Combining Social Network Strategies and Routine Substance Use Screening

Обзор

This study aims to improve health care for people who may have HIV or substance use disorders by bringing two services to a large community health center in Chicago. First, the clinic will begin offering routine screening for substance use to all patients. Second, the study will offer a social network-based program that helps people identify friends or partners who may need support and link them to care. The goal is to help more people learn their HIV status, reduce HIV levels in the community, and connect people with substance use treatment when needed. The study will also look at how well these services can be added into everyday clinic practice and what is needed to keep them going over time.

Подробное описание

This project will take place in a network of federally qualified health centers that serves communities in Chicago that experience some of the highest rates of new HIV infections. The study has two main parts: Routine Substance Use Screening and a Social Network Intervention (SNI).

Routine screening at the clinics will introduce a consistent, standardized way to ask patients about substance use during regular visits. Patients who screen positive will be offered help, referrals, and follow-up services.

The social network intervention asks patients to think about people in their social networks (such as partners, friends, or peers) who may have untreated HIV, may have fallen out of care, or may have substance use concerns. Participants will receive support and tools to help connect people in their network to HIV testing, care, and treatment or substance use services at these clinics.

Together, these activities aim to:

* Identify people who have HIV but are not in care * Reduce HIV viral load levels in the community * Identify people with substance use disorders and link them to treatment * Improve access to supportive services in the community

The study will also examine how easy or hard it is for clinics to use these two strategies in everyday practice. Researchers will gather feedback from clinic staff and patients to understand what helps or gets in the way of using these services in the long term. The goal is to create a package of tools and processes that other clinics can adopt in the future.

Вмешательства

• Поведенческое Substance use disorder screening
  Implement a routine SUD screening at the FQHC.
• Поведенческое Social network intervention
  Social network intervention (SNI) to identify individuals who are viremic, have SUD, or both and link them to harm reduction and HIV continuum of care services. There are three main activities that make up the SNI: 1) recruiting, screening, and interviewing "index participants"; 2) training the index participants to recruit others; 3) screening and interviewing persons who present a valid recruitment voucher given to them by an index participant.

Первичные конечные точки

• Rate of Substance Use Disorder (SUD) Detection [Срок оценки: Baseline through 24 months]
• Number of Individuals Identified as Viremic and/or Having SUD Through the Social Network Intervention (SNI) [Срок оценки: Baseline through 24 months]
• Linkage to HIV Care or Substance Use Services [Срок оценки: Baseline through 24 months]

Вторичные конечные точки (8)

• Viral Suppression Among Individuals Identified Through Screening or SNI [Срок оценки: Baseline through 24 months]
• Time to Linkage to HIV Care or Substance Use Services [Срок оценки: Baseline through 24 months]
• Number of New HIV Diagnoses Identified Through the SNI [Срок оценки: Baseline through 24 months]
• Substance Use Treatment Initiation [Срок оценки: Baseline through 24 months]
• Re-engagement in HIV Care [Срок оценки: Baseline through 24 months]
• Acceptability of SUD Screening and the SNI [Срок оценки: Measured at Months 6, 12, 18, and 24]
• Feasibility of Implementing the SUD Screener and SNI [Срок оценки: Baseline through 24 months]
• Sustainability of Screening and SNI Workflows (EPIS: Sustainment Phase) [Срок оценки: Measured at 24 months]

Критерии участия

Критерии включения

• Assigned male sex at birth
• Has sex with men
• Speaks English or Spanish

Критерии исключения

• Institutionalized individuals
• Women
• Non-Hispanic whites

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Нерандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Поддерживающая терапия

Центры проведения

США · 1 центр

• Howard Brown Health — Chicago

Публикации

• Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, Griffey R, Hensley M. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011 Mar;38(2):65-76. doi: 10.1007/s10488-010-0319-7. PMID 20957426
• Aarons GA, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health. 2011 Jan;38(1):4-23. doi: 10.1007/s10488-010-0327-7. PMID 21197565
• Oehler C, Rajagopal A, Songster T, Schmitt J, McNulty M, Schneider J, Pitrak D, Ridgway JP. Partner Notification Services for Patients with Established and New HIV Infection Leads to Diagnosis and Linkage of HIV-Positive Partners. AIDS Behav. 2021 Mar;25(3):809-813. doi: 10.1007/s10461-020-03043-5. Epub 2020 Sep 19. PMID 32949327
• Cummins B, Johnson K, Schneider JA, Del Vecchio N, Moshiri N, Wertheim JO, Goyal R, Skaathun B. Leveraging social networks for identification of people with HIV who are virally unsuppressed. AIDS. 2024 Feb 1;38(2):245-254. doi: 10.1097/QAD.0000000000003767. Epub 2023 Oct 26. PMID 37890471
• Skaathun B, Pho MT, Pollack HA, Friedman SR, McNulty MC, Friedman EE, Schmitt J, Pitrak D, Schneider JA. Comparison of effectiveness and cost for different HIV screening strategies implemented at large urban medical centre in the United States. J Int AIDS Soc. 2020 Oct;23(10):e25554. doi: 10.1002/jia2.25554. PMID 33119195
• Curran GM, Bauer M, Mittman B, Pyne JM, Stetler C. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care. 2012 Mar;50(3):217-26. doi: 10.1097/MLR.0b013e3182408812. PMID 22310560
• McPherson M, Smith-Lovin L, Cook JM. Birds of a Feather: Homophily in Social Networks. Annual Review of Sociology 2001; 27(1): 415-44.
• Shrader CH, Borquez A, Vasylyeva TI, Chaillon A, Artamanova I, Harvey-Vera A, Vera CF, Rangel G, Strathdee SA, Skaathun B. Network-level HIV risk norms are associated with individual-level HIV risk and harm reduction behaviors among people who inject drugs: a latent profile analysis. AIDS Behav. 2023 Feb;27(2):484-495. doi: 10.1007/s10461-022-03783-6. Epub 2022 Aug 8. PMID 35939177

Идентификаторы

NCT: NCT07414459 · 813457 · R37DA063274

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

Открыть это исследование на ClinicalTrials.gov ↗