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| ID | Type | Description | Link |
|---|---|---|---|
| R37DA063274 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| Howard Brown Health Center | OTHER |
| University of Chicago | OTHER |
| National Institute on Drug Abuse (NIDA) | NIH |
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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.
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:
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Routine Substance Use disorder (SUD) screening | Active Comparator | A routine screener for substance use disorder (SUD) will be added to the standard of care at HBH regardless of HIV status or demographic characteristics. |
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| Social Network Intervention (SNI) | Experimental | In addition to the routine screener for SUD, this arm will receive the Social Network Intervention (SNI), which include the following elements:
|
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Substance use disorder screening | Behavioral | Implement a routine SUD screening at the FQHC. |
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| Measure | Description | Time Frame |
|---|---|---|
| Rate of Substance Use Disorder (SUD) Detection | The number and proportion of patients who screen positive for substance use disorder using the routine SUD screening tool (NIDA Quick Screen) compared with the number identified through existing electronic medical record (EMR) documentation. This outcome measures whether routine screening increases the detection of individuals with possible SUD. | Baseline through 24 months |
| Number of Individuals Identified as Viremic and/or Having SUD Through the Social Network Intervention (SNI) | The number of people identified through the Social Network Intervention who have unsuppressed HIV (viremia), substance use disorder, or both. This will be compared to a functional control group (new or re-engaged clinic patients during the same time period) to determine whether the SNI is more effective at finding high-priority individuals needing care. | Baseline through 24 months |
| Linkage to HIV Care or Substance Use Services | The proportion of individuals identified through SUD screening or the SNI who successfully link to harm reduction, HIV care, or substance use treatment services. This outcome assesses early engagement in care following identification. | Baseline through 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Viral Suppression Among Individuals Identified Through Screening or SNI | The proportion of people identified with HIV who achieve viral suppression after being linked to care. This measures the downstream impact of improved identification and engagement. | Baseline through 24 months |
| Time to Linkage to HIV Care or Substance Use Services |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Britt Skaathun, PhD | Contact | 619-543-5011 | bskaathun@health.ucsd.edu | |
| Nicole Carter, MPH | Contact | 619-471-0796 | nscarter@health.ucsd.edu |
| Name | Affiliation | Role |
|---|---|---|
| Britt Skaathun | University of California, San Diego | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Howard Brown Health | Chicago | Illinois | 60657 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20957426 | Background | 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. | |
| 21197565 | Background | 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. |
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| ID | Term |
|---|---|
| D019966 | Substance-Related Disorders |
| D040261 | Harm Reduction |
| D057545 | Social Stigma |
| D000092862 | Psychological Well-Being |
| D016739 | Behavior, Addictive |
| ID | Term |
|---|---|
| D064419 | Chemically-Induced Disorders |
| D001523 | Mental Disorders |
| D001519 | Behavior |
| D012919 | Social Behavior |
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Viral suppression and SUD reduction will be monitored via chart review and used to parameterize an agent-based model (ABM) examining the potential population-level impact of implementing the SUD screener and SNI across Chicago on the local HIV epidemic. Control data will consist of standard intake data on new patients and patients returning to care at HBH. Standard intake data will be collected corresponding to the same timeframe as the recruitment period for the SNI.
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| Social network intervention | Behavioral | 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. |
|
The number of days from identification (via SUD screen or SNI) to the first attended HIV care appointment, harm reduction service, or substance use treatment visit. |
| Baseline through 24 months |
| Number of New HIV Diagnoses Identified Through the SNI | The number of individuals identified by SNI participants who test positive for HIV and were previously undiagnosed. | Baseline through 24 months |
| Substance Use Treatment Initiation | The proportion of people identified with SUD who initiate counseling, medication-assisted treatment, or other substance use services. | Baseline through 24 months |
| Re-engagement in HIV Care | The number and proportion of individuals previously out of care for ≥6 months who return for at least one HIV medical visit after identification. | Baseline through 24 months |
| Acceptability of SUD Screening and the SNI | Acceptability scores based on surveys and interviews with clinic staff and participants, assessing satisfaction, perceived burden, and overall fit within the clinical setting. | Measured at Months 6, 12, 18, and 24 |
| Feasibility of Implementing the SUD Screener and SNI | Assessment of whether the interventions can be carried out in the clinic as intended, measured by workflow fit, completion rates, and staff-reported ease of implementation. | Baseline through 24 months |
| Sustainability of Screening and SNI Workflows (EPIS: Sustainment Phase) | Indicators of ongoing use of SUD screening and SNI processes without external study support, including continued staff utilization and workflow integration. | Measured at 24 months |
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| D010549 |
| Personal Satisfaction |
| D003192 | Compulsive Behavior |
| D007175 | Impulsive Behavior |