Achieving Equity in Patient Outcome Reporting for Timely Assessments of Life With HIV and Substance Use
概览
- 阶段
- 不适用
- 干预措施
- Population level patient portal based substance involvement screening
- 疾病 / 适应症
- Substance Use Disorders
- 发起方
- University of Chicago
- 入组人数
- 900
- 试验地点
- 1
- 主要终点
- Percentage of participants screened for substance use disorder
- 状态
- 进行中（未招募）
- 最后更新
- 上个月
概览
简要总结
This study aims to achieve health equity in substance use disorder (SUD) screening and treatment among people living with human immunodeficiency virus (HIV) by implementing interventions to decrease barriers to screening (clinic-based, in-person) and treatment (referral-focused), a program the study investigators call "Achieving Equity in Patient Outcome Reporting for Timely Assessments of Life With HIV and Substance Use (ePORTAL HIV-S)." The ePORTAL HIV-S randomized control trial will focus on portal-based screening in the HIV clinic, regardless of whether the patient has a scheduled appointment with their HIV provider.
详细描述
Substance use disorder (SUD) and human immunodeficiency virus (HIV) are synergistic epidemics (syndemics) disproportionately affecting Black Americans. Structural racism related to inadequate access to healthcare, stigma, and criminalization, especially among those with intersectional identities related to gender and sexual minorities, further exacerbate disparities in HIV and SUD outcomes. SUD is often unrecognized and untreated among people living with HIV (PLWH). Only about half of HIV care sites routinely screen and refer to SUD treatment. In preliminary work, the study investigators found that nearly half of patients assessed in a HIV clinic waiting room met the criteria for a SUD, but 65% had not been diagnosed with SUD. A promising strategy to address structural barriers to SUD screening for PLWH is use of electronic patient portals. Patient portals are secure websites that give patients access to health information and allow for secure messaging with providers. They are associated with improved health outcomes and patient engagement. Notably, while most SUD screening currently occurs during clinic visits, portals can be utilized for SUD screening to reach patients who miss clinic visits, which is more common among people with HIV and SUD. The study team's preliminary work has demonstrated the potential of the portal for use in a population health approach to behavioral health screening. This study will implement and evaluate multi-level interventions to decrease barriers to SUD screening (clinic-based, in-person) and treatment (referral-focused), a program the study investigators call "Achieving Equity in Patient Outcome Reporting for Timely Assessments of Life With HIV and Substance Use (ePORTAL HIV-S)." ePORTAL HIV-S is conducting a randomized control trial to assess the effectiveness of population health vs. usual (clinic-visit) SUD screening among PLWH in a HIV clinic.
研究者
入排标准
入选标准
- •18 years or older
- •has been diagnosed with human immunodeficiency virus infection (HIV)
- •provider has assented
- •receives HIV care at the University of Chicago Ryan White Adult HIV Care Clinic, as evidenced by inclusion in the Epic HIV Registry
- •speaks English
- •has not completed in clinic SUD screening in the last year
- •has an active MyChart account
排除标准
- •Patients who have been screened for substance use disorder at the clinic in the last year using the NIDA Quick Screen
- •Patient's provider has not assented to the intervention
- •Patient is younger than 18 years
研究组 & 干预措施
Patient portal population level substance involvement risk screener
Participants randomized to this group will receive a NIDA Quick Screen V1.0 substance involvement screener over the patient portal regardless of having a scheduled appointment with their HIV clinician. If they do not complete the screener via the portal, they will be screened at HIV clinic appointments.
干预措施: Population level patient portal based substance involvement screening
Usual Care SUD Screening
Participants randomized to this intervention will receive the NIDA Quick Screen V1.0 if they attend their scheduled appointment with their HIV clinician.
干预措施: Usual Care Substance Use Involvement Screening
结局指标
主要结局
Percentage of participants screened for substance use disorder
时间窗: 1 year from screening start date
Percentage of participants who completed the validated NIDA Quick Screen V1.0 for substance use disorder in the HIV clinic.
次要结局
- Number and percentage of participants referred to substance use and misuse treatment(1 year from screening start date)
- Retention in care in the year post-screening(2 years from screening start date)
- HIV viral suppression(1 year from screening start date)
- Number and percentage of participants with moderate or high risk of substance involvement(1 year from screening start date)