Screening and Brief Intervention for Latino and non-Latino White Drug Users

对拉丁裔和非拉丁裔白人吸毒者的筛查和简短干预

• 批准号: 7806343
• 负责人: JOHN D CLAPP
• 金额: $ 49.56万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7806343
• 关键词: Accident and Emergency department; Data; Drug usage; Drug user; Effectiveness; Environment; Feasibility Studies; Focus Groups; Goals; Healthcare Systems; Hispanics; Intervention; Latino; Methods; Patients; Pharmaceutical Preparations; Population; Qualifying; Research Personnel; Screening procedure; experience; follow-up; innovation; intervention program; screening and brief intervention

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (05): Comparative Effectiveness Research and specific Challenge Topic, 05-DA-104: Comparing Drug Treatment Effectiveness in Ethnic Minority Populations. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a comprehensive, integrated public health approach to identify and deliver a spectrum of early detection and treatment services for substance use in general medical care settings. The effectiveness of SBIRT has been demonstrated in numerous studies, and SBIRT is considered best practice by leading national medical associations for identifying and treating substance misuse even at early states. However, it is not known if SBIRT is effective for Latino/Hispanic populations, an important gap in knowledge given the large and growing numbers of Latinos, their relatively high drug use prevalence, and the disparities between Latinos and other ethnic/racial groups in terms of substance abuse treatment. This 2-year study will evaluate the effectiveness of SBIRT for drug use and related factors among 500 Latino and 500 non-Latino Whites visiting a large urban emergency department for various reasons. A randomized two-group repeated measures design will be used in which drug-related outcomes of an intervention group will be compared to those of an attention-placebo control group. Participants who report illicit drug use will be recruited from the waiting room of a large hospital Emergency Department, and randomly assigned to one of the two conditions. The intervention group (¿Life Shift¿) will receive SBIRT drug intervention matched to their risk level and drug of choice. To assess the ¿true¿ effect of the SBIRT intervention (I.e., minus the effects of attention), a control group will receive the same quantity of intervention in the area of driving safety (¿Shift Gears¿). Baseline and 6-month follow-up measures will be collected for all participants, and will include (a) standardized subjective drug use measures, (b) other measures presumed to be targeted by the intervention (e.g., functional status, perceived barriers to change), and (c) a biological sample tested for the presence or absence of multiple illicit drugs to increase the accuracy of subjective abstinence reports at the follow-up. In addition, driving safety control items will be collected to test the result of the experimental manipulation, with the attention-placebo control group expected to have greater pre-post change on these measures than the SBIRT intervention group. Latino/White differences in responses to the intervention will be the primary focus of the study. Generalized estimating equations (GEE) will be sued to test intervention-control group differences in follow-up abstinence rates, and whether experimental group differences hold for both Latinos and non-Latino Whites. Impact of the intervention on other outcomes including frequency and amount of drug use, functioning in life areas, subsequent health care utilization, and presumed intermediate variables targeted by the intervention will also be analyzed overall and by ethnic group. Process and implementation variables, (e.g., intervention coverage, observational quality measures, patient satisfaction) will be collected to measure fidelity of implementation, and to assess possible ethnic differences. This randomized control group study will be the first to establish if screening and brief intervention delivered in primary care settings during a ¿teachable moment¿ can motivate both Latino and non-Latino Whites to reduce drug involvement.

描述（由应用程序提供）：此申请解决广泛的挑战领域（05）：比较有效性研究和特定挑战主题，05-DA-104：比较少数民族人口中的药物治疗有效性。筛查，简短的干预和对治疗（SBIRT）的转诊是一种全面的，综合的公共卫生方法，可在一般医疗服务中识别和提供各种早期检测和治疗服务，以供药物使用。在许多研究中已经证明了SBIRT的有效性，即使在早期州，SBIRT则被领导国家医学协会识别和治疗药物滥用的最佳实践。但是，尚不清楚Sbirt是否对拉丁裔/西班牙裔人群有效，这是鉴于大量和越来越多的拉丁裔的重要差距，其相对较高的药物使用率以及拉丁美洲人与其他种族/种族群体之间的分布在药物滥用治疗方面。这项为期两年的研究将评估SBIRT在500名拉丁裔和500名非拉丁裔白人中访问大型城市急诊室的毒品使用和相关因素的有效性。将使用随机的两组重复措施设计，其中将将干预组的药物相关结果与注意力安置对照组的结果进行比较。报告非法吸毒的参与者将从大型医院急诊室的候诊室招募，并随机分配给两个条件之一。干预组（»LifeShift¿）将接受SBIRT药物干预措施，其风险水平和选择的药物。为了评估SBIRT干预措施的真实影响（即减去注意力的影响），对照组将在驾驶安全区域（ShiftGears¿）接受相同数量的干预措施。 Baseline and 6-month follow-up measurements will be collected for all participants, and will include (a) standardized subjective drug use measures, (b) other measures presumed to be targeted by the intervention (e.g., functional status, perceived barriers to change), and (c) a biologic sample tested For the presence or absence of multiple illicit drugs to increase the accuracy of subjective abstinence reports at the follow-up.此外，将收集驾驶安全控制项目以测试实验操作的结果，而注意力安置对照组的这些措施的预期更改将比SBIRT干预组更大。拉丁裔/白人对干预措施的反应差异将是研究的主要重点。将执行广义估计方程（GEE），以测试随访戒酒率的干预 - 控制群体差异，以及Latinos和非拉丁裔白人的实验组差异是否存在。干预对其他结果的影响，包括药物使用的频率和数量，在生活领域的功能，随后的医疗保健利用以及介绍的中间变量，也将由整体和种族分析。将收集过程和实施变量（例如，干预覆盖率，观察质量指标，患者满意度），以衡量实施的忠诚度并评估可能的种族差异。这项随机对照组的研究将是第一个确定在教师时刻期间在初级保健环境中进行筛查和简短干预是否可以激发拉丁裔和非拉丁裔白人以减少药物参与的过程。