Micro-targeted Computerized Alcohol Misuse Intervention System for Health Care

用于医疗保健的微目标计算机酒精滥用干预系统

• 批准号: 8715016
• 负责人: Diana Howard Caldwell
• 金额: $ 51.09万
• 依托单位: RESEARCH CIRCLE ASSOCIATES, LLC
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8715016
• 关键词: Administrator; Adopted; Adoption; Age; Alcohol abuse; Alcohol consumption; Alcohols; Algorithms; Architecture; Attention; Attitude; Award; Behavioral Risk Factor Surveillance System; Characteristics; Clinic; Clinical; Clinical Services; Code; Community Health Centers; Complex; Computer software; Computers; Cost Savings; Data; Data Set; Development; Disease; Drug usage; Effectiveness; Effectiveness of Interventions; Electronic Health Record; Ensure; Epidemiology; Ethnic Origin; Feedback; Focus Groups; Gender; Generic Drugs; Genetic Crossing Over; Grant; Health; Health Promotion; Health behavior; Health education; Healthcare; Healthcare Systems; Industry; Intervention; Left; Mainstreaming; Marketing; Maryland; Mediator of activation protein; Medical; Motivation; National Ambulatory Medical Care Survey; Participant; Patients; Peer Review; Penetration; Phase; Physicians; Pilot Projects; Placebo Control; Population; Positioning Attribute; Prevention strategy; Preventive; Primary Health Care; Provider; Public Health; Questionnaires; Race; Randomized Controlled Trials; Readiness; Research; Review Literature; Risk Behaviors; Services; Site; Small Business Technology Transfer Research; Societies; Staging; Survey Methodology; Surveys; System; Target Populations; Thinking; Treatment Efficacy; United States; Update; Variant; Visit; Visual; Work; alcohol intervention; alcohol misuse; alcohol screening; alcohol screening and brief intervention; base; behavior change; binge drinking; brief intervention; commercialization; computerized; cost; design; drinking; drinking behavior; economic impact; evidence base; health economics; health record; improved; informant; information gathering; intervention effect; motivational enhancement therapy; multi-component intervention; normative feedback; novel; prevent; primary care setting; programs; prototype; public health relevance; reduced alcohol use; routine care; screening; screening and brief intervention; screening, brief intervention, referral, and treatment; social; therapy design; therapy development; usability

DESCRIPTION (provided by applicant): Alcohol misuse continues to pose a major burden for public health. Screening and brief intervention for alcohol misuse in primary care settings has been recommended for decades, and the evidence base supporting it in primary care is robust. However, many primary care providers do not intervene in alcohol misuse, and those that do often fail to do so systematically or in accordance with best-evidence standards. Computerization of screening and brief intervention for alcohol misuse holds the promise of alleviating many of the barriers that have prevented its adoption into routine care, and also offers new opportunities for optimizing the effectiveness of brief interventions. This Phase 2 STTR project follows up on Research Circle Associates' successful proof- of-concept work done under Phase 1, which led to the development of a versatile software platform (Interventionaire(c)) to support computerized alcohol misuse screening and brief intervention using evidence- based strategies including motivational interviewing and normative feedback. Our computerized alcohol misuse intervention includes a normative feedback component that is unique in its micro-targeting of alcohol use feedback based on participant demographic characteristics (race/ethnicity, gender, and age), drawing population normative data from the National Surveys on Drug Use and Health. This represents a novel use of epidemiological data to inform clinical services. The Phase 2 project is designed to answer a number of important research questions and prepare the product for successful commercialization. Specifically, during Phase 2 we intend to implement several refinements into the (Interventionaire(c)) platform that will increase its usability and streamline the creation of complex content with tailored feedback. We will also upgrade the software to make it compatible with a major electronic health record system used by our clinical partner site. This will increase the reach of the product and ensure maximum readiness for deployment into the modern healthcare marketplace, a dynamic and rapidly evolving industry. We will also conduct a study at our clinical partner site using qualitative key informant, focus group, and survey methodologies to investigate barriers to adopting computerized alcohol screening and brief intervention systems. A critical question is whether the computerized alcohol misuse intervention is effective in changing drinking behavior. To answer this question, we will conduct a cross-over randomized controlled trial examining the short-term impact of the computerized alcohol misuse intervention with micro-targeted normative feedback and motivational messaging compared to an "attention-control" (placebo) generic health promotion message. This trial will help to establish the short- term efficacy of the intervention and set the stage for larger trials and adoption of the product i healthcare settings. Finally, we will conduct a projection analysis of the economic and health impacts of the intervention under a variety of assumptions regarding intervention effect size, target population, and product penetration. Satisfying these Phase 2 objectives will leave RCA well-poised to deploy the product commercially, which will leverage the power of the market to improve clinical service delivery and promote public health.

描述（由申请人提供）：滥用酒精会继续为公共卫生带来重大负担。数十年来，建议在初级保健环境中进行筛查和简短的滥用酒精滥用，并且在初级保健中支持它的证据基础是强大的。但是，许多初级保健提供者不会干预滥用酒精，而那些通常无法系统地或符合最佳证据标准的提供者。筛查的计算机化和对酒精滥用的简短干预措施有望减轻许多阻止其采用常规护理的障碍，并为优化短暂干预的有效性提供了新的机会。该第2阶段的STTR项目跟进了研究圈中的协会，协会在第1阶段进行的成功证明了概念概念，这导致了多功能软件平台（Issentionaire（c））的开发，以支持计算机化的酒精滥用筛查和使用基于证据的策略进行简短的干预，包括动机访谈和规范反馈。我们的计算机酒精滥用干预包括基于参与者人口统计学特征（种族/民族，性​​别和年龄）的酒精使用反馈的规范反馈组成部分，从国家使用毒品使用和健康的国家调查中获取人口规范性数据。这代表了流行病学数据的新颖使用来为临床服务提供信息。第二阶段项目旨在回答许多重要的研究问题，并为成功的商业化准备产品。具体而言，在第2阶段，我们打算将多个改进实施到（Ispentionaire（C））平台中，以提高其可用性并简化使用量身定制的反馈来创建复杂内容。我们还将升级该软件，使其与临床合作伙伴网站使用的主要电子健康记录系统兼容。这将增加产品的覆盖范围，并确保最大的部署到现代医疗保健市场，这是一个动态且迅速发展的行业。我们还将使用定性的关键线人，焦点小组和调查方法在我们的临床合作伙伴站点进行一项研究，以调查采用计算机化酒精筛查和简短干预系统的障碍。一个关键的问题是计算机化的酒精滥用干预措施是否有效改变饮酒行为。为了回答这个问题，我们将进行一项交叉的随机对照试验，研究与“注意力控制”（安慰剂）通用健康促进信息相比，使用微目标的规范性反馈和动机传递对计算机化酒精滥用干预的短期影响。该试验将有助于建立干预措施的短期疗效，并为更大的试验和采用I Healthcare设置奠定了基础。最后，我们将在各种假设下对干预效果规模，目标人群和产品渗透的各种假设下的经济和健康影响进行投影分析。满足这些阶段2的目标将使RCA畅通无阻，以商业部署产品，这将利用市场的力量来改善临床服务的交付并促进公共卫生。