Screening for Substance Use with Computer Assisted Self Interview in Primary Care

在初级保健中通过计算机辅助自我访谈筛查药物使用

• 批准号: 8028169
• 负责人: Jennifer McNeely
• 金额: $ 17.94万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8028169
• 关键词: Screening; Substance; Use; Computer; Assisted; Screening; Substance; Use; Computer; Assisted

DESCRIPTION (provided by applicant): I am a physician and early career translational investigator, with a research focus on identifying effective approaches for integrating substance abuse treatment into general healthcare settings. Because screening patients for substance abuse is time consuming on the part of clinicians, I propose research to address the validity of patient self-administered screening. The specific research and training aims of this study are integrated around two primary areas of focus: behavioral research methods (survey research, quantitative analysis, qualitative methods) and implementation research. Each of these areas is anchored by an experienced mentor with corresponding expertise, and further developed through didactic instruction combining coursework and directed readings as well as research experience. Under the sponsorship of my primary mentor Marc Gourevitch, MD, MPH, my research and training plans utilize the clinical and academic resources of New York University-Langone Medical Center and Bellevue Hospital, where substance abuse treatment and research has been a longstanding area of emphasis. My proposed study explores an innovative approach to improving rates of substance use screening in primary care, a major impediment to which has been the lack of a brief instrument that can accurately and efficiently identify patients with unhealthy substance use behaviors. The widely accepted and validated "Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is too lengthy for the typical medical visit, and greatly under-utilized as a result. I will adapt the ASSIST, which was designed and validated to be administered as an in-person interview, to an audio guided computer-assisted self interview (ACASI) that patients can complete prior to their medical visit. I plan a mixed methods study in 3 phases to 1) adapt the ASSIST for ACASI administration in an urban safety- net primary care clinic population; 2) test its validity relative to the traditional interviewer-administered ASSIST; and 3) explore physician attitudes to using these screening results to address substance use in the primary care office. PUBLIC HEALTH RELEVANCE: The proposed study will make a valuable contribution to advancing the integration of substance use screening into regular primary care practice. This is an important step toward my long-term goal of developing, implementing, and disseminating simple but effective interventions that improve the capacity of medical systems to respond to the health burden of substance abuse and dependence. My research, mentorship and training activities lay the groundwork for a line of research that will define my career as an independent investigator and physician leader in improving the health of substance users.

描述（由申请人提供）：我是医师和早期职业转化调查员，研究重点是确定将药物滥用治疗纳入一般医疗保健环境的有效方法。由于临床医生筛查患者滥用药物的滥用时间很耗时，因此我建议研究以解决患者自我管理筛查的有效性。这项研究的具体研究和培训目的围绕着两个主要重点领域进行了整合：行为研究方法（调查研究，定量分析，定性方法）和实施研究。这些领域的每个领域都是由经验丰富的专业知识的经验丰富的导师锚定的，并通过结合课程和定向阅读和研究经验的教学教学进一步发展。在我的主要导师马克·古列维奇（Marc Gourevitch）的赞助下，我的研究和培训计划利用了纽约大学统一医学中心和贝尔维尤医院的临床和学术资源，在那里药物滥用治疗和研究一直是重点的长期重点。我提出的研究探讨了一种创新的方法来提高初级保健中物质使用筛查的速率，这是缺乏一种短暂的工具，可以准确有效地识别具有不健康药物使用行为的患者。被广泛接受和验证的“酒精，吸烟和物质参与筛查测试（Assiss）对于典型的医学访问太长，因此非常不足。我将适应助攻，该助攻被设计和验证，以至于无法作为面对面的访谈进行管理，以至于他们在计算机辅助的自我访谈（ACASI）的方法（ACASI）进行了研究。在城市安全诊所人口中，ACASI给药； 公共卫生相关性：拟议的研究将为推进将药物使用筛查纳入常规初级保健实践的整合做出宝贵的贡献。这是朝着我的长期目标迈出的重要一步，即开发，实施和传播简单但有效的干预措施，以提高医疗系统对滥用药物和依赖的健康负担的能力。我的研究，指导和培训活动为一系列研究奠定了基础，这些研究将定义我作为独立研究者和医师领导者的职业，以改善药物使用者的健康状况。