Facilitating the Decentralization of Methadone Maintenance Therapy Services into Communities in Vietnam

促进将美沙酮维持治疗服务分散到越南社区

• 批准号: 9768996
• 负责人: Chunqing Lin
• 金额: $ 30.77万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9768996
• 关键词: AIDS/HIV problem; Address; Car Phone; Caring; Client; Communities; Complex; Data; Decentralization; Development; Drug user; Empirical Research; Ensure; Epidemic; Epidemiology; Evaluation; Feedback; HIV; HIV therapy; Harm Reduction; Health; Health Services; Health Services Accessibility; Health care facility; Healthcare; Hygiene; Improve Access; Institutes; Intervention; Methodology; Monitor; Neighborhood Health Center; Opioid; Outcome; Participant; Persons; Phase; Prevention; Primary Health Care; Process; Provider; Province; Public Health; Randomized; Readiness; Research; Research Activity; Research Methodology; Self-Examination; Service delivery model; Service provision; Services; Site; Source; Structure; Supervision; System; Testing; Training; United States; Vietnam; base; care systems; combat; commune; design; dosage; experience; health care service; health care settings; illicit drug use; implementation science; improved; medication-assisted treatment; methadone treatment; model development; multidisciplinary; opioid epidemic; process optimization; programs; recruit; service delivery; service gap; service providers; service utilization; task analysis; therapy design; therapy development; usability; working group

Abstract Vietnam is currently decentralizing its methadone maintenance therapy (MMT) dispensing network to its local commune health centers (CHC), which provides a window of opportunity to study decentralization of harm reduction and HIV-related healthcare services into community-based healthcare settings. Commune health workers (CHW) in Vietnam have widespread misconceptions about harm reduction and perceived significant challenges associated with treating people who use drugs. Intervention effort is needed to address these issues to ensure a smooth implementation of the decentralized service model. The proposed two-year study plans to design and pilot test an intervention to facilitate the delivery of decentralized MMT/HIV services via three phases in Phu Tho Province, Vietnam. In Phase 1, we will conduct task analysis with MMT clients and cross-functional analysis with service providers to identify the steps/tasks that are associated with most procedural delays, errors, redundancies, and/or unnecessary reworks. We will also evaluate each CHC’s capacity and readiness to deliver the MMT services. In Phase 2, under the framework of intervention mapping, a multidisciplinary working group will go through the six steps to design the intervention and develop its implementation and evaluation plan. The intervention, with a primary focus on process optimization, will be executed through a combination of in-person training and mobile phone application utilization. In Phase 3, we will pilot the intervention in six CHC-based MMT distribution sites. The six CHC will be randomized to either an intervention condition or a control condition. The intervention outcomes on CHW and MMT clients will be evaluated at baseline, 3-, and 6-months. The intervention will be revised and finalized based on acceptability/feasibility evaluation data, process evaluation data, and feedbacks from intervention facilitators and participants.

抽象的 越南目前正在将其美沙酮维持治疗 (MMT) 配药网络下放给 其当地的社区卫生中心（CHC），为研究权力下放提供了一个机会之窗 将减少危害和与艾滋病毒相关的医疗保健服务纳入社区医疗保健环境。公社 越南的卫生工作者 (CHW) 对减少伤害存在广泛的误解，并认为 与治疗吸毒者相关的重大挑战。需要采取干预措施来解决 这些问题保证了去中心化服务模式的顺利实施。拟议的两年 研究计划设计和试点测试一项干预措施，以促进分散的 MMT/HIV 服务的提供 在越南富寿省分三个阶段进行。在第一阶段，我们将与MMT客户进行任务分析 与服务提供商进行跨职能分析，以确定与大多数相关的步骤/任务 程序延误、错误、冗余和/或不必要的返工。我们还将评估每个 CHC 提供 MMT 服务的能力和准备情况。在第二阶段，在干预映射的框架下， 多学科工作组将通过六个步骤来设计干预措施并制定其干预措施 实施和评估计划。干预措施的主要重点是流程优化， 通过现场培训和手机应用程序使用相结合的方式执行。在第三阶段，我们 将在六个基于 CHC 的 MMT 分发点进行试点干预。六个 CHC 将被随机分配到 干预条件或控制条件。对 CHW 和 MMT 客户的干预结果将是 在基线、3 个月和 6 个月时进行评估。干预措施将根据以下情况进行修订和最终确定： 可接受性/可行性评估数据、过程评估数据以及干预促进者的反馈 和参与者。