An innovative platform and smartphone app to deliver tailored interventions and facilitate completed referrals related to substance use.

摘要 这一快速SBIR提案的目标是提高患者对SBIRT相关建议的依从性 由初级保健提供者（PCP）提供给患者。SBIRT（筛查、短暂干预和 转诊治疗）在初级保健环境中的患者随访方面一直不一致， 平均低至10%。由于各种原因，许多患者， 无论其具体疾病如何，都不能很好地遵守临床建议。一种改进的方法 坚持一直是个性化的建议，为每个人的需要，特别是使用数字 技术，如APP。NIDA的目标是开发一个先进的智能手机为基础的工具， 因此，对SBIRT建议的患者随访是合理的。 CHESS Health已经开发了一种自动化数字工具（eIntervention），其中包含所需的关键要素 在这个RFA。eIntervention旨在鼓励患者遵循PCP建议， SBIRT。使用RFA所需的各种功能，电子干预旨在促进和激励 一旦患者被SBIRT确定为使用某种物质， 疾病（SUD）或处于这种风险中。eIntervention已上市，开发于 响应客户的要求。但是，eIntervention不包含 NIDA在该RFA中，我们没有数据来验证疗效。这种验证对于支持广泛的 传播传播。我们建议通过新功能增强现有的电子干预解决方案， 满足本RFA中规定的要求，并进行随机有效性研究。 在第一阶段，我们的具体目标是评估我们的计划的可行性，以提高遵守SBIRT 给患者的建议。这一具体目标将通过两项任务来实现： 任务1：为我们的原型添加功能，以满足RFA中概述的大多数需求。 任务2：证明原型电子干预在以下方面的可接受性、可行性和初步疗效： 改善患者与指定随访专科SUD护理的联系和参与。 如果证明可行，在第二阶段，我们的具体目标是评估接近商业质量的产品， 包含RFA所需的所有功能。具体目标将通过两项任务实现： 任务1：修改程序（1-3个月）。 任务2：随机临床试验，以测试SBIRT/eIntervention与SBIRT/TAU相比的疗效。 成功标准：我们的目标是将目前的随访专科SUD护理率提高一倍（例如，从约17%提高到 实现率约为35%），具有高度影响力的效果。所有患者，包括确定为有风险的患者，必须 显示药物使用减少。患者和PCP必须对该计划进行平均3.5分的评分， 五点Likert量表，用于可用性、满意度和再次使用该程序的意愿。

Abstract The goal of this fast-track SBIR proposal is to increase patient adherence to SBIRT-related recommendations given to patients by a primary care provider (PCP). The success of SBIRT (Screening, Brief Intervention, and Referral to Treatment) in the primary care setting has been inconsistent in terms of patients following through on treatment referral recommendations, with averages as low as 10%. For a variety of reasons, many patients, irrespective of their specific disease, do not adhere well to clinical recommendations. One way to improve adherence has been to personalize the recommendations for each individual’s needs, especially using digital technology, such as apps. The aim of NIDA to develop a sophisticated smart phone based tool for improving patient follow up to SBIRT recommendations is therefore well justified. CHESS Health has already developed an automated digital tool (eIntervention) with key elements requested by this RFA. eIntervention is designed to encourage patient adherence to PCP recommendations following SBIRT. Using a variety of the RFA required functionalities, eIntervention is designed to facilitate and motivate each patient to enter treatment, once that patient has been identified by SBIRT as having a substance use disorder (SUD) or as being at risk of such. eIntervention is commercially available and was developed in response to customer requests. However, eIntervention does not contain all of the functionalities requested by NIDA in this RFA and we do not have data to validate efficacy. Such validation is important for supporting wide spread dissemination. We propose to enhance our existing eIntervention solution with new functionalities that address the requirements set forth in this RFA and carry out a randomized study of efficacy. In Phase I, our Specific Aim is to evaluate feasibility of our program for improving adherence to SBIRT recommendations to patients from PCPs. This Specific Aim will be accomplished in two Tasks: Task 1: Add functionality to our prototype that address most requirements outlined in the RFA. Task 2: Demonstrate acceptability, feasibility, and preliminary efficacy of the prototype eIntervention in improving patient linkage to and engagement in indicated follow-up specialty SUD care. If shown to be feasible, in Phase II, our Specific Aim is to evaluate a near commercial quality product that contains all of the features required by the RFA. The Specific Aim will be accomplished in two Tasks: Task 1: Modifications to the program (months 1-3). Task 2: The randomized clinical trial to test efficacy of SBIRT/eIntervention compared to SBIRT/TAU. Criteria for Success: We aim to double the current rate of follow-up specialty SUD care (e.g. go from ~17% to an achieved rate of ~35%), a highly impactful effect. All patients, including those identified as at risk, must show a reduction in substance use. Patients and PCPs must rank the program with an average of 3.5 on a five-point Likert scale for usability, satisfaction, and willingness to use with the program again.