Zambia Alabama HIV Alcohol Comorbidities Program (ZAMBAMA)

赞比亚阿拉巴马州艾滋病毒酒精合并症计划 (ZAMBAMA)

• 批准号: 10303936
• 负责人: Karen L Cropsey
• 金额: $ 117.75万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-10 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10303936
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Adult; Africa South of the Sahara; Alabama; Alcohol consumption; Alcohols; Anxiety; Apache; Arizona; Back; Businesses; COVID-19 pandemic; Caring; Clinic; Clinical; Clinical effectiveness; Cognitive Therapy; Collaborations; Communities; Complex; Continuity of Patient Care; Data; Data Analyses; Data Collection; Data Element; Deep South; Disadvantaged; Educational Intervention; Elements; Enrollment; Epidemic; Evidence based intervention; Face; Funding; Gap Junctions; Gender; Geographic Locations; HIV; Health Personnel; Human Resources; Incidence; Infectious Diseases Research; Interpersonal Violence; Intervention; Knowledge; Mental Depression; Mental Health; Mental disorders; Methods; Modeling; Monitor; National Institute on Alcohol Abuse and Alcoholism; Outcome; Pain; Participant; Patients; Persons; Population Heterogeneity; Prevalence; Prevention; Professional counselor; Protocols documentation; Provider; Psychologist; Public Sector; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Research; Research Personnel; Research Project Grants; Resources; Rural Population; Southern Africa; Structure; Supervision; Telemedicine; Testing; Training; Translating; Treatment outcome; Underserved Population; United States; United States National Institutes of Health; Viral; Zambia; addiction; alcohol comorbidity; alcohol misuse; antiretroviral therapy; base; behavioral health; behavioral health intervention; brief alcohol intervention; brief intervention; common treatment; community clinic; comorbidity; compare effectiveness; contextual factors; cost; cost effective; data harmonization; design; effectiveness testing; implementation determinants; improved; low and middle-income countries; mortality; peer; population based; post-traumatic stress; post-traumatic symptoms; programs; reduce symptoms; response; screening; substance use; suicidal risk; synergism; therapy adherence; treatment as prevention; treatment effect; trial design

Project Summary/Abstract The overall aims of the Zambia Alabama HIV Alcohol Comorbidities Program (ZAMBAMA) are to (Aim 1) test the effectiveness of a transdiagnostic model, Common Elements Treatment Approach (CETA), to reduce unhealthy alcohol use and improve HIV clinical outcomes in under-resourced HIV clinics, (Aim 2) evaluate the mechanisms through which CETA impacts HIV outcomes, (Aim 3) investigate whether the treatment effect of CETA varies by clinical (e.g., presence of comorbidities), demographic (e.g., gender) and/or contextual factors (e.g., Zambia, Alabama), and (Aim 4) examine implementation factors, including cost, related to integrated delivery of alcohol reduction interventions to disadvantaged people with HIV and unhealthy alcohol use at front- line HIV clinics. The P01’s central theme is that, among people with HIV and unhealthy alcohol use, integrated screening and treatment of common behavioral and mental health comorbidities will lower unhealthy alcohol use and improve HIV treatment outcomes. ZAMBAMA will be implemented by a collaborative team that brings together groups of established and young investigators working to address scientific gaps at the nexus of HIV, substance use, and mental illness in priority geographical areas in the global HIV response: sub-Saharan Africa and the Southern U.S. Together, the team will implement two randomized controlled clinical trials in adults with HIV and unhealthy alcohol use to evaluate CETA’s effects on alcohol use, the HIV care continuum (antiretroviral therapy adherence, engagement and retention in HIV care, viral suppression), and common mental health and substance use comorbidities. Project 1 (CETA HIV Alcohol Reduction Trial in Zambia - CHARTZ) will be implemented at public sector primary HIV clinics in Zambia where existing HIV ‘peer educators’ (i.e., lay counselors) will be trained to provide an alcohol brief intervention (BI) and CETA to participants at in-person sessions. Project 2 (Telemedicine for Unhealthy Alcohol Use in Persons Living with HIV using CETA - TALC) will enroll participants receiving HIV care at community Ryan White HIV/AIDS program-funded clinics across Alabama that serve diverse and rural populations. Graduate-level providers (supervised by a licensed clinical psychologist) will provide the interventions (BI and CETA) remotely using telemedicine approaches that were rapidly expanded during the COVID-19 pandemic. Both research projects will also evaluate implementation factors, to enhance the impact of clinical effectiveness data, and both projects will be supported by 3 resource cores: a CETA core for clinical intervention training and oversight, a Methods and Analysis core to harmonize data elements across projects and create synergy in data analyses, and an Administrative core to manage business and regulatory requirements of the P01, monitor and manage overall progress, and promote bidirectional knowledge and idea exchange between Southern U.S.- and sub-Saharan Africa-focused investigators.

项目总结/文摘