Telemedicine for unhealthy alcohol use in adults living with HIV in Alabama using common elements treatment approach: A hybrid clinical efficacy-implementation trial protocol.
Telemedicine for unhealthy alcohol use in adults living with HIV in Alabama using common elements treatment approach: A hybrid clinical efficacy-implementation trial protocol.
复制标题
使用共同要素治疗方法对阿拉巴马州艾滋病毒感染者的不健康饮酒进行远程医疗：混合临床疗效实施试验方案。
DOI：
10.1016/j.conctc.2023.101123
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发表时间：
2023
影响因子：
1.5
通讯作者：
Cropsey,Karen
中科院分区：
文献类型：
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作者：
Gagnon,KellyW;Levy,Sera;Figge,Caleb;WolfordClevenger,Caitlin;Murray,Laura;Kane,JeremyC;Bosomprah,Samuel;Sharma,Anjali;Nghiem,VanThiHa;Chitambi,Chipo;Vinikoor,Michael;Eaton,Ellen;Cropsey,Karen
背景不健康的饮酒是实现和保持对人类免疫缺陷病毒(HIV)流行的控制的一个尚未解决的障碍。在一项随机对照临床试验中，我们将评估电话传递的常见元素治疗方法(T-CETA)对阿拉巴马州社区诊所接受护理的以农村为主的HIV成年人的不健康酒精使用、HIV、其他物质使用和精神健康结果的有效性和实施。方法在阿拉巴马州四家选定的社区诊所，接受HIV治疗的成年人将接受电话传递酒精短暂干预(BI)，然后随机分配(按临床和性别分层)，不再进行进一步干预或T-CETA。参与者将在对不健康饮酒进行积极筛查后或在提供者推荐后被招募。目标样本量为308。主要结果将是在注册后6个月和12个月时酒精使用障碍识别测试(AUDIT)的变化。其他结果包括艾滋病毒(保留护理和病毒抑制)、患者报告的精神健康(焦虑、抑郁、创伤后应激)和生活质量。评估一系列实施措施，包括T-CETA提供者和客户的可接受性、可行性、成本和成本效益。结论本试验将告知HIV护理项目中的酒精治疗，包括考虑共病的必要性，以及酒精干预对HIV和生活质量结果的潜在影响。
BackgroundUnhealthy alcohol use is an unaddressed barrier to achieving and maintaining control of the human immunodeficiency virus (HIV) epidemic. Integrated screening, treatment of common behavioral and mental health comorbidities, and telemedicine can improve alcohol treatment and HIV clinical and quality of life outcomes for rural and underserved populations.ObjectiveIn a randomized controlled clinical trial, we will evaluate the effectiveness and implementation of telephone-delivered Common Elements Treatment Approach (T-CETA), a transdiagnostic cognitive behavioral therapy protocol, on unhealthy alcohol use, HIV, other substance use and mental health outcomes among predominantly rural adults with HIV receiving care at community clinics in Alabama.MethodsAdults with HIV receiving care at four selected community clinics in Alabama will receive a telephone-delivered alcohol brief intervention (BI), and then be assigned at random (stratified by clinic and sex) to no further intervention or T-CETA. Participants will be recruited after screening positively for unhealthy alcohol use or when referred by a provider. The target sample size is 308. The primary outcome will be change in the Alcohol Use Disorder Identification Test (AUDIT) at six- and 12-months post-enrollment. Additional outcomes include HIV (retention in care and viral suppression), patient-reported mental health (anxiety, depression, posttraumatic stress), and quality of life. A range of implementation measures be evaluated including T-CETA provider and client acceptability, feasibility, cost and cost-effectiveness.ConclusionsThis trial will inform alcohol treatment within HIV care programs, including the need to consider comorbidities, and the potential impact of alcohol interventions on HIV and quality of life outcomes.