Development of a Novel Peer-Narrated Virtual Patient Decision Aid for Entry into Alcohol Treatment for ICU Survivors with Alcohol Misuse

开发新型同伴叙述虚拟患者决策辅助工具，帮助 ICU 酗酒幸存者接受酒精治疗

• 批准号: 10679242
• 负责人: Kelsey R Hills-Dunlap
• 金额: $ 8.34万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10679242
• 关键词: Abstinence; Address; Admission activity; Advisory Committees; Alcohol consumption; Alcohols; Area; Behavior; Benchmarking; Caring; Cessation of life; Clinical Sciences; Colorado; Counseling; Critical Care; Critical Illness; Data; Decision Aid; Decision Making; Dependence; Development; Ensure; Environment; Familiarity; Feedback; Fellowship Program; Future; Goals; Health Services; Health Services Accessibility; Health behavior change; Hearing; Hospitalization; Hospitals; Inpatients; Insurance Coverage; Intensive Care Units; Intention; Intervention; Interview; Knowledge; Learning; Link; Medical; Medicine; Mentors; Mentorship; Methodology; Motivation; Narration; National Institute on Alcohol Abuse and Alcoholism; Patient Admission; Patients; Prevalence; Process; Qualitative Methods; Recovery; Rehabilitation therapy; Reporting; Research; Research Methodology; Research Personnel; Risk; Structure; Survivors; Testing; Thinking; Time; Universities; Wait Time; Waiting Lists; Work; acute care; addiction; adverse outcome; alcohol abuse therapy; alcohol intervention; alcohol misuse; alcohol use disorder; career; clinical practice; drinking; effectiveness study; experience; hospital readmission; innovation; interest; long term recovery; metropolitan; multidisciplinary; novel; patient engagement; patient population; peer; pilot test; pilot trial; pragmatic trial; programs; prototype; skills; social separation; treatment center; treatment program; virtual; virtual intervention; virtual patient; virtual therapy

Project Summary / Abstract Alcohol misuse, which includes alcohol use disorder (AUD), is present in up to 2 million patients admitted to an intensive care unit (ICU) each year. The ICU admission may be a “teachable moment” and many ICU survivors are motivated to change their drinking. Unfortunately, the current paradigm for linking ICU survivors to alcohol treatment is ineffective. The unique challenge in harnessing an ICU patient’s motivation is that alcohol treatment programs are separated from the acute care environment. This proposal describes a 2-year research fellowship program that will iteratively develop and pilot a peer-narrated virtual tour regarding treatment for ICU survivors with AUD and will allow Dr. Kelsey Hills-Dunlap to develop an academic career in Critical Care Medicine. The proposed research program will develop the first and only virtual intervention for ICU survivors with AUD aimed at increasing entry to alcohol treatment and will provide the research skills necessary to further Dr. Hills- Dunlap toward her goal of becoming an independent investigator in alcohol health services and critical care research. The program will consist of direct mentoring from a multidisciplinary team of nationally renowned local experts in alcohol and critical illness, health behavior change, decision aids, and qualitative methodology. In addition, a formalized research advisory committee will ensure that the goals and benchmarks of this proposal are met. The program will also include coursework in clinical sciences, addiction medicine and medical decision making. This cohesive program will help Dr. Hills-Dunlap learn and apply multiple research methods, acquire foundational knowledge of addiction medicine focusing on AUD, and gain expertise in the development and implementation of decision aids for ICU survivors with AUD. The overall research goal of this proposal is to optimize the way in which alcohol treatment options are delivered to ICU survivors with AUD through the creation of a peer-narrated virtual tour prototype. Presenting treatment options in the form of a peer-narrated virtual tour may help overcome the separation between the acute care environment and alcohol treatment programs. Dr. Hills-Dunlap will build this prototype by first conducting semi- structured interviews in ICU survivors with AUD to determine the content of the tour. Subsequently, she will use a rigorous process of development and feedback to create a video prototype of a peer-narrated virtual tour of the Center for Dependency, Addiction and Rehabilitation (CeDAR), a nationally recognized addiction treatment center at the University of Colorado Anschutz Medical Campus, and will pilot the prototype for acceptability. This will pave the way for a NIAAA K23 submission to complete peer-narrated virtual tours for the remaining treatment options in the Denver area and conduct a pragmatic effectiveness study. A peer-narrated virtual tour for ICU survivors with AUD would help to close the treatment gap for a large population of patients at a time when they are uniquely motivated to change.

项目摘要 /摘要 滥用酒精滥用，包括酒精使用障碍（AUD），最多有200万患者接受 每年重症监护室（ICU）。 ICU入学可能是“可教的时刻”，许多ICU幸存者 有动力改变他们的饮酒。不幸的是，当前用于将ICU存活与酒精联系起来的范式 治疗无效。利用ICU患者动机的独特挑战是酒精治疗 程序与急性护理环境分开。该建议描述了一项为期两年的研究奖学金 该计划将迭代地开发和试行有关ICU幸存治疗的同伴纳尔虚拟旅行 与AUD一起，将允许Kelsey Hills-Dunlap博士在重症监护医学领域发展学术生涯。 拟议的研究计划将开发与AUD的ICU生存的第一个也是唯一的虚拟干预 旨在增加酒精治疗的进入，并将提供进一步的研究技能，以进一步 达拉普（Dunlap 研究。该计划将包括来自多学科的全国知名当地团队的直接心理 酒精和重症疾病，健康行为改变，决策辅助和定性方法的专家。 此外，正式的研究咨询委员会将确保该提案的目标和基准 被满足。该计划还将包括临床科学，成瘾医学和医疗决定的课程 制作。该凝聚力计划将帮助Hills-Dunlap博士学习并应用多种研究方法，获取 成瘾医学的基础知识专注于AUD，并在开发方面获得专业知识和 使用AUD实施ICU表面的决策辅助工具。 该建议的总体研究目标是优化提供酒精治疗选择的方式 通过创建同龄人的虚拟旅游原型，通过AUD进行ICU冲浪者。提出治疗 以同伴的虚拟游览形式的选项可能有助于克服急性护理之间的分离 环境和酒精治疗计划。 Hills-Dunlap博士将通过首先进行半 与AUD的ICU生存中的结构化访谈以确定巡回演出的内容。随后，她会的 使用严格的开发和反馈过程来创建同伴纳尔的虚拟旅行的视频原型 依赖，成瘾和康复中心（Cedar），这是一个全国认可的成瘾 科罗拉多大学安索兹大学医疗校园的治疗中心，并将试行原型 可接受性。这将为NIAAA K23提交的方式铺平道路 丹佛地区的剩余治疗选择并进行了务实的有效性研究。同伴 使用AUD的ICU幸存的虚拟旅行将有助于缩小大量患者的治疗差距 这是他们独特地动力改变的时期。