Community I-STAR Mozambique: Community Implementation of SBIRT using Technology for Alcohol use Reduction in Mozambique

莫桑比克社区 I-STAR：在莫桑比克使用减少酒精使用技术社区实施 SBIRT

• 批准号: 10687646
• 负责人: MILTON L WAINBERG
• 金额: $ 12.13万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-20 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10687646
• 关键词: Administrative Supplement; Award; Budgets; COVID-19; COVID-19 pandemic; Cities; Clinic; Clinical Trials; Cluster randomized trial; Communities; Community Health Aides; Decision Making; Effectiveness; Ensure; Funding; Health; Health Technology; Human Resources; Investments; Modification; Morbidity - disease rate; Mozambique; Parents; Phase; Policies; Policy Maker; Program Sustainability; Public Health; Recommendation; Research; Research Activity; Research Assistant; Risk; Safety; Sampling; Site; Supervision; Technology; Testing; Time; Training; Training Activity; Travel; Work; clinical practice; community based service; coronavirus disease; cost; cost effective; cost effective intervention; evidence base; hazardous drinking; human subject; low and middle-income countries; mHealth; member; mortality; pandemic disease; preservation; reduced alcohol use; rural area; scale up; screening, brief intervention, referral, and treatment; social; tool

Hazardous drinking (HD) is a major public health burden worldwide with significant morbidity and mortality. To reduce HD, the WHO recommends using Screening, Brief Intervention, Referral to Treatment (SBIRT). Mobile health technology (mHealth), such as the mSBIRT app developed by members of our team, is a promising tool for widespread cost-effective delivery of evidence-based HDS by community health workers (CHWs) because of its potential to increase fidelity, effectiveness, and sustainability. Community I-STAR (Implementation of SBIRT using Technology for Alcohol use Reduction) Mozambique comprises three phases: 1) mSBIRT adaptation – completed, 2) a cluster-randomized trial – in progress, and 3) scale-up of the most cost-effective intervention – to be started after the trial is completed. Community I-STAR Mozambique will scale-up a cost- effective, sustainable program and inform policy applicable to Mozambique and other LMICs. Early in the COVID-19 pandemic, all activities were put on hold. Once we were able to restart activities, the social restrictions during the pandemic required changing how trainings needed to be conducted to ensure safety. Instead of conducting fewer number of trainings with large numbers of trainees in one site as originally planned, we had to conduct much more many trainings with smaller number of trainees. Trainers also had to travel more times from Nampula City or Maputo City to train the (same) number of trainees in rural areas required to conduct the project as originally proposed. Also, in November 2019, the Ministry of Health (MoH) hired 162 more CHWs to work within the districts where we are conducting the study. Therefore an additional 228 CHWs need to be trained, which also required hiring more research assistants to provide the support needed at the clinic (and CHW) level. Also, per diem costs during training of MoH personnel (e.g., CHWs) triplicated as of 11/2019. Therefore, the training budget was much higher than originally planned and training activities have taken longer than expected, and the changes instituted by the MoH also had a financial impact in our study. This administrative supplement requests funding to cover the costs of the training the yet to be trained 228 CHWs that are required to attain the sample needed to test the hypothesis. This administrative supplement application does not propose changes to the overall human subjects/clinical trial designation of the award and preserves the parent award’s overall impact within the original scope of the award and the likelihood that this project will exert a sustained, powerful influence on the field. The administrative supplement will be used only to cover the cost increases for unanticipated expenses due to COVID-19 or related mitigation efforts that could not be covered by re-budgeting existing funds without modifications to the original scope of the approved project and is not intended to support COVID-related research. Because we are about to begin the last year of the award, without the funds requested in this supplement, the entire investment is at risk. Our request represents a significant need for additional funds to cover the research activities of this investment.

危险性饮酒（HD）是世界范围内的一个主要公共卫生负担，具有显著的发病率和死亡率。 为了减少HD，WHO建议使用筛查，短暂干预，转诊治疗（SBIRT）。移动的 健康技术（mHealth），如我们团队成员开发的mSBIRT应用程序，是一个很有前途的工具 社区卫生工作者（CHW）广泛提供基于证据的HDS的成本效益， 其提高保真度、有效性和可持续性的潜力。社区I-STAR（实施 使用减少酒精使用技术的SBIRT）莫桑比克包括三个阶段： 适应-已完成，2）一项分组随机试验-正在进行，3）扩大最具成本效益的 干预-在试验结束后开始。莫桑比克社区I-STAR将扩大成本- 有效、可持续方案编制和知情政策。 于COVID-19疫情初期，所有活动均暂停。一旦我们能够重新开始活动， 疫情期间的社会限制要求改变培训方式，以确保 安全为代价的不再像原来那样，在一个地点进行数量较少的培训， 计划中，我们不得不进行更多的培训，但受训人数较少。培训师还必须 从楠普拉市或马普托市到农村地区培训所需人数（相同）的受训者的次数增加 按照最初的提议进行项目。此外，2019年11月，卫生部（MoH）雇用了162名 在我们进行研究的地区内提供更多社区卫生工作者的服务。因此，额外增加了228个社区卫生工作者 这也需要雇用更多的研究助理，以提供所需的支持， 临床（和CHW）水平。此外，卫生部人员培训期间的每日津贴费用（例如，CHW）三重，截至 11/2019.因此，培训预算比原计划高得多， 花费的时间比预期的要长，卫生部制定的变化也对我们的研究产生了财务影响。这 行政补助金要求拨款支付培训费用228名尚待培训的社区卫生工作者 这是为了获得检验假设所需的样本。这份行政补充申请 不建议对该奖项的整体人类受试者/临床试验指定进行更改，并保留 在原奖励范围内，母奖励的总体影响以及该项目将 在球场上施加持续而强大的影响。行政补充金仅用于支付 因COVID-19或相关缓解措施导致的不可预见费用的成本增加无法覆盖 通过重新预算现有资金，而不修改已批准项目的原始范围， 旨在支持COVID相关研究。因为我们即将开始颁奖的最后一年， 在这个补充要求的资金，整个投资是有风险的。我们的要求代表了一种重要的需要， 为额外的资金，以支付这项投资的研究活动。