Validation of the TAPS-Electronic Spanish Platform (TAPS-ESP): A Technology to Improve Access to Substance Use Screening and Reduce Behavioral Health Disparities in Hispanic Primary Care Patients

TAPS-电子西班牙语平台 (TAPS-ESP) 的验证：一种改善西班牙裔初级保健患者药物使用筛查并减少行为健康差异的技术

• 批准号: 10490979
• 负责人: Steven Bernard Carswell
• 金额: $ 86.99万
• 依托单位: COG ANALYTICS, LLC
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-19 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10490979
• 关键词: Address; Adult; Advisory Committees; Alcohols; Assessment tool; Awareness; Biological Markers; COVID-19; Client satisfaction; Clinic; Clinical; Clinical Trials Network; Detection; Development; Diagnosis; Diagnostic; Disease; Drug Prescriptions; Effectiveness; Elements; English Language; Epidemic; Evidence based practice; Federally Qualified Health Center; Funding; Health; Health Services; Health system; Healthcare; Healthcare Systems; Hispanic; Hispanic Americans; Hispanic Populations; Home; Illicit Drugs; Improve Access; Individual; Infrastructure; Internet; Intervention; Interview; Language; Limited English Proficiency; Linguistics; Liquid substance; Low income; Medical; Mental Health; Mental disorders; Minority Groups; National Institute of Drug Abuse; National Institute on Minority Health and Health Disparities; Oral; Outcome; Patient Care; Patient Education; Patients; Phase; Population; Preventive service; Primary Health Care; Provider; Public Health; Recommendation; Reference Standards; Research; Role; Saliva; Sampling; Screening procedure; Self Administration; Seminal; Small Business Innovation Research Grant; Small Business Technology Transfer Research; Social Problems; Substance Use Disorder; Surgeon; System; Tablets; Technology; Texas; Tobacco; Tobacco Use Disorder; Training; Underserved Population; United States National Institutes of Health; Update; Ursidae Family; Validation; Work; alcohol screening; behavioral health; burden of illness; care providers; clinically relevant; commercialization; comorbidity; design; drug testing; effectiveness implementation design; effectiveness implementation study; ethnic minority; evidence base; experience; health care quality; health care settings; health disparity; health disparity populations; health information technology; illicit drug use; implementation barriers; implementation facilitators; implementation trial; innovation; misuse of prescription only drugs; new technology; nonEnglish language; novel; opioid overdose; phase 2 study; physical conditioning; primary care setting; racial minority; screening; standard care; substance use; tobacco screening; tool; validation studies

ABSTRACT Language accessibility and cultural awareness are essential elements of quality healthcare. Individuals with limited English proficiency are less likely to self-identify a need for behavioral health services, which results in longer duration of untreated disorders. Accurate identification, diagnosis, and treatment are entirely dependent on a linguistically-accurate screening and assessment, especially for sensitive topics such as substance use. Substance use screening in primary care is now recommended as an evidence-based practice for all adults, but remains underutilized. The shortcomings of existing substance use screening tools led the NIH to develop and validate the “Tobacco, Alcohol, Prescription drug, and illicit Substance use Tool (TAPS Tool), a two-stage screening and brief assessment tool to detect substance use problems in primary care. As part of our Phase I NIMHD STTR project, our team led a research-driven adaptation of the TAPS Tool into a Spanish language version, and developed a mobile/tablet technology platform to support its deployment in healthcare settings (the TAPS-Electronic Spanish Platform, or TAPS-ESP). The current Phase II SBIR study builds on this effort. For Aim 1, we will integrate the TAPS-ESP into the existing health information technology infrastructure of Baylor Scott and White Health (BSWH), a large healthcare system in Texas that serves a large number of Spanish-speaking patients. For Aim 2, we will conduct a large-scale validation study of the TAPS-ESP against a widely-used diagnostic reference standard, other screening tools, and oral fluid/saliva drug testing in a large sample of 1,000 Spanish-speaking primary care patients. Separately, for Aim 3 we will conduct a real-world implementation trial in which 10 primary care providers receive training on the TAPS-ESP, incorporate it into standard care, and complete a qualitative interview on barriers and facilitators of implementation from a provider workflow perspective. To the best of our knowledge, this will be the largest validation study of a Spanish-language substance use screening tool in the US to date. The project could expand access to evidence-based, linguistically-accurate substance use screening and brief assessment for an underserved population that experiences significant behavioral health disparities. Thus, the project could have high scientific and public health impact, along with strong commercialization potential.

抽象的 语言可及性和文化意识是优质医疗保健的重要因素。有个人 有限的英语水平不太可能自我确定对行为健康服务的需求，这导致 准确的识别，诊断和治疗完全取决于 在语言准确的筛查和评估中，尤其是对于诸如药物使用之类的敏感主题。 现在，建议在初级保健中筛查药物筛查，以作为所有成年人的循证实践， 但仍未得到充分利用。现有物质使用筛查工具的缺点导致NIH发展 并验证“烟草，酒精，处方药和非法药物使用工具（TAPS工具），两阶段 筛选和简短评估工具，以检测初级保健中的药物使用问题。作为第一阶段的一部分 NIMHD STTR项目，我们的团队将TAPS工具的研究驱动型改编为西班牙语 版本，并开发了一个移动/平板电脑技术平台，以支持其在医疗机构中的部署 （Taps-Electronic Spanish平台或TAPS-ESP）。 当前的II期SBIR研究基于这项工作。对于AIM 1，我们将将TAPS-ESP整合到 贝勒·斯科特（Baylor Scott）和白人健康（BSWH）现有的健康信息技术基础设施，这是一个大型 德克萨斯州的医疗保健系统为大量讲西班牙语的患者提供服务。对于目标2，我们将 对TAPS-ESP进行大规模验证研究，以广泛使用的诊断参考标准， 其他筛查工具和口服液体/唾液药物测试在1,000个讲西班牙语的主要样本中 护理患者。另外，对于目标3，我们将进行现实世界实施试验，其中10个初级保健 提供者接受TAPS-ESP的培训，将其纳入标准护理中，并完成定性 从提供商工作流的角度来看，对实施障碍和促进者的采访。 据我们所知，这将是西班牙语用途的最大验证研究 迄今为止，美国的筛选工具。该项目可以扩展访问基于证据的，语言精确的 对服务不足的人群的物质使用筛查和简短评估，经历了重要的 行为健康差异。那个项目可能会对 强大的商业化潜力。