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（由申请人提供）：本申请涉及广泛的挑战领域 (05)：比较有效性研究和具体挑战主题，05-DA-104：比较少数族裔人群的药物治疗效果、简短干预和转诊治疗（ SBIRT）是一种全面、综合的公共卫生方法，用于在一般医疗保健环境中识别和提供一系列针对药物滥用的早期检测和治疗服务。SBIRT 的有效性已得到证实。在许多研究中，SBIRT 被领先的国家医学协会认为是识别和治疗药物滥用的最佳实践，即使在早期各州也是如此。然而，尚不清楚 SBIRT 对拉丁裔/西班牙裔人群是否有效，鉴于存在巨大的知识差距。这项为期 2 年的研究将评估 SBIRT 对 500 名吸毒者的有效性以及相关因素。将使用随机两组重复测量设计，将干预组的药物相关结果与注意力安慰剂对照组的结果进行比较。报告非法药物使用的参与者将从一家大型医院急诊科的候诊室招募，并随机分配到两种情况之一的干预组（¿生活转变¿ ）将接受与其风险水平和选择药物相匹配的 SBIRT 药物干预，以评估 ¿真的SBIRT 干预的效果（即减去注意力的影响），对照组将在驾驶安全领域接受相同数量的干预（“换档”）和 6 个月的后续措施。为所有参与者收集，并将包括（a）标准化主观药物使用测量，（b）推测为干预目标的其他测量（例如，功能状态，感知的改变障碍），以及（c）生物样本存在或不存在此外，还将收集驾驶安全控制项目来测试实验操作的结果，注意安慰剂对照组预计会有更大的预控。在这些措施发生变化后，拉丁裔/白人对干预反应的差异将成为研究的主要焦点，将利用广义估计方程（GEE）来测试干预组与对照组在后续戒酒方面的差异。费率，以及是否拉丁裔和非拉丁裔白人的实验组差异也将被分析，干预措施对其他结果的影响包括吸毒频率和数量、生活领域的功能、随后的医疗保健利用以及干预措施所针对的假定中间变量。将收集总体和种族群体的过程和实施变量（例如干预覆盖范围、观察质量测量、患者满意度）以衡量实施的保真度，并评估可能的种族差异。确定是否进行筛查和简短干预¿ 期间的初级保健机构受教时刻¿可以激励拉丁裔和非拉丁裔白人减少毒品参与。