Multidisciplinary Approach to Reduce Injury and Substance Abuse

减少伤害和药物滥用的多学科方法

• 批准号: 7849055
• 负责人: CRAIG A FIELD
• 金额: $ 64.05万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-15 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7849055
• 关键词: Abstinence; Alcohol abuse; American College of Surgeons; Attitude; Behavioral; Caring; Cessation of life; Cost Savings; Cost-Benefit Analysis; Drug usage; Effectiveness; Employment; Equilibrium; Feedback; Funding; Future; HIV; Health; Hospitals; Injury; Intervention; Length; Measures; Mediating; Medical; Modeling; Outcome; Participant; Patients; Perception; Pharmaceutical Preparations; Preclinical Drug Evaluation; Process; Quality of life; Randomized Clinical Trials; Readiness; Research; Risk; Risk Behaviors; Services; Substance abuse problem; Testing; Texas; Trauma; austin; brief advice; brief alcohol intervention; brief intervention; brief motivational intervention; cost effectiveness; disability; evidence base; illegal behavior; improved; injured; interdisciplinary approach; interest; knowledge base; patient population; primary outcome; public health relevance; reduced alcohol use; screening and brief intervention; screening, brief intervention, referral, and treatment; substance abuse treatment; trauma centers; trauma units

DESCRIPTION (provided by applicant): The American College of Surgeons (ACS) recently established requirements for Level I Trauma Centers to provide screening and brief intervention (SBI) for alcohol problems. The impetus for this mandate was the evidence base supporting the effectiveness of brief alcohol interventions with injured patients on reducing alcohol use and risk of future injury, as well as cost savings. However, there is a lack of evidence regarding the effectiveness of SBI for drug use. In addition, there is little evidence on the effectiveness of drug SBI on HIV risk and other health outcomes strongly associated with drug use. This application proposes a randomized clinical trial evaluating the effectiveness of brief advice (BA), brief motivational intervention with feedback (BMI), and brief motivational intervention with feedback and booster (BMI+B) in injured patients with drug problems. The setting is a trauma center serving a large and diverse patient population. The primary outcome of interest will be subsequent drug use. Other outcomes of interest include: (a) HIV-related risk behaviors, (b) improved health outcomes including injury reduction, (c) increased employment, (d) decreased engagement in illegal behavior (e) increased substance abuse treatment utilization, and (e) enhanced quality of life at three, six, and twelve month follow-ups. This study will also examine the potential moderating and mediating effects of patient readiness to change, use of experiential and behavioral processes of change and decisional balance considerations. In addition, this project will examine implementation factors at the organizational level and the cost effectiveness of BA, BMI, and BMI+B. Funding of the proposed study will increase the knowledge base with regard to the effectiveness of brief intervention among injured patients with drug use problems and, thereby, provide the ACS and the field with the necessary evidence base for screening, brief intervention and referral for treatment for drug use problems in the trauma care setting. PUBLIC HEALTH RELEVANCE: More deaths, illness and disabilities are attributed to substance misuse than any other preventable condition. This study will increase the knowledge base regarding the effectiveness of brief screening and intervention among injured patients with drug use problems in trauma centers and other medical settings, thus leading to reduced injury and related health outcomes associated with drug use.

描述（由申请人提供）：美国外科医生学会 (ACS) 最近制定了对一级创伤中心提供针对酒精问题的筛查和简短干预 (SBI) 的要求。这项任务的推动力是有证据基础支持对受伤患者进行短暂酒精干预对于减少饮酒和未来受伤风险以及节省成本的有效性。然而，缺乏关于 SBI 对药物使用有效性的证据。此外，几乎没有证据表明药物 SBI 对艾滋病毒风险和其他与吸毒密切相关的健康结果有效。 本申请提出了一项随机临床试验，评估简短建议 (BA)、简短反馈激励干预 (BMI) 以及反馈和加强简短激励干预 (BMI+B) 对药物问题受伤患者的有效性。该场所是一个创伤中心，为大量不同的患者群体提供服务。感兴趣的主要结果将是随后的药物使用。其他值得关注的成果包括：(a) 与艾滋病毒相关的危险行为，(b) 改善健康结果，包括减少伤害，(c) 增加就业，(d) 减少参与非法行为，(e) 增加药物滥用治疗的利用率，以及 ( e) 在三个月、六个月和十二个月的随访中生活质量得到提高。 这项研究还将研究患者改变的准备程度、改变的经验和行为过程的使用以及决策平衡考虑因素的潜在调节和中介作用。此外，该项目还将研究组织层面的实施因素以及BA、BMI和BMI+B的成本效益。 拟议研究的资助将增加关于对有吸毒问题的受伤患者进行短暂干预的有效性的知识基础，从而为 ACS 和该领域提供必要的证据基础，以进行筛查、短暂干预和转诊治疗创伤护理环境中的药物使用问题。 公共卫生相关性：与任何其他可预防的疾病相比，滥用药物造成的死亡、疾病和残疾更多。这项研究将增加关于在创伤中心和其他医疗机构中对有吸毒问题的受伤患者进行简短筛查和干预的有效性的知识库，从而减少与吸毒相关的伤害和相关健康结果。