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Feasibility of SBIRT for Underserved HIV+ Adults 50+ in Primary Care Settings

对初级保健机构中服务不足的 HIV 成年人 50 进行 SBIRT 的可行性

基本信息

批准号：
9975106
负责人：
Nicole Ennis
金额：
$ 15.38万
依托单位：
FLORIDA STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-01 至 2022-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9975106
关键词：
Acquired Immunodeficiency Syndrome Address Adherence Adoption Adult Age Aging Alcohol or Other Drugs use Alcohols Appointment Area Caring Chronology Clinic Clinical Clinical Investigator Communities Consumption Data Demographic Factors Development Plans Disease Disease Management Dose Effectiveness Effectiveness of Interventions Elderly Evidence based intervention Florida Goals HIV HIV Seropositivity Health Illicit Drugs Individual Infrastructure Institutes Intervention Interview Intoxication Knowledge Laboratory Research Link Literature Low income Maintenance Mental Depression Mentored Patient-Oriented Research Career Development Award Mentors Methods Mission Modeling National Institute of Drug Abuse Outcome Pain Patient Care Patient Recruitments Patients Pharmaceutical Preparations Population Primary Health Care Psychologist Public Health Randomized Research Research Methodology Research Personnel Research Project Grants Rest Rural Community Sampling Science Social support Testing Tobacco Training Training Programs United States Vulnerable Populations aged alcohol misuse alcohol research antiretroviral therapy brief intervention career career development cooking effective intervention ethnic minority population evidence base experience follow-up high risk behavior illicit drug use implementation science improved improved outcome investigator training nonmedical use peer peer support post intervention primary care setting public health relevance racial and ethnic recruit screening and brief intervention screening, brief intervention, referral, and treatment skills substance misuse success treatment arm treatment as usual treatment center uptake

项目摘要

DESCRIPTION (provided by applicant): The goal of this Mentored Patient-Oriented Research Career Development Award (K23) is to support Dr. Nicole Ennis Whitehead, a Clinical Psychologist, in developing the critical skills necessary to become an independent researcher in the implementation of substance use interventions in real world settings. She seeks to acquire skills in: 4 areas: substance use intervention science, implementation science, mixed methods, and research conduct Both the National Institute on Drug Abuse (NIDA) and the Office of AIDS Research (OAR) have prioritized research that promotes the uptake of evidence based interventions into real-world settings. Extant literature indicates that 20-50% of those aging with HIV misuse alcohol, illicit drugs or prescription medications. Interventions that reach this population are needed. To date many effective interventions do not translate into meaningful outcomes that improve patient care. Substance use interventions in particular have lagged in moving from research laboratories to real-world settings (primary care clinics, community treatments centers, etc.). The Screening, Brief Intervention and Treatment (SBIRT) model has been effective in decreasing high risk behaviors such as tobacco, alcohol, and illicit drug use. However, recent data suggests that brief intervention models alone may not be effective with vulnerable populations. The evidence supporting SBIRT indicates that other models such as SBIRT with a peer navigator (SBIRT-PN) should be examined for this population. Therefore, the training goal for this K23 is to advance the candidate's skills in implementing SBIRT-PN in HIV primary care clinics for HIV+ adults 50 and older. Training aims include: (1) Describe and differentiate optimal methods of substance use intervention with vulnerable populations; (2) Obtain skills to implement substance use interventions in real-world settings; and (3) Acquire skills in advanced intervention modeling and mixed methods research and use these methods to evaluate substance use interventions. Execution of these research aims along with a comprehensive training program will be led by Dr. Robert Cook, Dr. Linda B. Cottler and Dr. Xinguang Chen with additional collaborators to address training specific needs. The research project will use the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to pilot and evaluate the SBIRT-PN using the Southern HIV and Alcohol Research Consortium (SHARC) HIV primary care clinic network. Aim 1: Pilot effectiveness of SBIRT-PN versus treatment as usual in HIV primary care clinics to improve substance-use treatment engagement and HIV appointment adherence among adults aged 50 and older. Aim 2: Describe the influence of demographic factors, depression and pain on substance-use treatment engagement outcomes. Aim 3: Examine and enhance feasibility (recruitment, dose, retention) of intervention uptake for a larger trial. The proposed research will provide the preliminary data needed to support an R01 testing the implementation of this intervention (SBIRT-PN) across a broad clinical network serving older HIV+ adults. Completion of this plan will prepare me for a career as an independent clinical investigator trained to implement substance use interventions in real world settings.

描述(由申请者提供)：这个以患者为导向的研究职业发展奖(K23)的目标是支持临床心理学家Nicole Enennis Whitehead博士发展必要的关键技能，成为在现实世界环境中实施药物使用干预的独立研究员。她试图在4个领域获得技能：物质使用干预科学、实施科学、混合方法和研究进行国家药物滥用研究所(NIDA)和艾滋病研究办公室(OAR)都将促进基于证据的干预措施纳入现实世界的研究放在优先位置。现有文献表明，20%-50%的老年人艾滋病毒滥用酒精、非法药物或处方药。需要针对这一人群的干预措施。到目前为止，许多有效的干预措施并没有转化为改善患者护理的有意义的结果。物质使用干预措施在从研究实验室转向现实环境(初级保健诊所、社区治疗中心等)方面尤其滞后。筛查、短期干预和治疗(SBIRT)模式在减少烟草、酒精和非法药物使用等高危行为方面是有效的。然而，最近的数据表明，仅靠简单的干预模式对脆弱人群可能并不有效。支持SBIRT的证据表明，应该为这一群体检查其他模式，如具有同行导航器的SBIRT(SBIRT-PN)。因此，K23的培训目标是提高候选人在艾滋病毒+50岁及以上成年人的艾滋病毒初级保健诊所实施SBIRT-PN的技能。培训目标包括：(1)描述和区分弱势人群的最佳物质使用干预方法；(2)获得在现实世界环境中实施物质使用干预的技能；(3)掌握高级干预建模和混合方法研究的技能，并使用这些方法评估物质使用干预措施。这些研究目标的执行以及全面的培训计划将由Robert Cook博士、Linda B.Cottler博士和陈新光博士领导，并有更多的合作者来满足特定的培训需求。该研究项目将使用REACH、Efficiency、Adption、Implementation和Maintenance(RE-AIM)框架，利用南方艾滋病毒和酒精研究联盟(SHARC)艾滋病毒初级保健诊所网络试行和评估SBIRT-PN。目的1：在HIV初级保健诊所进行SBIRT-PN与常规治疗相比的试点效果，以改善50岁及以上成年人的物质使用治疗参与度和HIV预约依从性。目的2：描述人口统计学因素、抑郁和疼痛对物质使用治疗参与度结果的影响。目的3：为一项更大规模的试验检查和增强干预摄取的可行性(招募、剂量、保留)。拟议的研究将提供所需的初步数据，以支持R01在服务于艾滋病毒+老年人的广泛临床网络中测试这种干预措施(SBIRT-PN)的实施情况。这项计划的完成将为我的职业生涯做好准备，成为一名独立的临床调查员，接受过在现实世界中实施药物使用干预的培训。