Implementation of Traumatic Brain Injury Screening in Behavioral Healthcare Organizations

在行为医疗机构中实施创伤性脑损伤筛查

• 批准号: 10506325
• 负责人: Kathryn Hyzak
• 金额: $ 4.2万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-30 至 2023-07-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10506325
• 关键词: Active Learning; Address; Adopted; Adoption; Adult; Affect; Anxiety; Attitude; Behavior; Behavior Control; Behavioral; Characteristics; Client; Complex; Development; Diagnosis; Diffusion of Innovation; Dissemination and Implementation; Ensure; Feeling suicidal; Fibrinogen; General Population; Goals; Health Personnel; Health Services; Healthcare; Individual; Interview; Knowledge; Lead; Literature; Mental Depression; Mental Health; Mentorship; Methods; National Institute of Neurological Disorders and Stroke; National Research Service Awards; Ohio; Outcome; Overdose; Patient-Focused Outcomes; Persons; Planning Theory; Positioning Attribute; Professional counselor; Prospective cohort study; Provider; Psychologist; Public Health; Recording of previous events; Research; Research Personnel; Research Proposals; Resources; Risk; Services; Social Workers; Strategic Planning; Structure; Substance Use Disorder; Suicide attempt; Symptoms; Techniques; Testing; Time; Training; Translating; Translations; Traumatic Brain Injury; Universities; behavioral health; clinical care; cohort; comorbidity; design; disability; evidence base; follow-up; health care service organization; implementation strategy; improved; innovation; non-compliance; novel; pressure; prospective; routine practice; screening; service delivery; skills; social; substance use treatment; theories; treatment organization; uptake

PROJECT SUMMARY/ABSTRACT Traumatic brain injury (TBI) is a major public health crisis for adults in the U.S. and globally. TBI can lead to new or worsened substance use disorders (SUDs) and mental health comorbidities. Strikingly, TBI can contribute to a 10-fold increase in the likelihood of unintentional overdose. TBIs are especially common among adults who seek treatment for SUDs and other mental health comorbidities in behavioral health treatment organizations. Effective and evidenced-based TBI screening methods exist (e.g., the Ohio State University TBI Identification Method) that can be used by behavioral health providers to identify lifetime history of TBI among clients; yet, providers have failed to adopt TBI screening into routine behavioral healthcare. Lack of TBI identification could affect clinical care decisions and client outcomes. However, studies have yet to investigate the determinants influencing TBI screening adoption among behavioral health providers in behavioral health treatment organizations. The primary aims of this proposal are guided by the Theory of Planned Behavior (TBP) and Roger’s Diffusions of Innovations Theory (DOI). I propose to conduct a prospective cohort study to investigate whether provider-level characteristics from the TBP (attitudes, subjective norms, perceived behavioral control, intentions), and innovation-level factors from the DOI (acceptability, feasibility, and appropriateness of TBI screening) affect the adoption of TBI screening in behavioral health treatment contexts. Using mixed methods, I propose three specific aims: (1) Examine the relationships between behavioral health providers’ attitudes, perceived behavioral control, and subjective norms as predictors to TBI screening intentions and examine whether intentions to adopt TBI screening predicts actual TBI screening behaviors at a one month follow-up; (2) Investigate whether the acceptability, feasibility, and appropriateness of TBI screening moderates the relationship between TBI screening intentions and actual screening behaviors; and (3) Qualitatively assess the contextual determinants to TBI screening adoption through semi-structured interviews. This proposed study is a necessary advancement toward the translation and implementation of existing and effective innovations developed for adults with TBI within behavioral healthcare contexts. A training plan consisting of individualized mentorship, formal coursework in advanced statistical techniques, and experiential learning has been designed to ensure the proposed study is conducted rigorously and to develop my skills in leading cutting-edge research as an independent investigator in the dissemination and implementation of effective innovations for TBI.

项目摘要/摘要 创伤性脑损伤（TBI）是美国和全球成年人的重大公共卫生危机。 TBI可以导致 新的或恶化的药物使用障碍（SUD）和心理健康合并症。令人惊讶的是，TBI可以 无意间过量的可能性增加了10倍。 TBI在 在行为健康治疗中寻求治疗SUD和其他心理健康合并症的成年人 组织。存在有效且基于证据的TBI筛查方法（例如，俄亥俄州立大学TBI 识别方法）可以由行为健康提供者使用来识别TBI的终生历史 客户；然而，提供者未能将TBI筛查用于常规行为医疗保健。缺乏TBI 识别可能会影响临床护理决策和客户结果。但是，研究尚未调查 在行为健康方面的行为健康提供者中影响TBI筛查采用的决定者 治疗组织。该提案的主要目的是由计划行为理论指导 （TBP）和罗杰的创新理论扩散（DOI）。我建议进行一项前瞻性队列研究 调查提供商级别的特征是否来自TBP（态度，主观规范，感知到 行为控制，意图）和DOI的创新级因素（可接受性，可行性和 TBI筛查的适当性）会影响行为健康治疗环境中TBI筛查的采用。 使用混合方法，我提出了三个具体目的：（1）检查行为健康之间的关系 提供者的参加，感知的行为控制和主观规范是TBI筛查的预测指标 意图并检查是否采用TBI筛选预测的意图是否在A 一个月随访； （2）调查TBI筛选的可接受性，可行性和适当性 调节TBI筛选意图与实际筛选行为之间的关系； （3） 通过半结构化访谈评估了TBI筛选采用TBI筛选的上下文决定者。 这项拟议的研究是在现有和实施现有和实施的必要进步和 在行为医疗保健环境中为患有TBI的成年人开发的有效创新。培训计划 由个性化的心态，高级统计技术的正式课程和专家组成 学习旨在确保进行了严格进行拟议的研究，并发展我的技能 作为传播和实施的独立研究者的领先尖端研究 TBI的有效创新。

项目成果

Implementing traumatic brain injury screening in behavioral healthcare: protocol for a prospective mixed methods study.

• DOI: 10.1186/s43058-022-00261-x
• 发表时间: 2022-02-14
• 期刊: Implementation science communications
• 作者: Coxe-Hyzak KA;Bunger AC;Bogner J;Davis AK;Corrigan JD
• 通讯作者: Corrigan JD

Implementing traumatic brain injury screening in behavioral health treatment settings: results of an explanatory sequential mixed-methods investigation.

• DOI: 10.1186/s13012-023-01289-w
• 发表时间: 2023-08-16
• 期刊: IMPLEMENTATION SCIENCE
• 影响因子: 7.2
• 作者: Hyzak, Kathryn A.;Bunger, Alicia C.;Bogner, Jennifer;Davis, Alan K.;Corrigan, John D.
• 通讯作者: Corrigan, John D.