Universal substance use care for adolescents with chronic medical conditions: a protocol to examine equitable implementation determinants and strategies for SBIRT at a pediatric hospital

IF 3.7 2区医学 Q1 SUBSTANCE ABUSE

Addiction Science & Clinical Practice Pub Date : 2024-09-11 DOI:10.1186/s13722-024-00492-4

Faith Summersett Williams, Robert Garofalo, Niranjan S. Karnik, Geri Donenberg, Hayley Centola, Sara Becker, Sarah Welch, Lisa Kuhns

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引用次数: 0

Abstract

Adolescents with chronic medical conditions (CMC) use alcohol and marijuana at levels equal to or even greater than their peers without CMC and are more likely to initiate substance use at 14 years or younger. Approximately 33% of adolescents with CMC binge drink alcohol and 20% use marijuana. When using substances, adolescents with CMC are at elevated risk for problem use and adverse consequences given their medical conditions. Although there has recently been progress integrating substance use services into adult hospitals, there has been almost no implementation of standardized substance use services into pediatric hospitals for adolescents with CMC. Screening, Brief Intervention, and Referral to Treatment (SBIRT) for adolescents is an evidence-based, public health approach to promote the early detection and intervention of risky alcohol use in high-risk youth. This paper describes a study protocol combining two leading implementation science frameworks, the Consolidated Framework for Implementation Research (CFIR) and the Health Equity Implementation framework (HEIF), to engage pediatric hospital partners (hospital staff and clinicians, patients with CMC, and caregivers) to identify and specify contextual determinants of SBIRT implementation, which can be used to derive implementation strategies to optimize SBIRT adoption, reach, and fidelity. This study will use semi-structured interviews and focus groups with pediatric hospital partners (e.g., hospital staff and clinicians, adolescent patients, and caregivers) to identify SBIRT implementation determinants, using semi-structured interview and focus group guides that integrate CFIR and HEIF dimensions. Understanding implementation determinants is one of the first steps in the implementation science process. The use of two determinant frameworks highlighting a comprehensive set of determinants including health equity and justice will enable identification of barriers and facilitators that will then map on to strategies that address these factors. This study will serve as an essential precursor to further work evaluating the feasibility of and the degree of engagement with SBIRT among this vulnerable pediatric population.

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为患有慢性疾病的青少年提供普遍的药物使用护理：研究一家儿科医院公平实施 SBIRT 的决定因素和策略的方案

患有慢性疾病（CMC）的青少年使用酒精和大麻的水平与没有慢性疾病（CMC）的同龄人相当甚至更高，并且更有可能在 14 岁或更小的时候开始使用药物。大约 33% 患有慢性疾病的青少年酗酒，20% 吸食大麻。患有 CMC 的青少年在使用药物时，由于其身体状况，出现问题和不良后果的风险更高。虽然近来成人医院在整合药物使用服务方面取得了进展，但儿科医院几乎还没有为患有 CMC 的青少年实施标准化的药物使用服务。针对青少年的筛查、简单干预和转介治疗（SBIRT）是一种以证据为基础的公共卫生方法，旨在促进对高危青少年危险饮酒的早期发现和干预。本文介绍了一项研究方案，该方案结合了两个领先的实施科学框架，即实施研究综合框架（CFIR）和健康公平实施框架（HEIF），让儿科医院的合作伙伴（医院员工和临床医生、CMC 患者和护理人员）参与进来，以识别并明确 SBIRT 实施的背景决定因素，并以此为基础制定实施策略，优化 SBIRT 的采用、覆盖范围和忠实度。本研究将采用半结构化访谈和焦点小组的方式，对儿科医院的合作伙伴（如医院员工和临床医生、青少年患者和护理人员）进行访谈，以确定 SBIRT 实施的决定因素。了解实施的决定因素是实施科学过程的第一步。使用两个决定因素框架，突出包括健康公平和正义在内的一整套决定因素，将有助于识别障碍和促进因素，然后将其映射到解决这些因素的策略上。这项研究将成为进一步评估 SBIRT 在这一弱势儿科人群中的可行性和参与程度的重要前奏。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction Science & Clinical Practice Psychology-Clinical Psychology

CiteScore

3.90

自引率

10.80%

发文量

审稿时长

28 weeks

期刊介绍： Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings. Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use. Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations. Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.