The SPIN Trial (Stories to Promote Information through Narrative): A RCT testing

描述（由申请人提供）：摘要：SPIN试验（Stories to Promote Information Using Narrative）是一项混合方法的随机对照传播试验，旨在测试一种利用书面叙事促进急诊阿片类药物处方循证指南传播和使用的创新策略医生。2012年5月，美国急诊医师学会（ACEP）将发布循证指南，为治疗疼痛患者的急诊医师提供与阿片类药物处方相关的临床决策支持。制定这一指南的部分原因是，处方类阿片意外过量在全国流行。急诊医生是这类药物的最高处方群体之一。众所周知，临床指南建议的传播和实施效率低下。本应用程序的目的是测试新的处方阿片类药物指南的两种传播策略：叙述和总结。基于先前的调查，我们假设接触故事的急诊医生，与那些只接触常规摘要描述的医生相比，更有可能阅读、回忆和打算采用指南建议，这些故事是为了最大限度地发挥叙事说服的已知特征。这项研究将分为三个阶段。第一阶段将使用半结构化访谈来引出急诊医生与阿片类药物处方相关的知识差距、态度和信念。然后，叙事将根据这些数据和叙事说服的已知特征进行开发。第二阶段将随机抽取30,000名ACEP成员，让他们每天收到一份易读的电子通讯，其中包含与指南相关的叙述或其他摘要内容。衡量的结果将包括使用在线超链接打开指南，以及使用在线注册机制登记参加国家资助的处方药监测项目（PDMPs），这是指南的建议。这些结果反映了传播和采纳的意愿。第三阶段将使用定性方法测量试验后知识和采用指南建议的意向，按随机分组分层。SPIN试验提供了一个机会，可以测试围绕以患者为中心的重要主题的证据传播的新策略。

DESCRIPTION (provided by applicant): The SPIN Trial (Stories to Promote Information through Narrative) A RCT testing narratives for the dissemination of a national guideline for opioid prescription use in emergency medicine Abstract The SPIN Trial (Stories to Promote Information Using Narrative) is a mixed-methods randomized controlled dissemination trial to test an innovative strategy using written narratives to promote dissemination and utilization of evidence-based guidelines related to opioid prescriptions for emergency physicians. In May 2012, the American College of Emergency Physicians (ACEP) will release evidence-based guidelines to support clinical decisions related to opioid prescriptions for emergency physicians who treat patients with pain. This guideline was developed, in part, due to a national epidemic of unintentional drug overdoses from prescribed opioids. Emergency physicians are one of the highest prescriber groups for this class of medication. Dissemination and implementation of clinical guideline recommendations are notoriously inefficient. The goal of this application is to test two dissemination strategies for the new prescription opioid guideline: narrative and summary. Based on previous investigations, we hypothesize that emergency physicians who are exposed to stories, developed to maximize known characteristics of narrative persuasion, will be more likely to read, recall and intend-to- adopt guideline recommendations compared to those who are exposed to routine summary descriptions alone. This study will have three phases. Phase One will used semi-structured interviews to elicit knowledge gaps, attitudes and beliefs related to opioid prescriptions among emergency physicians. Narratives will then be developed based on these data and known characteristics of narrative persuasion. Phase Two will randomize 30,000 ACEP members to receive a well-read daily e-newsletter containing the narratives or other summary content related to the guideline. Outcomes measured will include use of online hyperlinks to open the guideline and use of an online registration mechanism for enrollment in state sponsored prescription drug monitoring programs (PDMPs), a guideline recommendation. These outcomes reflect dissemination and intention-to-adopt. Phase Three will use qualitative methods to measure post-trial knowledge and intention-to-adopt guideline recommendations, stratified by randomization arm. The SPIN Trial represents an opportunity to test a novel strategy around the dissemination of evidence for an important patient-centered topic.