Organizational Change and Nicotine Dependence Treatment

组织变革和尼古丁依赖治疗

基本信息

批准号：
7621125
负责人：
Joseph R Guydish
金额：
$ 5万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-04-20 至 2011-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7621125
关键词：
Address Adopted Adoption Client Clinic Clinical Trials Network Dentistry Dependence Drug abuse Drug usage Economics Effectiveness Effectiveness of Interventions Evidence based practice Exposure to Faculty Funding General Population Goals Health Health Knowledge, Attitudes, Practice Health Services Research Intervention Intervention Studies Measurement Measures Medicine Modeling Morbidity - disease rate National Institute of Drug Abuse New Jersey Nicotine Nicotine Dependence Organizational Change Outpatients Persons Pharmaceutical Preparations Policies Policy Developments Population Procedures Public Health Schools Rate Research Residential Treatment Risk Sampling Services Smoke Smoking Surveys Technology Telephone Testing Time Tobacco United States Universities addiction burden of illness cost design development policy experience follow-up improved mortality nicotine abuse programs response shift work therapy design therapy development treatment program

项目摘要

Nicotine dependence continues to be the single most preventable cause of morbidity and mortality in the United States. Persons entering drug abuse treatment smoke at 3-4 times the rate, and staff in publicly funded programs smoke at twice the rate, of the general population. Although the burden of illness and associated economic costs of nicotine addiction are elevated in the drug treatment population, treatment programs rarely address comorbid nicotine addiction. While treatment programs increasingly recognize this paradox, there are few models available to guide them in nicotine dependence intervention. This study will test the effectiveness of the manualized Addressing Tobacco through Organizational Change (ATTOC) intervention in facilitating the integration of drug abuse and nicotine dependence treatments. In a multiple baseline design with each program acting as its own control, three residential treatment programs will participate in a 6 month intervention designed to support organizational changes in nicotine policies, staff - level changes in nicotine knowledge, attitudes, practices, and client-level changes in exposure to and utilization of nicotine dependence treatment. At each measurement point (pre-intervention, post-intervention, and follow-up), a longitudinal sample of 50 agency staff will complete surveys concerning nicotine-related knowledge, attitudes and practices, and a cross-sectional sample of 50 agency clients will participate in phone surveys concerning nicotine-related services they have received. This work shifts the focus of nicotine dependence intervention from the person level to the organizational level, and tests the effectiveness of an organizational change intervention designed to address nicotine dependence. The investigative team unites the strengths of the UMDNJ intervention development team with those of the UCSF organizational change study team, in a context where both the intervention and the research procedures have been piloted. The study will be conducted on the NIDA CTN platform with the participation of nationally recognized and research-experienced treatment clinics. The short term goal is to test the effectiveness of the ATTOC intervention in addressing nicotine dependence among drug using persons in treatment. The long term goal,is to develop and disseminate organizational change technologies that can be applied broadly, beyond nicotine dependence, to support programs in adopting evidence based practices.

尼古丁依赖仍然是导致发病率和死亡率的最可预防的单一原因美国。接受药物滥用治疗的人吸烟率是其 3-4 倍，公共场所的工作人员受资助项目的吸烟率是普通人群的两倍。尽管疾病和负担在戒毒治疗人群中，尼古丁成瘾的相关经济成本升高，治疗项目很少解决共病尼古丁成瘾问题。虽然治疗计划越来越认识到这一点矛盾的是，很少有模型可以指导他们进行尼古丁依赖干预。这项研究将测试通过组织变革手动解决烟草问题 (ATTOC) 的有效性促进药物滥用和尼古丁依赖治疗一体化的干预措施。在多个每个项目作为其自身控制的基线设计，三个住院治疗项目将参加为期 6 个月的干预措施，旨在支持尼古丁政策的组织变革，工作人员 - 尼古丁知识、态度、实践水平的变化，以及接触和接触尼古丁水平的变化利用尼古丁依赖治疗。在每个测量点（干预前、干预后、和后续），50名机构工作人员的纵向样本将完成有关尼古丁相关的调查知识、态度和实践，以及 50 个代理客户的横截面样本将参与有关他们接受的尼古丁相关服务的电话调查。这项工作转移了焦点从个人层面到组织层面进行尼古丁依赖干预，并测试旨在解决尼古丁依赖问题的组织变革干预措施的有效性。这调查团队将 UMDNJ 干预开发团队与 UCSF 的优势结合起来组织变革研究团队，在干预和研究程序的背景下已进行试点。该研究将在NIDA CTN平台上进行，全国范围内的参与公认且具有研究经验的治疗诊所。短期目标是测试其有效性 ATOC 干预治疗中吸毒者的尼古丁依赖问题。长的术语目标是开发和传播可广泛应用的组织变革技术，除了尼古丁依赖之外，还支持采用基于证据的做法的计划。