I am a physician and early career translational investigator, with a research focus on identifying effective approaches for integrating substance abuse treatment into general healthcare settings. Because screening patients for substance abuse is time consuming on the part of clinicians, I propose research to address the validity of patient self-administered screening. The specific research and training aims of this study are integrated around two primary areas of focus: behavioral research methods (survey research, quantitative analysis, qualitative methods) and implementation research. Each of these areas is anchored by an experienced mentor with corresponding expertise, and further developed through didactic instruction combining coursework and directed readings as well as research experience. Under the sponsorship of my primary mentor Marc Gourevitch, MD, MPH, my research and training plans utilize the clinical and academic resources of New York University-Langone Medical Center and Bellevue Hospital, where substance abuse treatment and research has been a longstanding area of emphasis. My proposed study explores an innovative approach to improving rates of substance use screening in primary care, a major impediment to which has been the lack of a brief instrument that can accurately and efficiently identify patients with unhealthy substance use behaviors. The widely accepted and validated "Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is too lengthy for the typical medical visit, and greatly under-utilized as a result. I will adapt the ASSIST, which was designed and validated to be administered as an in-person interview, to an audio guided computer-assisted self interview (ACASI) that patients can complete prior to their medical visit. I plan a mixed methods study in 3 phases to 1) adapt the ASSIST for ACASI administration in an urban safety- net primary care clinic population;2) test its validity relative to the traditional interviewer-administered ASSIST;and 3) explore physician attitudes to using these screening results to address substance use in the primary care office.

Public Health Relevance

The proposed study will make a valuable contribution to advancing the integration of substance use screening into regular primary care practice. This is an important step toward my long-term goal of developing, implementing, and disseminating simple but effective interventions that improve the capacity of medical systems to respond to the health burden of substance abuse and dependence. My research, mentorship and training activities lay the groundwork for a line of research that will define my career as an independent investigator and physician leader in improving the health of substance users.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DA030395-03
Application #
8323430
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Denisco, Richard A
Project Start
2010-09-30
Project End
2015-08-31
Budget Start
2012-09-01
Budget End
2013-08-31
Support Year
3
Fiscal Year
2012
Total Cost
$180,316
Indirect Cost
$13,357
Name
New York University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
121911077
City
New York
State
NY
Country
United States
Zip Code
10016
McNeely, Jennifer; Halkitis, Perry N; Horton, Ariana et al. (2014) How patients understand the term "nonmedical use" of prescription drugs: insights from cognitive interviews. Subst Abus 35:12-20
Lee, Joshua D; McNeely, Jennifer; Grossman, Ellie et al. (2014) Clinical case conference: unobserved "home" induction onto buprenorphine. J Addict Med 8:309-14
McNeely, Jennifer; Strauss, Shiela M; Wright, Shana et al. (2014) Test-retest reliability of a self-administered Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in primary care patients. J Subst Abuse Treat 47:93-101
McNeely, Jennifer; Wright, Shana; Matthews, Abigail G et al. (2013) Substance-use screening and interventions in dental practices: survey of practice-based research network dentists regarding current practices, policies and barriers. J Am Dent Assoc 144:627-38