RANDOMIZED TRIAL OF THE BRIEF NEGOTIATED INTERVIEW

简短协商访谈的随机试验

基本信息

批准号：
2837884
负责人：
Edward Bernstein Bernstein
金额：
$ 64.56万
依托单位：
BOSTON UNIVERSITY MEDICAL CAMPUS
依托单位国家：
美国
项目类别：
财政年份：
1997
资助国家：
美国
起止时间：
1997-12-10 至 2002-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/2837884
关键词：
case history clinical research clinical trials cocaine crack cocaine drug abuse drug abuse therapy health care service utilization heroin human subject interview questionnaires

项目摘要

DESCRIPTION: (Applicant's Abstract) Practical methods to facilitate detection of drug abuse and referral to treatment must be investigated. Brief intentions based on negotiation, decisional balance, and readiness to change are effective with alcohol abusers, but have not been adequately tested among crack/cocaine and heroin drug users. This study utilizes a randomized controlled trial to test the effectiveness of a brief negotiated interview and active referral process for linking crack/cocaine and heroin abusing patients from the general medical setting to the drug treatment system. Outreach workers from the same minority communities as the patients (the indigenous leader model) will be used to increase the effectiveness of intervention. 17,600 patients will be screened in the Urgent Care and Women's Health clinics at Boston Medical Center, using DAST and frequency of use questions embedded in a Health Needs History. We expect to detect 10% or 1760 patients with heroin and/or crack/cocaine use in the last three months and a DAST score > 3, and offer them enrollment. All enrollees will be assessed at baseline by researchers blinded to intervention or control status with biochemical analysis of hair for crack/cocaine and heroin, the Addiction Severity Instrument (ASI) and the Readiness to Change Ruler. After random allocation, a control group of 800 will receive the standard of care only (written advice/referral to treatment) and an intervention group of 800 will receive the same advice/referral materials plus a brief negotiated interview to encourage them to seek treatment. Follow up of control and intervention groups will occur at 3 and 6 months, and will consist of biochemical analysis, a structured interview, and repeat of the ASI Questionnaires. Treatment contact records obtained from subjects and from the State MIS Treatment database, and comprehensive charge and health care utilization data obtained from subjects and from Boston Medical Center for an 18 month preperiod and 18 month post-period will be analyzed to permit comparison of control and intervention groups. Subjects will also be compared for self-reported behaviors (improvement in DAST and ASI scores) and by biochemical test results. We hypothesize that the use of the brief negotiated interview and active referral process by outreach workers will facilitate access to treatment for patients in the general medical setting, (1) result in a 3:1 ratio of treatment contact compared to controls, (2) improve DAST and ASI scores, (3) reduce the number of hair samples positive for crack/cocaine and heroin, and (4) reduce Emergency Department and inpatient utilization, and substance abuse-related hospital admissions, visits and costs.

描述：（申请人摘要）促进药物滥用检测和转介的实用方法必须对治疗进行研究。基于谈判的简短意向，决策平衡和改变的准备对于酒精来说是有效的滥用者，但尚未在快克/可卡因和海洛因中进行充分测试吸毒者。本研究利用随机对照试验来测试简短协商面试和积极转介流程的有效性用于将快克/可卡因和海洛因滥用患者与普通患者联系起来医疗环境到药物治疗系统。外展工作人员来自与患者相同的少数族裔社区（土著领袖模式）将用于提高干预的有效性。 17,600 名患者将在波士顿医疗中心的紧急护理和妇女健康诊所进行筛查中心，使用健康需求中嵌入的 DAST 和使用频率问题历史。我们预计将检测到 10% 或 1760 名携带海洛因和/或过去三个月内使用快克/可卡因且 DAST 分数 > 3，并提供他们报名。研究人员将在基线上对所有参与者进行评估对头发生化分析的干预或控制状态不知情对于快克/可卡因和海洛因，成瘾严重程度仪器 (ASI) 和准备改变统治者。随机分配后，对照组 800 将仅接受标准护理（书面建议/转介至治疗），800 人的干预组将接受相同的治疗建议/推荐材料加上简短的协商面试以鼓励他们寻求治疗。对照组和干预组的随访将发生在 3 个月和 6 个月时，包括生化分析、结构化访谈，并重复 ASI 问卷。治疗从受试者和国家 MIS 治疗中获得的接触记录数据库，并获得综合收费和医疗保健利用数据来自受试者和波士顿医疗中心 18 个月的前期和将分析 18 个月的后期，以便比较控制和干预组。还将对受试者的自我报告进行比较行为（DAST 和 ASI 分数的改善）和生化测试结果。我们假设使用简短的协商访谈和外展工作人员的积极转介过程将有助于获得在一般医疗环境中对患者进行治疗，(1) 结果为 3:1 与对照组相比，治疗接触的比例，(2) 改善 DAST 和 ASI 分数，(3) 减少快克/可卡因阳性头发样本的数量，以及海洛因，以及 (4) 减少急诊室和住院病人的使用，以及与药物滥用相关的住院、就诊和费用。