Brief Intervention in the ER in Poland

对波兰急诊室的简短干预

基本信息

批准号：
7209884
负责人：
CHERYL J CHERPITEL
金额：
$ 18.28万
依托单位：
PUBLIC HEALTH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-03-05 至 2009-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7209884
关键词：
Accident and Emergency department Address Affect Age Alcohol abuse Alcohol consumption Alcohol dependence Alcohol or Other Drugs use Alcoholic beverage heavy drinker Alcohols American College of Surgeons Analysis of Variance Applications Grants Biological Blinded Caring Charge Cities Consent Consumption Country Cultural Characteristics Data Data Collection Development Disease regression Early identification Effectiveness Effectiveness of Interventions Emergency Medicine Environment Equation Esthesia European Evaluation Event Feasibility Studies Funding Geographic Locations Guidelines Health Health Services Accessibility Healthcare Systems Heavy Drinking Human Resources Impulsivity Injury International Intervention Intervention Studies Intervention Trial Knowledge Laboratories Lead Logistic Regressions National Institute on Alcohol Abuse and Alcoholism Neuro-Oncological Ventral Antigen 2 Numbers Nurses Outcome Outcome Assessment Patient Self-Report Patients Pattern Physicians Poland Policies Polishes Population Prevalence Primary Health Care Protocols documentation Provider Public Hospitals Quality of life Randomized Rate Readiness Relative (related person)Research Research Personnel Risk Risk-Taking Sampling Score Screening procedure Selection Bias Services Site Staging Standards of Weights and Measures Substance of Abuse System Techniques Testing Thinking Time Training Translating Trauma Treatment Protocols Treatment outcome United States Substance Abuse and Mental Health Services Administration Visit Week alcohol abuse therapy alcohol related problem alcohol use disorder breath alcohol measurement care seeking cost day drinking early /brief intervention /therapy follow-up injured motivational enhancement therapy motivational intervention problem drinker programs social trauma centers willingness

项目摘要

DESCRIPTION (provided by applicant): The aims of this Developmental Grant Proposal for Collaborative International Projects are to: 1) examine the effectiveness of Screening, Brief Intervention and Referral to Treatment (SBIRT) using a nurse-delivered motivational intervention, relative to standard care with and without assessment, on a reduction in heavy drinking (drinking days per week, number of drinks per day, maximum number of drinks on an occasion) and alcohol-related problems (RAPS4 and SIPS + 6) in the emergency room (ER) in Sosnowiec, Poland; and, 2) identify variables that are related to effectiveness of the intervention and that predict successful treatment outcome. We plan to translate motivational interventions that have been successful in primary care and which were recently implemented in the U.S. 14 Academic Emergency Medicine SBIRT study to a non-academic ER setting outside of the U.S. The SBIRT study, recently funded by NIAAA and SAMHSA, is the first multisite, collaborative study of screening, brief intervention and referral for at-risk and dependent drinking in the ER. We will conduct a blinded randomized brief motivational intervention trial in which both injured and noninjured patients over the aged of 18 will be screened for at-risk or dependent (using the RAPS4) drinking. Those screening positive will be asked to participate in the study. Consenting patients will be randomized into one of three groups: screened only, assessed, and brief intervention, with n=292 in each group. Intervention and assessment groups will be followed-up at 3 months and all three groups at 12 months. Modifying variables include drinking in the event, risk taking disposition and readiness and stage of change. Prior research in the ER in Sosnowiec and a pilot feasibility study of SBIRT in Sosnowiec suggest: 1) a large number of "at risk", heavy problem and dependent drinkers who meet screening criteria for brief intervention in a relatively short period of time; 2) a socialized health care system which provides equal access to care and is not subject to selection bias affecting patient access; 3) a patient sample covering a large geographic area; 4) a stable environment facilitating high follow-up rates post-intervention; and, 5) a well integrated referral system and high accessibility to alcohol treatment services. Outcome data will be analyzed using ANOVA, logistic regression and Generalized Estimating Equations. The interaction of modifying variables on outcomes will also be analyzed. The ER is an important setting for screening and brief intervention for those with alcohol-related problems in order to reduce subsequent alcohol-related ER visits and associated costs and increase quality of life. This project will inform the development and spread of more effective techniques and protocols for addressing at-risk and dependent drinking in the ER, and provide a better understanding of those factors that influence effectiveness of brief intervention and predict successful patient outcomes.

描述（由申请人提供）：对国际协作项目的这项发展赠款提案的目的是：1）使用护士分配的动机干预，相对于具有和无评估的标准护理，对筛查，简短干预和转诊（SBIRT）的有效性（SBIRT），每周的饮酒日，每天饮料，每天饮料，每天的饮料（每天）饮料（每天），均为酒精饮料（每天），乘以酒精的数量（均可）在波兰索斯诺伊奇的急诊室（ER）； 2）确定与干预有效性相关的变量，并预测成功的治疗结果。我们计划将在美国14学术急诊医学SBIRT研究中实施的激励性干预措施翻译为美国以外的非学术急诊医学SBIRT研究，该研究是在美国以外的非学术急诊室环境，该研究最近由NIAAA和SAMHSA资助，是NIAAA和SAMHSA的资助，是第一项多现场的筛查，简短的介入，简短的介入，干预和参考，以便在ER中饮酒。我们将进行一项盲目的随机简短动机干预试验，其中年龄在18岁时受伤和未受伤的患者将被筛选，以供处于危险或依赖（使用RAPS4）饮酒。那些筛查积极的人将被要求参加研究。同意患者将被随机分为三组之一：仅筛选，评估和简短干预，每组n = 292。干预和评估组将在3个月和12个月的所有三个组中进行随访。修改变量包括在此事件中喝酒，冒着处置，准备就绪和变化阶段的风险。 Sosnowiec的ER研究和SBIRT的试点可行性研究表明：1）大量“面临的危险”，“沉重的问题”，与依赖的饮酒者符合筛查标准，以在相对较短的时间内进行短暂干预； 2）社会化的医疗保健系统，可提供平等的护理机会，并且不受影响患者访问的选择偏见； 3）覆盖较大地理区域的患者样本； 4）稳定的环境，促进干预后较高的随访率； 5）综合的推荐系统和酒精治疗服务的高可访问性。结果数据将使用方差分析，逻辑回归和广义估计方程进行分析。还将分析修改变量在结果上的相互作用。 ER是与酒精相关问题的人进行筛查和简短干预的重要环境，以减少随后与酒精相关的急诊就诊和相关成本并提高生活质量。该项目将为解决急诊室中高危和依赖饮酒的更有效技术和协议的开发和传播提供信息，并更好地理解那些影响短暂干预并预测成功患者结果的因素。