Screening for Youth Alcohol and Drug Use: A Study of Primary Care Providers

青少年酗酒和吸毒筛查：初级保健提供者的研究

基本信息

批准号：
8668826
负责人：
CONSTANCE M. WEISNER
金额：
$ 44.81万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-04-15 至 2017-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8668826
关键词：
Abstinence Accounting Address Administrator Adolescent Adult Affect Alcohol consumption Attitude Behavioral Medicine Beryllium California Characteristics Chemicals Childhood Clinic Clinical Comorbidity Computerized Medical Record Data Dependency Development Drug usage Early Diagnosis Early Intervention Early identification Early treatment Effectiveness Environment Family Federally Qualified Health Center Goals Health Health Information System Health Planning Health system Healthcare Home environment Insurance Intervention Interview Knowledge Laboratories Legal Mainstreaming Managed Care Measures Medical Medical Marijuana Medical center Mental Health Modeling Monitor National Institute on Alcohol Abuse and Alcoholism Outcome Outcome Study Patients Pattern Pediatrics Pilot Projects Policy Maker Preclinical Drug Evaluation Primary Care Physician Primary Health Care Process Provider Questionnaires Randomized Relative (related person)Research Resources Role Schools Services Societies Specialist Statutes and Laws Structure Surveys Teenagers Testing Training Treatment Protocols Visit Youth adolescent alcohol alcohol and other drug arm base brief intervention clinical practice compare effectiveness cost cost effective cost effectiveness evidence base follow-up improved innovation medical specialties parity screening screening and brief intervention screening, brief intervention, referral, and treatment three-arm study tool treatment as usual

项目摘要

DESCRIPTION (provided by applicant): This is a renewal of "Screening for Youth AOD Use: A Study of Primary Care Providers. Health systems have not implemented Screening, Brief Intervention and Referral to Treatment (SBIRT) for adolescents despite research demonstrating its effectiveness. Based on prior research that identified barriers to AOD screening for adolescents in pediatric Primary Care (PC) and a pilot study that found SBIRT was feasible, well-received and promoted referrals to and initiation of specialty treatment, the current research application proposes to randomize Primary Care Physicians (PCPs) in the pediatrics clinic of a medical center within a large, managed care health system, Kaiser Permanente Northern California, to three arms - 1) Usual Care; 2) SBIRT delivered by PCPs; and 3) SBIRT delivered by Behavioral Medicine Specialists (BMS). The study objective is to compare the implementation, effectiveness and cost-effectiveness of SBIRT for adolescents in PC in the three study arms. Patients will complete evidence-based screening and AOD assessment measures which have been embedded in the health plan's electronic medical record (EMR). A mixed model will be used to compare implementation outcomes (rates of screening and identification, brief intervention, referral to Chemical Dependency treatment and treatment initiaion), and effectiveness (patient outcomes of AOD use and abstinence) at 12 months. The model accounts for the intra-class correlations across patients within providers. Cost-effectiveness relative to implementation and patient outcomes will be examined. Barriers and facilitators of implementation, and feasibility via qualitative interviews with clinicians and administrators will be examined as well. The study is significant in that it examines issues that must be addressed to spur widespread adaptation of SBIRT. The proposed intereventions are highly feasible in the current environment of health reform due to increased resources and training to Federally Qualified Health Centers and private health plans. It is innovative in using the EMR to change clinical practice and systematically integrate AOD in PC, and as a platform for collecting research data.

描述（由申请人提供）：这是“对青年AOD使用的筛查：对初级保健提供者的研究。卫生系统尚未对青少年进行筛查，简短的干预和转诊（SBIRT），尽管研究证明了其有效性。基于先前的研究，该研究确定了针对小儿初级保健（PC）青少年筛查的障碍和一项试验研究，发现SBIRT是可行的，良好的，良好的并推广到专业治疗的推荐和启动的，目前的研究申请提出了随机分配主要原则。在北加利福尼亚州的大型托管护理卫生系统中的医疗中心的儿科诊所中的护理医生（PCP）医学专家（BMS）。患者将完成基于证据的筛查和AOD评估措施，这些措施已嵌入了健康计划的电子病历（EMR）中。混合模型将用于比较实施结果（筛查和识别率，简短的干预措施，转介到化学依赖治疗和治疗初期），以及在12个月（在AOD使用和禁欲的患者结局）（患者的结果）。该模型解释了提供者内患者之间的类内相关性。相对于实施和患者结果的成本效益将被检查。还将检查实施的障碍和促进者，以及通过与临床医生和管理员进行定性访谈的可行性。这项研究很重要，因为它研究了必须解决的问题，以刺激Sbirt的广泛适应。由于资源和对联邦资格的健康中心和私人卫生计划的培训增加，因此在当前的卫生改革环境中，拟议中的发生在当前的卫生改革环境中是非常可行的。使用EMR来改变临床实践并系统地将AOD整合到PC中，并作为收集研究数据的平台，这具有创新性。