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.

项目概要/摘要 创伤性脑损伤 (TBI) 是美国乃至全球成年人面临的重大公共卫生危机。 新的或恶化的物质使用障碍 (SUD) 和心理健康合并症引人注目的是，TBI 可以。 导致意外用药过量的可能性增加 10 倍，这在 TBI 中尤其常见。 在行为健康治疗中寻求 SUD 和其他心理健康合并症治疗的成年人 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） 行为健康提供者可以使用识别方法来识别 TBI 的终生史 客户；然而，提供者未能将 TBI 筛查纳入常规行为医疗保健中。 识别可能会影响临床护理决策和客户结果然而，研究尚未调查。 影响行为健康提供者采用 TBI 筛查的决定因素 该提案的主要目标以计划行为理论为指导。 （TBP）和罗杰的创新扩散理论（DOI）我建议进行一项前瞻性队列研究。 调查 TBP 中的提供者层面的特征（态度、主观规范、感知 行为控制、意图）以及来自 DOI 的创新水平因素（可接受性、可行性和 TBI 筛查的适当性）影响 TBI 筛查在行为健康治疗背景下的采用。 使用混合方法，我提出了三个具体目标：（1）检查行为健康之间的关系 提供者的态度、感知行为控制和主观规范作为 TBI 筛查的预测因素 意图并检查采用 TBI 筛查的意图是否可以预测实际的 TBI 筛查行为 1个月随访；（2）调查TBI筛查的可接受性、可行性和适当性； 调节 TBI 筛查意图和实际筛查行为之间的关系；以及 (3) 通过半结构化访谈定性评估 TBI 筛查采用的背景决定因素。 这项拟议的研究是翻译和实施现有的和实施的必要进步。 在行为医疗保健背景下为 TBI 成人开发的有效创新培训计划。 包括个性化指导、高级统计技术的正式课程以及体验式课程 学习的目的是确保拟议的研究严格进行并发展我的技能 作为独立研究者在传播和实施方面领导尖端研究 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.