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: 10685452
• 负责人: Karen L Cropsey
• 金额: $ 114.3万
• 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/10685452
• 关键词: 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; Diagnostic; Disparity; Disparity population; Educational Intervention; Elements; Epidemic; Evidence based intervention; Face; Funding; Gender; Geographic Locations; HIV; HIV/AIDS; Health Personnel; Human Resources; Incidence; Infectious Diseases Research; Interpersonal Violence; Intervention; Knowledge; Licensing; 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; Telemedicine; Training; Translating; Treatment outcome; Underserved Population; United States; United States National Institutes of Health; Viral; Washington; Zambia; addiction; alcohol comorbidity; alcohol misuse; antiretroviral therapy; 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; implementation evaluation; improved; low and middle-income countries; mortality; participant enrollment; peer; pilot test; 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/摘要 赞比亚亚拉巴马艾滋病毒酒精合并症项目（ZAMBAMA）的总体目标是（目标1）检测 跨诊断模型的有效性，共同要素治疗方法（CETA），以减少 不健康的酒精使用和改善资源不足的艾滋病毒诊所的艾滋病毒临床结果，（目标2）评估 CETA影响艾滋病毒结局的机制，（目的3）调查CETA的治疗效果是否 CETA因临床而异（例如，合并症的存在），人口统计学（例如，性别）和/或背景因素 (e.g.,赞比亚、亚拉巴马）和（目标4）审查与综合 向感染艾滋病毒和不健康饮酒的弱势群体提供减少饮酒的干预措施， 线艾滋病诊所。P01的中心主题是，在艾滋病毒感染者和不健康的酒精使用者中， 筛查和治疗常见的行为和心理健康共病将减少不健康的酒精使用 改善艾滋病治疗效果。ZAMBAMA将由一个合作团队实施， 由资深和年轻的研究人员组成的小组致力于解决艾滋病毒关系方面的科学空白， 全球艾滋病毒应对工作重点地理区域的吸毒和精神疾病情况：撒哈拉以南非洲 该团队将在美国南部的成年人中进行两项随机对照临床试验， HIV和不健康的酒精使用，以评估CETA对酒精使用的影响，HIV护理连续体（抗逆转录病毒 治疗依从性，参与和保留艾滋病毒护理，病毒抑制），以及常见的心理健康和 物质使用合并症。项目1（赞比亚CETA艾滋病毒酒精减少试验- CHARTZ）将 在赞比亚的公共部门初级艾滋病毒诊所实施，现有的艾滋病毒“同伴教育者”（即，层 顾问）将接受培训，以提供酒精简短干预（BI）和CETA的参与者在人 sessions.项目2（使用CETA - TALC对艾滋病毒感染者不健康饮酒进行远程医疗） 将招募在社区瑞安白色艾滋病毒/艾滋病项目资助的诊所接受艾滋病毒护理的参与者， 亚拉巴马，为不同的农村人口服务。研究生水平的提供者（由有执照的临床 心理学家）将使用远程医疗方法远程提供干预措施（BI和CETA）， 于2019冠状病毒病大流行期间迅速扩张。这两个研究项目还将评估实施情况 因素，以增强临床有效性数据的影响，这两个项目将得到3个资源的支持 核心：用于临床干预培训和监督的CETA核心，用于协调 跨项目的数据元素，并在数据分析中创建协同作用，以及管理核心 P01的业务和法规要求，监控和管理整体进度，并促进 美国南部之间的双向知识和思想交流-撒哈拉以南非洲 investigators.

项目成果

Telemedicine for unhealthy alcohol use in adults living with HIV in Alabama using common elements treatment approach: A hybrid clinical efficacy-implementation trial protocol.

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
• 发表时间: 2023
• 期刊: Contemporary clinical trials communications
• 影响因子: 1.5
• 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
• 通讯作者: Cropsey,Karen