Public Health in the Emergency Department: Surveillance, Screening, and Intervent

描述（由申请人提供）：2009年急诊部公共卫生：监测、筛查和干预共识会议，由学术急诊医学主办，新奥尔良，洛杉矶，2009年5月13日。与危险健康行为有关的疾病和伤害占急诊科就诊的很大比例。非法药物、酒精、烟草使用、伤害、人际暴力和不安全的性行为合计约占所有急诊科就诊的30%。由于有危险健康行为而到急诊科就诊的个人可能会接受“教育时刻”；因此，急诊科可能会为医疗保健提供者提供一个适当的干预时间。这些行为已成为急诊医学广泛临床研究的焦点。在人群层面（通过监测）和个人层面（通过筛查）研究健康行为，并设计干预措施，将急诊医学置于临床医学传统的以疾病或伤害为中心的护理领域与更广泛的人群健康和预防领域之间的联系。正如医学研究所2006年的报告《急诊护理的未来》所指出的那样，决策者和研究人员经常将急诊科作为监测疾病和损伤新趋势的场所。虽然这项工作的重点是描述和定义归因于危险行为的疾病和伤害的流行病学，但目前的许多调查都集中在筛查和干预上。这些后一种活动统称为筛查、短暂干预和转诊治疗（SBIRT）。例如，越来越多的证据表明，以ed为基础的简短干预措施可能会减少危险和有害饮酒患者的饮酒量和饮酒的负面后果。为此，《学术急诊医学》的编辑们召开了一次研究共识会议，题为“急诊部门的公共卫生：监测、筛查和干预”。会议将于2009年5月13日在洛杉矶新奥尔良举行，也就是学术急诊医学学会（SAEM）年度科学会议的前一天。为期一天的会议旨在帮助确定与公共卫生有关的干预措施领域的国家研究议程，重点是为有危险健康行为的患者设计和测试筛查和干预措施。在ED共识会议的概念框架下，公共卫生将沿着五个轨道组织，每个轨道都集中于与公共卫生相关的急诊科研究的一个关键领域：共识轨道1，酒精和物质使用；共识轨道2，伤害预防/亲密伴侣暴力；共识专场3：性传播感染/艾滋病毒；共识专场4：精神健康障碍；共识轨道5，监测数据库的使用。《学术急诊医学》将专门为会议主题出版一本完整的期刊。这期杂志将于2009年11月出版，将包括共识建议和会议记录，以及同行评议的研究手稿。一组急诊医学专业内外的国家专家将领导会议并编写会议记录。该小组（预计约有160人参加）的工作旨在帮助为紧急医疗护理中与公共卫生有关的干预措施的根本贡献奠定基础。公共卫生相关性：本次会议的公共卫生在急诊科：监测，筛查和干预，由学术急诊医学杂志主办，将确定和推进公共卫生和急诊医学的研究议程。这将是该领域同类议程中的第一个统一议程。这一研究议程将允许急诊医生和其他人研究流行病学和危险健康行为的治疗，设计基于证据的、成本和时间敏感的干预措施，并检查对临床相关结果的影响。我们预计，这一领域的研究进展将导致与公共卫生有关的紧急护理方面的实质性改善。

DESCRIPTION (provided by applicant): Public Health In The Emergency Department: Surveillance, Screening And Intervention Consensus Conference 2009, sponsored by Academic Emergency Medicine New Orleans, LA-May 13, 2009. Illness and injury related to risky health behaviors account for a substantial proportion of ED visits. Illicit drugs, alcohol, tobacco use, injury, interpersonal violence, and unsafe sexual behavior collectively account for approximately 30% of all ED visits. Individuals who present to the ED as a consequence of risky health behavior may be receptive to a "teachable moment;" thus, the ED may provide an opportune time for intervention by a healthcare provider. These behaviors have become the focus of extensive clinical investigation in emergency medicine. Studying health behaviors at the population level (via surveillance), and individual level (via screening), and designing interventions, positions emergency medicine at the nexus between clinical medicine's traditional realm of disease- or injury-centered care, and the broader domains of population health and prevention. Policymakers and researchers have often used the ED as a site for surveillance for emerging trends in illness and injury, as noted in the 2006 report by the Institute of Medicine, Future of Emergency Care. While this work has focused on describing and defining the epidemiology of illness and injury attributed to risky behavior, much current investigation is focused on screening and intervention. Collectively, these latter activities are known as Screening, Brief Intervention, and Referral to Treatment (SBIRT). For example, a growing body of evidence suggests that brief ED-based interventions may reduce alcohol consumption and negative consequences of drinking in patients with hazardous and harmful drinking. For this reason, the Editors of Academic Emergency Medicine are convening a research consensus conference entitled, "Public Health in the Emergency Department: Surveillance, Screening, and Intervention." The conference will be held on May 13, 2009 in New Orleans, LA, the day prior to the Society for Academic Emergency Medicine (SAEM) annual scientific meeting. The day-long conference is intended to help define a national research agenda in the field of public health-relevant interventions in the ED, concentrating on the design and testing of screening and intervention measures for patients with risky health behaviors. The Public Health in the ED Consensus Conference's conceptual framework will be organized along five tracks, each designed to concentrate on a key area of public health-relevant emergency department research: Consensus Track 1, Alcohol and Substance Use; Consensus Track 2, Injury Prevention/Intimate Partner Violence; Consensus Track 3, Sexually Transmitted Infections/HIV; Consensus Track 4, Mental Health Disorders; and Consensus Track 5, Use of Surveillance Databases. A full journal issue of Academic Emergency Medicine will be devoted to the conference topics. The issue will be published in November 2009 and will include consensus recommendations and conference proceedings, as well as peer-reviewed research manuscripts. A group of national experts, both inside and outside of the specialty of Emergency Medicine, will lead the conference and compile the proceedings. The work of the group (about 160 expected participants) is intended to help lay the foundation for fundamental contributions to public health-relevant interventions in emergency medical care. PUBLIC HEALTH RELEVANCE: This conference on Public Health in the Emergency Department: Surveillance, Screening and Intervention, sponsored by the journal Academic Emergency Medicine, will define and advance a research agenda in public health and emergency medicine. This would be the first unified agenda of its kind in the field. This research agenda will allow emergency physicians and others to study the epidemiology and treatment of risky health behaviors, design evidence-based, cost- and time-sensitive interventions, and examine effects on clinically pertinent outcomes. We anticipate that research advances in this field will lead to substantial improvements in public health-relevant aspects of emergency care.