IVR for Automated Alcohol Screening & BI in Primary Care

用于自动酒精筛查的 IVR

• 批准号: 7142164
• 负责人: JOHN E HELZER
• 金额: $ 18.11万
• 依托单位: UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7142164
• 关键词: alcoholic beverage consumption; alcoholism /alcohol abuse; alcoholism /alcohol abuse therapy; biomedical automation; clinical research; diagnosis design /evaluation; disease /disorder proneness /risk; early /brief intervention /therapy; human subject; human therapy evaluation; interview; mental disorder diagnosis; patient care management; questionnaires; telemedicine

DESCRIPTION (provided by applicant): This is an R21 application for an exploratory /developmental study of Interactive Voice Response (IVR) as a tool for automated screening and brief intervention for heavy/problem drinking in primary care settings. There is overwhelming evidence that a brief alcohol intervention (Bl) by a primary care provider is effective in reducing at-risk drinking among patients. But, there is also evidence that screening and Bl are grossly underutilized by primary care providers. Possible explanations include lack of time, lack of provider awareness of their patients' consumption level, provider discomfort with behavioral interventions, provider doubts about the efficacy of Bl, and lack of reimbursement for preventive services. The results of studies testing the impact of targeted education and/or provider encouragement have been disappointing. In response, there have been calls for automating screening and brief intervention. Most efforts so far have been computer based and not widely tested in primary care settings. While computer-based approaches are worthy of further pursuit, they are not an ideal solution. Computerization requires on-site computer hardware and software, technical support, and clinic staff time to initiate the screening & Bl with patients, some of whom may be intimidated by computers. This is an ongoing financial investment that discourages use in most clinics. This R21 application is for an exploratory effort to test a telephone technology (IVR) as a method of alcohol screening and brief intervention that is inexpensive, uses a familiar and nearly universal technology (touch-tone telephones), and requires essentially no clinical staff time. If this developmental project is successful, we will use the resulting data as a basis for a subsequent randomized controlled trial of the efficacy of IVR-based Bl compared to Bl done by primary care providers. Methods: The study will be done in two phases. In Phase I, we will create an IVR-based screening tool (IVR-Screen) that is acceptable to patients, utilitarian for providers, and valid for identifying patients who are appropriate for brief intervention. After completing Phase I, in Phase II we will develop an IVR-based brief intervention tool (IVR-BI) and test its acceptance among clinic patients who are positive on the IVR-Screen and are appropriate for alcohol brief intervention. Although this is not an efficacy study, we will also assess whether the IVR-BI has a short-term impact on alcohol consumption in this small feasibility sample.

描述（由申请人提供）：这是一项 R21 申请，用于交互式语音应答 (IVR) 的探索性/开发性研究，作为初级保健机构中重度/问题饮酒的自动筛查和简短干预的工具。大量证据表明，初级保健提供者进行的短暂酒精干预 (Bl) 可有效减少患者的高风险饮酒。但是，也有证据表明初级保健提供者对筛查和 BL 的利用严重不足。 可能的解释包括缺乏时间、提供者缺乏对患者消费水平的认识、提供者对行为干预的不适、提供者对 BL 功效的怀疑以及缺乏预防性服务报销。测试有针对性的教育和/或提供者鼓励的影响的研究结果令人失望。作为回应，有人呼吁进行自动化筛查和短暂干预。迄今为止，大多数工作都是基于计算机的，尚未在初级保健机构中进行广泛测试。虽然基于计算机的方法值得进一步追求，但它们并不是理想的解决方案。计算机化需要现场计算机硬件和软件、技术支持以及诊所工作人员对患者进行筛查和 BL 的时间，其中一些患者可能会被计算机吓倒。这是一项持续的财务投资，阻碍了大多数诊所的使用。 此 R21 应用程序旨在探索性地测试电话技术 (IVR) 作为酒精筛查和简短干预的方法，该方法价格低廉，使用熟悉且几乎通用的技术（按键式电话），并且基本上不需要临床工作人员时间。如果这个开发项目成功，我们将使用所得数据作为后续随机对照试验的基础，以比较基于 IVR 的 BI 与初级保健提供者所做的 BI 的功效。方法：该研究将分两个阶段进行。在第一阶段，我们将创建一个基于 IVR 的筛查工具（IVR-Screen），该工具对于患者来说是可以接受的，对于提供者来说是实用的，并且可以有效地识别适合短暂干预的患者。完成第一阶段后，在第二阶段，我们将开发基于 IVR 的简短干预工具 (IVR-BI)，并测试其在 IVR 屏幕上呈阳性且适合酒精简短干预的临床患者中的接受度。虽然这不是一项功效研究，但我们还将在这个小可行性样本中评估 IVR-BI 是否对饮酒量产生短期影响。