The STUN (STop UNhealthy) Alcohol Use Now! Project: Using Practice Facilitation to Disseminate and Implement Patient-Centered Outcomes Research (PCOR) Evidence on Screening and Management of Unhealthy Alcohol Use in Primary Care
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 32
- 试验地点
- 7
- 主要终点
- Percent of adults screened for unhealthy alcohol use
研究概览
简要总结
STUN Alcohol Use Now is an intervention designed to use primary care practice support services (practice facilitation) to help small to medium-size practices (10 or fewer providers) identify and provide services for people with unhealthy alcohol use. The original recruitment goal was 135 primary care practices in North Carolina, which we were unable to meet due to pandemic-related barriers.
详细描述
STUN Alcohol Use Now is an intervention designed to use primary care practice support services (practice facilitation or PF) to help small to medium-size practices (10 or fewer providers) identify and provide services for people with unhealthy alcohol use. 135 primary care practices in North Carolina will be recruited.
Specific Aim 1 will evaluate the effect of PF on uptake of evidence-based screening and brief intervention (SBI) for unhealthy alcohol use. The investigators hypothesize that PF will increase screening for unhealthy alcohol use and provision of brief counseling. The secondary hypothesis is that practice-level and contextual factors (capacity for quality improvement, organizational readiness to implement change, and implementation climate) will moderate the effect of PF on use of evidence-based screening and brief intervention (SBI) for unhealthy alcohol use.
Specific Aim 2 will evaluate whether PF increases provision, among those identified as having an alcohol use disorder (AUD), provision of medication assisted treatment (MAT) or referral to specialty care.
Aim 3 (effect of providing embedded telehealth services) will not be evaluated due to lower enrollment than anticipated and delayed data collection (both related to the COVID-19 pandemic) which have prevented randomization among practices with slower uptake of SBI after 6 months of PF.
In Aim 4 the investigators will evaluate the effect of PF on the implementation of clinical practice and office systems changes to improve evidence-based SBI and MAT. The primary hypothesis is that PF will increase implementation of clinical practice and office systems changes to improve evidence-based SBI and MAT. The secondary hypotheses are that (a) practice capacity for quality improvement (QI), organizational readiness to implement change, and contextual factors will moderate the effect of PF on the implementation of clinical practice and office systems changes and (b) embedded telehealth services will increase implementation of clinical practice and office systems changes among practices with slower uptake.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Small-to-medium sized primary care practices (10 or fewer providers) in North Carolina
排除标准
- •Practices with fewer than 100 adult patients (18+ years) or more than 10 providers;
- •practices unwilling to implement evidence-based screening and management of patients with unhealthy alcohol use.
研究组 & 干预措施
Practice Facilitation
All enrolled practices will receive practice facilitation for the duration of the intervention period.
干预措施: Practice Facilitation (Other)
结局指标
主要结局
Percent of adults screened for unhealthy alcohol use
时间窗: 6 months
percent of those aged 18 or older who were screened with a validated tool for unhealthy alcohol use
Number of adults screened for unhealthy alcohol use
时间窗: 6 months
number aged 18 or older who were screened with a validated tool for unhealthy alcohol use
Number of adults screened for unhealthy alcohol use
时间窗: 18 months
number aged 18 or older who were screened with a validated tool for unhealthy alcohol use
Number of adults screened for unhealthy alcohol use
时间窗: 12 months
number aged 18 or older who were screened with a validated tool for unhealthy alcohol use
Percent of adults screened for unhealthy alcohol use
时间窗: 18 months
percent of those aged 18 or older who were screened with a validated tool for unhealthy alcohol use
Percent of adults screened for unhealthy alcohol use
时间窗: 12 months
percent of those aged 18 or older who were screened with a validated tool for unhealthy alcohol use
次要结局
- Percent of adults with AUD who were prescribed pharmacotherapy for AUD(6 months)
- Percent of adults with a positive screen for unhealthy alcohol use(6 months)
- Number of adults with a positive screen for unhealthy alcohol use(6 months)
- Number of adults provided with brief counseling for risky drinking(6 months)
- Percent of adults provided with brief counseling for risky drinking(6 months)
- Number of adults identified as having alcohol use disorder (AUD)(6 months)
- Percent of adults identified as having alcohol use disorder (AUD)(6 months)
- Number of adults with AUD referred to specialty care for AUD(6 months)
- Number of adults prescribed pharmacotherapy for AUD(6 months)
- Percent of adults with AUD referred to specialty care for AUD(6 months)
- Number of adults with a positive screen for unhealthy alcohol use(18 months)
- Number of adults with a positive screen for unhealthy alcohol use(12 months)
- Percent of adults with a positive screen for unhealthy alcohol use(18 months)
- Percent of adults with a positive screen for unhealthy alcohol use(12 months)
- Number of adults provided with brief counseling for risky drinking(18 months)
- Number of adults provided with brief counseling for risky drinking(12 months)
- Percent of adults provided with brief counseling for risky drinking(18 months)
- Percent of adults provided with brief counseling for risky drinking(12 months)
- Number of adults identified as having alcohol use disorder (AUD)(18 months)
- Number of adults identified as having alcohol use disorder (AUD)(12 months)
- Percent of adults identified as having alcohol use disorder (AUD)(18 months)
- Percent of adults identified as having alcohol use disorder (AUD)(12 months)
- Number of adults prescribed pharmacotherapy for AUD(18 months)
- Number of adults prescribed pharmacotherapy for AUD(12 months)
- Percent of adults with AUD who were prescribed pharmacotherapy for AUD(18 months)
- Percent of adults with AUD who were prescribed pharmacotherapy for AUD(12 months)
- Number of adults with AUD referred to specialty care for AUD(18 months)
- Number of adults with AUD referred to specialty care for AUD(12 months)
- Percent of adults with AUD referred to specialty care for AUD(18 months)
- Percent of adults with AUD referred to specialty care for AUD(12 months)