence base supporting the effectiveness of brief alcohol interventions with injured patients on reducing alcohol use and risk of future injury, as well as cost savings. However, there is a lack of evidence regarding the effectiveness of SBI for drug use. In addition, there is little evidence on the effectiveness of drug SBI on HIV risk and other health outcomes strongly associated with drug use. This application proposes a randomized clinical trial evaluating the effectiveness of brief advice (BA), brief motivational intervention with feedback (BMI), and brief motivational intervention with feedback and booster (BMI+B) in injured patients with drug problems. The setting is a trauma center serving a large and diverse patient population. The primary outcome of interest will be subsequent drug use. Other outcomes of interest include: (a) HIV-related risk behaviors, (b) improved health outcomes including injury reduction, (c) increased employment, (d) decreased engagement in illegal behavior (e) increased substance abuse treatment utilization, and (e) enhanced quality of life at three, six, and twelve month follow-ups. This study will also examine the potential moderating and mediating effects of patient readiness to change, use of experiential and behavioral processes of change and decisional balance considerations. In addition, this project will examine implementation factors at the organizational level and the cost effectiveness of BA, BMI, and BMI+B. Funding of the proposed study will increase the knowledge base with regard to the effectiveness of brief intervention among injured patients with drug use problems and, thereby, provide the ACS and the field with the necessary evidence base for screening, brief intervention and referral for treatment for drug use problems in the trauma care setting.