SBIRT in New Mexico

新墨西哥州的 SBIRT

基本信息

批准号：
7587059
负责人：
ROBERT P SCHWARTZ
金额：
$ 43.9万
依托单位：
FRIENDS RESEARCH INSTITUTE, INC.
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-30 至 2014-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7587059
关键词：
Absenteeism at work Accident and Emergency department Address Adopted Adoption Adult Advisory Committees Affect Age Alcohol consumption Alcohol or Other Drugs use Alcohols American Area Behavior Behavioral Biological Biological Assay Categories Characteristics Clinic Clinical Research Collaborations Community Health Computers Counseling Data Data Analyses Dependence Detection Development Disclosure Drug usage Effect Modifiers (Epidemiology)Effectiveness Effectiveness of Interventions Employment Status Environment Ethnic Origin Federal Government Frequencies Friends Gender HIV Hair Health Healthcare Hospitalization Human Resources Illicit Drugs Immunoassay Income Individual Injury Intervention Investigation Investments Knowledge Literature Marital Status Measures Medical Staff Methodology Methods Mexican Americans Minority Modeling New Mexico Outcome Outcome Measure Participant Patient Self-Report Patients Persons Physicians Policy Maker Population Preventive Primary Health Care Public Health Race Radio Randomized Randomized Controlled Trials Recommendation Reimbursement Mechanisms Relative (related person)Research Research Institute Resources Risk Risk Behaviors Role Sampling Science Screening procedure Self-Administered Services Site Standardization Substance of Abuse System Testing Time Tobacco Treatment Effectiveness Treatment outcome United States Substance Abuse and Mental Health Services Administration Visit Work base brief intervention clinical care clinical practice compare effectiveness computerized cost drug of abuse evidence base expectation experience high risk improved innovation intervention effect meetings misuse of prescription only drugs motivational enhancement therapy post intervention pressure primary outcome programs psychological distress public health relevance screening and brief intervention screening, brief intervention, referral, and treatment secondary outcome tool treatment site working group

项目摘要

DESCRIPTION (provided by applicant): A firm evidence base has emerged supporting screening and brief intervention for alcohol use in healthcare settings. However, important gaps exist in the evidence for screening and brief intervention for illegal drug use. Rigorous research is needed that tests the effectiveness of screening and brief intervention for illegal drug use. In the proposed project, Friends Research Institute is partnering with Sangre de Cristo Community Health Partnership, the organization responsible for implementing the SAMHSA Screening, Brief Intervention, Referral, and Treatment (SBIRT) Initiative at over 35 primary care sites throughout the State of New Mexico since 2003. The proposed study will use a randomized controlled trial to compare the effectiveness of a standardized interpersonal brief intervention (IBI) based on motivational interviewing (currently used in the New Mexico SBIRT initiative) with a promising computerized brief intervention (CBI) in reducing illegal drug use and its associated health consequences. In addition, the study will assess whether patients' computer experience differentially moderates the effectiveness of the two interventions. The study will take place at two large primary care clinics in New Mexico. All patients will complete a screening for substance use via the Alcohol, Tobacco, and Substance Involvement Screening Tool (ASSIST) as part of regular clinical care. Patients who score in a moderate-risk category for illegal drug use (n = 360, 180 at each site) will be randomized within their respective clinics to the IBI or CBI condition. Patients with high-risk drug use will be referred for more intensive services as per standard clinical practice. Primary outcomes include drug use levels for major substances of abuse as measured by radio immunoassay analysis of hair samples, as well as global illicit drug risk ASSIST scores. Secondary outcomes include self-reported frequency of hospitalizations, emergency room utilization, injuries, psychological distress, HIV risk behaviors, arrests, missed work days, and earned income. Data analysis will be conducted using a Generalized Linear Mixed Model approach. An effective computerized brief intervention has the potential to make a substantial impact on SBIRT practice and improve public health. An effective CBI has the potential to offer a more acceptable format for addressing drug use behaviors than an interpersonal encounter, and has the expected advantages of having high reach and easy replication with comparatively lower investment of clinicians' time and resources. PUBLIC HEALTH RELEVANCE: The relevance of this research to public health will show that targeted screening in primary care health settings for moderate drug use will have a significant impact on public health by implementing brief interventions that target risky behaviors in moderate drug using individuals. This research, which also tests the differential effectiveness of two brief interventions for illegal drug use, has the potential to make a significant contribution to understanding the role that brief interventions have in reducing drug use and its associated consequences.

描述（由申请人提供）：已经出现了坚实的证据基础，支持在医疗机构中对饮酒进行筛查和简短干预。然而，针对非法药物使用的筛查和短暂干预的证据存在重大差距。需要进行严格的研究来测试非法药物使用筛查和短暂干预的有效性。在拟议的项目中，Friends Research Institute 正在与 Sangre de Cristo Community Health Partnership 合作，该组织负责在新墨西哥州超过 35 个初级保健站点实施 SAMHSA 筛查、简短干预、转诊和治疗 (SBIRT) 计划自 2003 年以来。拟议的研究将使用随机对照试验来比较基于动机访谈（目前在新墨西哥州 SBIRT 计划中使用）的标准化人际简短干预 (IBI) 与有希望的方法的有效性。计算机化简短干预（CBI）减少非法药物使用及其相关的健康后果。此外，该研究还将评估患者的计算机体验是否对两种干预措施的有效性产生差异影响。该研究将在新墨西哥州的两家大型初级保健诊所进行。作为常规临床护理的一部分，所有患者都将通过酒精、烟草和物质参与筛查工具 (ASSIST) 完成物质使用筛查。非法药物使用中度风险类别的患者（n = 360，每个中心 180 名）将在各自的诊所内随机分配至 IBI 或 CBI 状况。根据标准临床实践，高危吸毒患者将被转介接受更强化的服务。主要结果包括通过头发样本的放射免疫分析测量的主要滥用物质的药物使用水平，以及全球非法药物风险 ASSIST 评分。次要结果包括自我报告的住院频率、急诊室使用情况、受伤、心理困扰、艾滋病毒危险行为、逮捕、缺勤和收入。将使用广义线性混合模型方法进行数据分析。有效的计算机化简短干预有可能对 SBIRT 实践产生重大影响并改善公众健康。有效的 CBI 有可能为解决吸毒行为提供比人际接触更容易接受的形式，并且具有预期的优势，即具有较高的覆盖面和易于复制，而临床医生的时间和资源投入相对较少。公共卫生相关性：这项研究与公共卫生的相关性将表明，通过针对中度吸毒个体的危险行为实施简短的干预措施，在初级保健卫生机构中针对中度吸毒进行有针对性的筛查将对公共健康产生重大影响。这项研究还测试了两种针对非法药物使用的短暂干预措施的不同效果，有可能为了解短暂干预措施在减少药物使用及其相关后果方面的作用做出重大贡献。