Using Implementation Science for Community-Based SBIRT Delivery to Older Adults

利用实施科学为老年人提供基于社区的 SBIRT

• 批准号: 8967014
• 负责人: Denise McCray Scott
• 金额: $ 32.46万
• 依托单位: HOWARD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-15 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8967014
• 关键词: Accidents; Activities of Daily Living; Address; Adopted; Adoption; Adult; Age; Aging; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Anxiety; Awareness; Caring; Characteristics; Communities; Community Health; Community Services; Confusion; Data; Demographic Survey; Disease; Dizziness; Drug Interactions; Elderly; Emergency Department Physician; Emotional; Epidemiology; Event; Evidence based practice; Florida; Health; Healthcare; Hospitalization; Impairment; Intervention; Literature; Memory; Mental Depression; Mental Health; Metabolism; Methods; Non-Prescription Drugs; Pharmaceutical Preparations; Pilot Projects; Prevention; Prevention strategy; Primary Health Care; Privacy; Procedures; Protocols documentation; Provider; Randomized; Randomized Controlled Trials; Recruitment Activity; Research; Research Personnel; Research Project Grants; Research Support; Risk; Self Assessment; Services; Site; Sleep Disorders; Social Health Services; Social Work; Staging; Substance abuse problem; System; Target Populations; Testing; Time; Training; Translations; Visit; aged; alcohol misuse; base; behavioral health; brief intervention; chronic pain; clinical practice; community setting; evidence base; experience; falls; implementation science; improved; innovation; member; misuse of prescription only drugs; population based; prevent; programs; public health relevance; scale up; screening; screening and brief intervention; screening, brief intervention, referral, and treatment; social; substance abuse treatment; tool; treatment adherence; treatment program; treatment strategy

 DESCRIPTION (provided by applicant): Older adults experience chronic pain-related conditions, sleeping disorders, and anxiety and depression that are treated with prescription drugs and over-the-counter medications, often with potentially dangerous interactions with alcohol and across medications. Importantly, levels of alcohol use that are relatively safe for most adults may be unsafe for many older adults, both because of drug interactions and because of differences in metabolism and elimination and may result in accidents and impairments in activities of daily living, leading to increased emergency department and physician visits and hospitalizations. Health care analysts project that by 2030 the number of older adults with behavioral health conditions, including substance abuse disorder, will equal or exceed the number of younger people with these disorders. With these changes occurring, aging baby boomers will require a significant shift in behavioral health and substance abuse/misuse prevention strategies and treatments in the next two decades. The Primary Care Research in Substance Abuse and Mental Health for the Elderly and the Florida BRITE studies demonstrated that brief interventions have a positive impact for older adults. However, as with many interventions, there is concern about the timely translation of SBIRT from research to community-based social and health care settings. Despite the strong research support for SBIRT, its widespread and sustained implementation has not occurred. Several distinct barriers to implementation have been identified including workflow hurdles and providers' time constraints as well as issues around reimbursement and privacy. While strategies for dissemination have been suggested, evidence-based practices for guiding health care or social service professionals as to how to implement and sustain SBIRT are non-existent. The proposed pilot study will collect Information using a mixed methods approach guided by implementation science, specifically the Quality Implementation Framework. The findings will be reviewed by a Collaborative Team composed of the researchers and members of the participating service sites. This information will form the basis for the SBIRT Implementation Protocol (SIP) that will be evaluated in a larger RCT. The SIP represents an innovation for the field to have evidence-based practices and programs adopted and implemented by community service providers with quality, and sustained over time. The study aims are to: 1) Identify organizational- and staff-based barriers and facilitators relevant for the successful implementation of SBIRT 2) Implement SBIRT in community partner organizations 3) Assess the ability to recruit and retain older adults in the SBIRT program: a) identify provider specific barriers and facilitators for program reach of the target population and b) identify characteristic of older adults related to participation and retention in the SBIRT program; and, 4) Identify provider-specific technical assistants needs for continuous delivery of SBIRT and adherence to the SBIRT procedures and its sustainability over a six month period.

 描述（由适用提供）：老年人患有慢性疼痛疾病，睡眠障碍以及焦虑和抑郁症，这些疾病和抑郁症经过处方药和非处方药治疗，通常与酒精以及跨药物的潜在危险相互作用。重要的是，对于大多数成年人而言，相对安全的饮酒水平对于许多老年人来说可能是不安全的，这是由于药物相互作用和代谢和消除的差异，并且可能导致日常生活活动的事故和损害，从而导致急诊室增加，身体就诊和身体就诊和住院。卫生保健分析师预测，到2030年，患有行为健康状况的老年人（包括药物滥用障碍）的数量将等于或超过患有这些疾病的年轻人的数量。随着这些变化的发生，衰老的婴儿潮一代将需要在未来二十年内进行行为健康和滥用药物的预防策略和治疗方法的重大变化。对老年人和佛罗里达州的Brite研究的药物滥用和心理健康的初级保健研究表明，短暂的干预措施对老年人产生了积极影响。但是，与许多干预措施一样，人们担心SBIRT从研究到基于社区的社会和医疗保健环境的及时翻译。尽管对SBIRT有强有力的研究支持，但其宽度和持续实施并未发生。已经确定了几个不同的实施障碍，包括工作流障碍和提供商的时间限制以及围绕报销和隐私的问题。尽管已经提出了传播策略，但指导医疗保健或社会服务专业人员如何实施和维持Sbirt的基于证据的实践是不存在的。拟议的试点研究将使用以实施科学为指导的混合方法来收集信息，尤其是质量实施框架。研究结果将由由研究人员和参与服务网站的成员组成的合作团队进行审查。此信息将构成SBIRT实施协议（SIP）的基础，该协议将在较大的RCT中进行评估。 SIP代表了该领域的一种创新，以具有质量质量并随着时间而维持的社区服务提供商采用和实施的循证实践和计划。 The study aims are to: 1) Identify organizational- and staff-based barriers and facilitators relevant for the successful implementation of SBIRT 2) Implement SBIRT in community partner organizations 3) Assess the ability to recruit and retain older adults in the SBIRT program: a) identify provider specific barriers and facilitators for program reach of the target population and b) Identify characteristic of older adults related to participation and retention in the SBIRT program;以及4）确定提供者特定的技术助理在六个月内连续交付Sbirt和遵守SBIRT程序及其可持续性的需求。