Technology Enhanced Substance Use and HIV Service Navigation for Justice-Involved Young Adults

技术增强了对参与正义的年轻人的药物使用和艾滋病毒服务导航

• 批准号: 10327137
• 负责人: Emily F Dauria
• 金额: $ 17.55万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10327137
• 关键词: AIDS prevention; Adherence; Adult; Awareness; Case Management; Characteristics; Communities; Community of Practice; Consolidated Framework for Implementation Research; Continuity of Patient Care; Criminal Justice; Development; Drug Compounding; Drug abuse; Effectiveness; Enhancement Technology; Feasibility Studies; Feedback; Focus Groups; Future; Goals; HIV; HIV Seropositivity; Health; Health Technology; Healthcare; Imprisonment; Improve Access; Individual; Intervention; Interview; Justice; Lead; Learning; Link; Mental Health; Modeling; Movement; Participant; Persons; Phase; Pilot Projects; Population; Prevention strategy; Prevention trial; Process; Provider; Publishing; Randomized Controlled Trials; Reporting; Research; Research Personnel; Risk; Risk Behaviors; San Francisco; Services; Substance Use Disorder; Supervision; System; Technology; Testing; Time; Translations; Underserved Population; United States; Woman; Work; acceptability and feasibility; aged; alcohol abuse prevention; behavioral health; behavioral health intervention; design; disorder prevention; effective intervention; efficacy testing; evidence base; feasibility testing; follow-up; health care availability; high risk; implementation process; improved; innovation; interest; intervention delivery; minority children; multidisciplinary; navigator intervention; pandemic coronavirus; parole; pilot trial; pre-exposure prophylaxis; prevention service; preventive intervention; primary outcome; probation; programs; racial and ethnic; racial and ethnic disparities; satisfaction; service intervention; standard of care; study population; substance use; substance use treatment; tool; treatment services; trial comparing; uptake; young adult

Project Summary/Abstract There is a strong scientific premise for the study of integrated substance use disorders (SUDs) and HIV- prevention interventions for criminal justice-involved (CJI) populations. SUDs lead to increased rates of justice involvement as well as increased risk for HIV-acquisition. Estimates of the proportion of the CJI-population with a SUD reach 72%, and ~150,000 persons with HIV pass through a correctional facility annually. Although pre- exposure prophylaxis (PrEP), is a proven effective intervention for HIV-prevention, its maximal impact depends on uptake, and adherence among those at high risk. To date, few published studies have examined PrEP uptake among CJI populations. Our ongoing work with CJI women (San Francisco, CA) has identified high rates of risk behaviors (including substance use), low levels of PrEP awareness, and high levels of interest in PrEP once learning of it. Participants reported a strong interest in participating in a navigator-led intervention to screen and link them to PrEP-related services; younger participants (i.e., those aged 18 to 29 years) were eager to incorporate electronic health (eHealth) into navigation services. Navigator models use a one-on-one relationship to promote the timely movement of an individual through a health care continuum by eliminating barriers and have successfully increased healthcare access for CJI HIV-positive adults and individuals with SUDs. eHealth approaches to SUD and HIV prevention also hold promise because they improve access to effective intervention services, particularly for younger people. As a multidisciplinary team with expertise in behavioral health (substance use and HIV prevention) among justice-involved populations, and eHealth supported and navigator- led healthcare access and engagement interventions, we propose to develop and test an eHealth enhanced, navigator-led substance use and HIV-prevention referral and linkage intervention for CJI-young adults. Study aims are to: 1) Adapt an existing evidence-based navigator model (The Navigation Project) to incorporate codeveloped eHealth technology, to refer and link CJI young adults (aged 18 to 29 years) to substance use treatment and HIV-prevention services; 2) Refine and test the adapted, eHealth enhanced, navigator-led substance use treatment and HIV prevention intervention for CJI-young adults for fidelity, satisfaction, and appropriateness; 3) Assess the feasibility, acceptability, and impact of the adapted eHealth enhanced, navigator program to refer and link CJI-young adults substance use treatment and HIV-prevention services. The proposed study has the potential to: 1) reduce HIV-acquisition and improve access to substance use treatment among a high-risk, underserved group of young adults in the US; 2) test the feasibility, acceptability, fidelity, effectiveness, appropriateness, and satisfaction of implementing an eHealth enhanced, navigator-led substance use and HIV- prevention intervention, and 3) create an intervention suitable for large-scale efficacy testing and translation to other criminal justice settings.

项目总结/摘要 综合药物使用障碍（SUD）和艾滋病毒的研究有一个强有力的科学前提- 对涉及刑事司法的人群采取预防干预措施。SUD导致司法率提高 参与以及增加感染艾滋病毒的风险。估计拥有一个 吸毒率达到72%，每年约有150 000名艾滋病毒感染者通过教养所。虽然预- 暴露预防（PrEP）是一种有效的预防艾滋病毒的干预措施，其最大影响取决于 在高危人群中的吸收和坚持。到目前为止，很少有已发表的研究检查了PrEP摄取 在CJI人群中。我们对CJI妇女（加利福尼亚州旧金山弗朗西斯科）的持续研究发现， 行为（包括物质使用），PrEP意识水平低，对PrEP的兴趣水平高， 参与者报告说，他们对参与导航员主导的干预措施有浓厚的兴趣， 将他们与PrEP相关服务联系起来;年轻参与者（即，年龄在18至29岁之间的人）渴望 将电子健康（eHealth）纳入导航服务。导航器模型使用一对一关系 通过消除障碍，促进个人在医疗保健连续体中的及时流动， 成功增加了CJI艾滋病毒阳性成年人和SUD患者获得医疗保健的机会。eHealth SUD和艾滋病毒预防方法也有希望，因为它们改善了获得有效干预的机会 服务，尤其是年轻人。作为一个在行为健康方面具有专业知识的多学科团队 （药物使用和艾滋病毒预防），以及电子保健支持和导航- 领导的医疗保健准入和参与干预措施，我们建议开发和测试电子健康增强， 导航员主导的药物使用和艾滋病毒预防转诊和联系干预CJI年轻人。研究 目的是：1）调整现有的循证导航模型（导航项目）， 共同开发电子健康技术，将CJI年轻人（18至29岁）与药物使用联系起来 治疗和艾滋病毒预防服务; 2）完善和测试经过调整的、增强的、导航员引导的电子健康 物质使用治疗和艾滋病毒预防干预CJI-年轻成年人的忠诚度，满意度， 适当性; 3）评估适应电子健康增强，导航器的可行性，可接受性和影响 转介和联系CJI-年轻成人药物使用治疗和艾滋病毒预防服务的方案。拟议 这项研究有可能：1）减少艾滋病毒感染，改善药物使用治疗的可及性， 美国高风险、服务不足的年轻人群体; 2）测试可行性、可接受性、忠诚度、有效性， 适当性和实施电子健康增强的满意度，导航引导的药物使用和艾滋病毒- 预防干预，以及3）创建适合大规模功效测试和转化的干预措施， 其他刑事司法机构。