CHARTZ

图表

• 批准号: 10685464
• 负责人: Michael Jeffrey Vinikoor
• 金额: $ 31.12万
• 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/10685464
• 关键词: 18 year old; Acceleration; Address; Adult; Affect; Africa South of the Sahara; Alabama; Alcohol abuse; Alcohol consumption; Alcohols; Behavioral; Biological Markers; Caring; Clinic; Clinical; Cognitive; Cognitive Therapy; Complex; Computerized Medical Record; Continuity of Patient Care; Counseling; Data; Diagnostic; Effectiveness; Elements; Eligibility Determination; Enrollment; Epidemic; HIV; HIV Infections; HIV/AIDS; Health Personnel; Hybrids; Incidence; Individual; Intervention; Measures; Mental Health; Mental disorders; Modeling; NIH Office of AIDS Research; Outcome; Outcome Measure; Participant; Patient Outcomes Assessments; Persons; Pharmaceutical Preparations; Population; Prevalence; Prevention; Prevention program; Professional counselor; Program Research Project Grants; Protocols documentation; Provider; Psyche structure; Public Health; Public Sector; Randomized; Randomized Controlled Clinical Trials; Randomized, Controlled Trials; Research; Research Project Grants; Resource-limited setting; Symptoms; Testing; Translational trial; Trauma; Viral; Zambia; alcohol abuse therapy; alcohol comorbidity; alcohol intervention; alcohol misuse; antiretroviral therapy; arm; behavioral health; brief alcohol intervention; brief intervention; clinical care; comorbidity; comparative effectiveness; cost; cost effective; cost effectiveness; cost-effectiveness ratio; depressive symptoms; design; effectiveness evaluation; effectiveness/implementation trial; epidemic response; evidence base; experience; flexibility; follow-up; health goals; health related quality of life; implementation determinants; implementation evaluation; improved; incremental cost-effectiveness; intervention delivery; low and middle-income countries; marginalized population; mortality; novel; peer; phosphatidylethanol; pilot test; programs; psychologic; randomized trial; reduced alcohol use; response; screening; standard of care; substance use; therapy adherence; trauma symptom; treatment effect; treatment program; trial design

Project Summary/Abstract The intersection of unhealthy alcohol use and HIV infection is most significant in sub-Saharan Africa (SSA) where HIV prevalence exceeds 20% in some populations and alcohol consumption is on the rise. Most HIV treatment and prevention programs in SSA do not have evidence-based alcohol interventions and the professional mental health workforce is extremely limited. Alcohol brief interventions (BI), which have been moderately effective in other settings, were not effective in SSA for unhealthy alcohol use among people with HIV in several previous trials. Unhealthy alcohol use is often complicated by comorbid mental illness and/or other substance use. We previously demonstrated the feasibility, acceptability, and potential effectiveness of a transdiagnostic model called Common Elements Treatment Approach (CETA) for people with HIV and unhealthy alcohol use. CETA was designed for delivery by lay providers (non-professionals with limited or no previous mental health experience) and can address a range of conditions (including unhealthy alcohol use) within a single protocol delivered over 6-12 therapy sessions. CETA was evaluated in 3 previous randomized trials and found to be effective for a range of conditions in trauma-affected and marginalized populations. CETA HIV Alcohol Reduction Trial in Zambia (CHARTZ), a research project within the Zambia Alabama HIV Alcohol Comorbidities Program, is a hybrid effectiveness-implementation trial to evaluate the effects of CETA, and a novel alcohol BI, on HIV, alcohol, and comorbidity outcomes. Adults (18+ years old) with HIV, unhealthy alcohol use, and suboptimal engagement in HIV care at public sector HIV clinics in Lusaka will be enrolled and randomized to the standard of care (ART adherence counseling), BI alone, or BI plus CETA. The BI and CETA will be provided by HIV peer educators, a cadre of lay counselors who are embedded at HIV clinics across Zambia. Patient reported outcome measures (for alcohol use, mental illness, and other substance use) and HIV electronic medical records (for ART adherence, retention in HIV care, viral suppression) will be used to assess trial eligibility and evaluate outcomes at 6 and 12 months. Phosphatidylethanol, a direct alcohol biomarker, will be measured to strengthen assessment of trial outcomes. Implementation factors related to the integrated delivery of CETA and the BI will be evaluated including cost and cost effectiveness. In summary, CHARTZ will generate evidence on psychological treatments for unhealthy alcohol use that have strong potential for implementation in low-resource settings and can address complex and overlapping behavioral issues that undermine HIV treatment and prevention.

项目摘要/摘要 在撒哈拉以南非洲（SSA）中，不健康的酒精使用和艾滋病毒感染的交集最为重要。 在某些人群中，艾滋病毒患病率超过20％，饮酒率正在上升。大多数艾滋病毒治疗 SSA中的预防计划没有循证酒精干预和专业精神 健康员工极为有限。酒精简介干预措施（BI），在 其他环境在SSA中对艾滋病毒患者的不健康饮酒在以前的几个以前的饮酒中无效 试验。合并症的精神疾病和/或其他药物使用通常会使不健康的饮酒变得复杂。我们 以前证明了转诊模型的可行性，可接受性和潜在有效性 称为艾滋病毒和不健康饮酒患者的常见元素治疗方法（CETA）。 CETA 专为外行提供商（有限或以前没有心理健康的非专业人士提供服务 经验），可以解决单个协议中的一系列条件（包括不健康的饮酒） 进行了6-12多次治疗课程。在先前的3个随机试验中评估了CETA，发现 对于受创伤影响和边缘化的人群的一系列条件有效。 CETA HIV降低酒精 赞比亚（Chartz）的试验是赞比亚阿拉巴马州艾滋病毒合并症计划的研究项目， 是一项评估CETA和新型酒精BI对HIV的影响的杂种有效性试验 酒精和合并症的结果。成人（18岁以上）患有艾滋病毒，不健康的饮酒和次优 在卢萨卡的公共部门艾滋病毒诊所参与艾滋病毒护理，并将随机分配为标准 护理（艺术依从性咨询），单独使用BI或BI Plus CETA。 BI和CETA将由HIV PEER提供 教育工作者是一群外行辅导员的干部，他们嵌入了赞比亚的艾滋病毒诊所。患者报告了结果 措施（用于饮酒，精神疾病和其他药物使用）和HIV电子病历（用于艺术 依从性，在艾滋病毒护理中保留，病毒抑制）将用于评估试验资格和评估结果 在6和12个月。磷脂酰乙醇（一种直接酒精生物标志物）将被测量以加强评估 试验结果。将评估与CETA和BI集成交付有关的实施因素 包括成本和成本效益。总而言之，Chartz将为心理治疗提供证据 对于不健康的饮酒，在低资源环境中具有强大的实施潜力，并且可以解决 破坏HIV治疗和预防的复杂和重叠的行为问题。