Comparative Effectiveness and Feasibility of SBIRT in a General Dental Clinic

SBIRT 在普通牙科诊所中的有效性和可行性比较

基本信息

批准号：
7826393
负责人：
THOMAS F BABOR
金额：
$ 48.5万
依托单位：
UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
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：
2009-09-21 至 2011-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7826393
关键词：
Address Alcohol consumption Alcohol or Other Drugs use Alcohols Area Attention Attitude Behavior Behavioral Chronic Clinic Clinical Sciences Clinical Trials Clinical Trials Design Communities Conduct Clinical Trials Connecticut Counseling Data Dental Dental Care Dental Clinics Dental caries Dentistry Disadvantaged Drug Addiction Drug usage Early identification Education Effectiveness Gingival Recession Goals Growth Health Health Services Accessibility Hour Impaired wound healing Individual Interview Knowledge Leukoplakia Link Low income Malignant neoplasm of pharynx Measures Medicaid Medical Methods Mouth Diseases Oral cavity Oral health Oropharyngeal Outcome Participant Pathology Patients Periodontal Diseases Prevention Primary Health Care Procedures Process Measure Protocols documentation Public Health Dentistry Randomized Randomized Controlled Trials Recruitment Activity Research Residencies Resources Risk Risk Factors Screening procedure Secondary Prevention Services Smoke Smoker Smoking Substance Use Disorder Technology Testing Time Tobacco Tobacco use Tooth Loss Training Translational Research Trauma Uninsured Universities Waiting Lists World Health Organization abstracting active method alcohol risk base brief intervention clinical practice cohort comparative effectiveness drinking effectiveness research evidence base follow-up improved primary care setting programs screening and brief intervention success willingness working group

项目摘要

DESCRIPTION (provided by applicant): (Abstract) "Comparative Effectiveness and Feasibility of SBIRT in a General Dental Clinic" addresses the broad Challenge Area, (05) Comparative Effectiveness Research and specific Challenge Topic, 05-DE-102: Treatment of tobacco and drug dependence in dental settings. This protocol describes a 2-year, randomized controlled trial designed to achieve two primary aims: 1) to evaluate the short-term effectiveness of screening, brief intervention and referral services (SBIRT) for tobacco and other psychoactive substance use when delivered separately and in combined forms and 2) to evaluate the feasibility of implementing SBIRT for patients with at-risk substance use in a community general dental setting. This research will provide the basis for a more ambitious clinical trial that would be conducted in multiple dental settings and include a longer follow-up period. To achieve Aim 1, 175 patients who are smokers and at-risk substance users (including at-risk alcohol users) will be recruited from the general dentistry clinic at the University of Connecticut Health Center. Research staff will use the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), developed by the World Health Organization, to identify eligible patients. Participants will be randomized to one of three experimental conditions: 1) a smoking-only brief intervention group; 2) a smoking + other substance use brief intervention group; or 3) a wait-list control condition that includes general dental health counseling. Those assigned to the "active" treatment conditions will be given a brief intervention that will link the patient's screening assessment data with dental risk factors associated with tobacco only or tobacco + other substance use. Participants will be re- interviewed at 12-weeks post randomization to assess outcome and process measures using a combination of quantitative and qualitative interviewing methods. Regarding Aim 2, the timing of this opportunity and implementation of this clinical trial provides a unique opportunity to follow two cohorts of dental residents to examine the impact of SBIRT residency training on subsequent clinical practice. The first cohort will already be on staff when the study begins and will not have received SBIRT training as part of the residency requirements. The second cohort of residents will be exposed to a three-hour SBIRT training session that will supplement the residency requirements for July, 2010. Although residents will not be asked to provide the brief interventions for the randomized study, they will be encouraged to reinforce the information delivered by research staff. Differences between the two cohorts with regard to attitudes, knowledge and willingness to engage in SBIRT program activities will be measured. There has been a remarkable growth in translational research organized around the SBIRT concept, with numerous clinical trials conducted, new screening tests developed, and implementation programs evaluated to determine the feasibility of SBIRT in primary care and other medical settings. Despite the obvious relevance of SBIRT to the prevention of dental pathology, there has been little attention to the determination of its feasibility, effectiveness and implementation in dental settings. We believe there is now a real research opportunity to not only evaluate the effectiveness of SBIRT with dental patients, but also to improve the technology so that oral health practitioners can feel confident conducting screening, brief intervention and referrals for at-risk users of tobacco, alcohol and other substances. The research described in this application could have significant implications on both clinical science and public health dentistry.

描述（由申请人提供）：（摘要）“牙科诊所中SBIRT的比较有效性和可行性”解决了广泛的挑战领域，（05）比较有效性研究和特定挑战主题，05-DE-102：牙齿环境中烟草和药物依赖的治疗。该协议介绍了一项为期两年的随机对照试验，旨在实现两个主要目的：1）评估筛查，短暂干预和转诊服务（SBIRT）的短期有效性（SBIRT），用于烟草和其他形式的交付时，并以组合形式分别提供和2次使用精神活性药物使用，以及2），以评估用于在社区中使用良好型在社区中实施SBIRT患者的可靠性。这项研究将为更雄心勃勃的临床试验提供基础，该试验将在多个牙科环境中进行，并包括更长的随访期。为了达到目标1、175例吸烟者和高危药物使用者（包括高危酒精使用者），将从康涅狄格大学健康中心的通用牙科诊所招募。研究人员将使用世界卫生组织开发的酒精，吸烟和物质参与筛查测试（Assid）来识别合格的患者。参与者将被随机分为三个实验条件之一：1）仅吸烟的短暂干预组； 2）吸烟 +其他物质使用简短干预组；或3）等待名单控制条件，包括一般牙科健康咨询。分配给“主动”治疗条件的人将进行简短的干预措施，将患者的筛查评估数据与仅与烟草或烟草 +其他药物使用相关的牙齿风险因素联系起来。随机分组后，将在12周的12周进行接受采访，以使用定量和定性访谈方法的组合评估结果和过程度量。关于目标2，这一机会的时机和该临床试验的实施提供了一个独特的机会，可以跟随两名牙科居民研究SBIRT居住培训对随后的临床实践的影响。研究开始后，第一个队列将已经成为工作人员，并且不会接受SBIRT培训作为居住要求的一部分。第二个居民将接触三个小时的SBIRT培训课程，该课程将补充2010年7月的居民要求。尽管不会要求居民为随机研究提供简短的干预措施，但将鼓励他们加强研究人员提供的信息。两个人群之间在态度，知识和参与SBIRT计划活动的意愿方面的差异将得到衡量。围绕SBIRT概念组织的转化研究已经出色，进行了许多临床试验，开发了新的筛查测试以及评估的实施计划，以确定SBIRT在初级保健和其他医疗环境中的可行性。尽管Sbirt与预防牙齿病理学有明显的相关性，但很少关注其在牙科环境中其可行性，有效性和实施的确定。我们认为，现在有一个真正的研究机会不仅可以评估牙科患者的SBIRT有效性，还可以改进技术，以便对口腔健康从业人员可以对烟草，酒精和其他物质的高危用户进行筛查，简短的干预以及转诊的信心。本应用中描述的研究可能对临床科学和公共卫生牙科具有重大影响。