montoya by zhangyun

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									         Report of the
  Blue Ribbon Task Force on
Health Services Research
              at the
National Institute on Drug Abuse




                 Isaac D. Montoya, Ph.D.
     NIDA HEALTH SERVICES RESEARCH
TASK FORCE REPORT AND RECOMMENDATIONS

                  Charge to Task Force

• Dissemination of research findings to
  practice

• Utilization of CTN as a platform for HSR

• Organization and leadership of HSR within NIDA’s
Divisions and centers and other Federal agencies to ensure
bi-directional approaches in intervention development and
dissemination.
       NIDA HEALTH SERVICES RESEARCH
  TASK FORCE REPORT AND RECOMMENDATIONS

                       Task Force Members

Andrea Barthwell, M.D.             Richard Frank, Ph.D.
Caryn Blitz, Ph.D.                 Warren Hewitt, M.S.
Rick Catalano, Ph.D.               James Inciardi, Ph.D.
Mady Chalk, Ph.D.                  Marguerita Lightfoot, Ph.D.
Linda Chinnia, M.Ed.               Isaac D. Montoya, Ph.D.
Lorraine Collins, Ph.D.            Claire Sterk, Ph.D.
Wilson Compton, M.D., M.P.E.       Marina Volkov, Ph.D.
Michael Dennis, Ph.D.              Janet Wood, M.B.A., M.Ed.

Co-Chairs: Thomas McLellan, Ph.D.,
           Constance Weisner, Dr.P.H., M.S.W.
                   DEFINITION
Health services research is a multidisciplinary field of
inquiry, both basic and applied, that examines how
social factors, financing systems, organizational
structures and processes, health technologies, and
personal beliefs and behaviors affect access to and
utilization of healthcare, the quality and cost of
healthcare, and in the end our health and well-being.
Ultimately, the goals of health services research are to
identify the most effective ways to organize, manage,
finance, and deliver high quality care.
         UNIQUE FEATURES OF DRUG
       ABUSE PREVENTION & TREATMENT

• Services delivered in multiple types of settings
• Medications are rarely a part of treatment
• Non-voluntary treatment
• Important relationship with SAMHSA and
• ONDCP
• Policies from other sectors impact services
           NIDA Health Services Research
              Blue Ribbon Task Force
           Report and Recommendations

• Definition
• Critical First Steps: Priorities and Indicators of Change
• Recommendations
   1.   Prevention Services Research
   2.   Treatment Services Research
   3.   Leading and Managing Services Research at NIDA
   4.   Services Research Collaborations within the NIH
        and with External Partners
             CRITICAL FIRST STEPS:
     PRIORITIES AND INDICATORS OF CHANGE


                            Goal I
NIDA management must develop a clear understanding drug
abuse services research; and how it can serve NIDA’s broader
mission of contributing to the health of the public.
            CRITICAL FIRST STEPS:
   PRIORITIES AND INDICATORS OF CHANGE


                      Goal II
NIDA/DESPR should increase its portfolio of research on
prevention and treatment systems, and on organizational,
management, financing practices, policies, and cost.
           CRITICAL FIRST STEPS:
   PRIORITIES AND INDICATORS OF CHANGE


                         Goal III
There is a need for NIDA leadership and collaboration in the
development of standards for evidence-based practice.
            CRITICAL FIRST STEPS:
    PRIORITIES AND INDICATORS OF CHANGE

                         Goal IV
Given the complexity of the issues affecting drug abuse
prevention and treatment as well as an understanding of the
appropriate role of services research – it is imperative for
NIDA to collaborate:
     - Across NIDA Divisions, Centers, and Branches
     - With other NIH Institutes
     - With SAMHSA and other Federal Agencies
         NIDA Health Services Research
    Task Force Report and Recommendations

    Prevention Services Research Recommendations
1. Increase in randomized, controlled prevention trials, &
   including organizational, cost, and dissemination
   components

1. Increase non-academic research settings

3. Development of epidemiological monitoring system for
   use as benchmarks
         NIDA Health Services Research
    Task Force Report and Recommendations

    Prevention Services Research Recommendations

4. Research on “best practices” and sustaining quality
   services

5. Encourage research on understanding elements of
   effective diffusion of prevention practices and policies
         NIDA Health Services Research
    Task Force Report and Recommendations

              Treatment Services Research
6. Identify and study “usual practices” that are believed to
   be effective
7. Cover range of settings and population groups
8. Portfolio represent the full spectrum of service needs:
    hazardous use patterns and chronic problems (brief
    interventions & continuing care models)
9. Increase research on diffusion of innovations: process
    and barriers to implementation (financial, organizational,
    purchaser, provider, clinical &patient factors)
         NIDA Health Services Research
    Task Force Report and Recommendations
               Treatment Services Research
10. Increase portfolio on impact of organizational,
    management, financing on cost, including linkages
    across systems
11. Continue integrating financing/economics research into
    portfolio
12. Focus on fit of research questions between empirical and
    descriptive studies
13. Methodology development -- causal inferences
    (benchmarks, analysis of program and group-level
    interventions)
         NIDA Health Services Research
    Task Force Report and Recommendations

          Leading and Managing HSR at NIDA
14. Communicate shared definition of HSR -- Include HSR
    components earlier in research process.
15. Maintain center of HSR in DESPR, and identify roles of
    HSR in CTN, DTRD, CAMCODA
16. Maintain HSR IRG, and continually update review criteria
   to HSR and orient IRG members to new issues - use
   mechanisms that will allow for more innovative and high-
   risk/high impact innovation.
         NIDA Health Services Research
    Task Force Report and Recommendations

          Leading and Managing HSR at NIDA
17. Work with other NIDA Divisions and Centers to enhance
    dissemination and transfer of research findings to
    practice
18. Take a proactive stance & develop a planning process
    toward development of RFAs & other funding
    mechanisms (including rapid response mechanisms)
19. Increase mechanisms to encourage new investigators
         NIDA Health Services Research
    Task Force Report and Recommendations

      Collaborations within NIH and external partners
20. Collaboration with other Federal agencies, State
    directors, providers and consumers in establishing
    formal, ongoing process for developing and monitoring
    the services research agenda
20. Collaboration across Federal agencies to move effective
    interventions into practice
22. Collaborate with NIAAA, NIMH, SAMHSA, and AHRQ in
   development of shared standards for evidence-based
   interventions
         NIDA Health Services Research
    Task Force Report and Recommendations

       Collaborations within NIH and external partners
23. NIDA, SAMHSA, and ONDCP convene Agency
    representatives to explain and publicize evidence-based
    interventions
24. Collaborate with other Federal agencies to develop new
   developments in prevention and treatment methodology,
   particularly in set of process, outcomes, and cost-
   effectiveness measures for use in benchmarking.
               Services Research



Intervention Research       Intervention Research




                Basic Research

								
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