Tobacco Use Disorder Clinical Trial
Official title:
Screening to Augment Referral to Treatment- Project START
The investigators propose to use obstetric-gynecological clinics to conduct a randomized clinical trial that would compare two SBIRTS (Screening, Brief Intervention, Referral and Treatment), delivered either by a trained nurse or by computer, to usual care (a control condition). As part of this trial, the investigators will include outcomes that allow us to assess the cost effectiveness of these three conditions.
Aim 1: To assess whether SBIRT, based upon motivational interviewing and delivered either by
computer or a trained nurse, leads to decreased use of a subject's primary drug of abuse.
Hypothesis #1a: Referrals based upon motivational principles and delivered by computer, as
compared to usual care (health brochure with treatment resources), will lead to greater
reductions in a woman's primary substance of abuse.
Hypothesis #1b: Referrals based upon motivational principles and delivered by nurse, as
compared to usual care (health brochure with treatment resources), will lead to greater
reductions in a woman's primary substance of abuse.
Aim 2: To determine whether SBIRT based upon motivational interviewing and delivered either
by computer or by a nurse will promote substance abuse treatment utilization for the primary
drug of abuse.
Hypothesis #2a: Treatment utilization (eg. treatment initiation, attendance, use of
quit-line or medication) will be higher if a woman receives the computer delivered brief
intervention than if she receives usual care only.
Hypothesis #2b: Treatment utilization (eg. treatment initiation, attendance, use of
quit-line or medication) will be higher if a woman receives the nurse delivered brief
intervention than if she receives usual care only.
Secondary Aim 3: To evaluate whether SBI leads to a decrease in HIV/AIDS risk
Hypothesis #3: Rates of sexually transmitted diseases, injection drug use and risky sexual
behavior will be lower at follow up for subjects who receive either computer or a nurse
delivered brief intervention than usual care subjects.
Secondary Aim 4: To compare the relative cost-effectiveness of the three interventions.
Hypothesis #4a: Screening and usual care will be the most cost-effective intervention method
when the value of an additional unit of effect for the given individual's outcome is
relatively low.
Hypotheses #4b: Screening, and a brief intervention delivered by computer, will be the most
cost-effective treatment method when the value of an additional unit of effect is relatively
high.
Hypotheses #4c: Screening, and a brief intervention delivered by a nurse, will be less
cost-effective than a brief intervention delivered by computer.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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