Improving the Integration of Mental Health and Substance Use Treatment Into Ryan White-Funded Care Sites in Atlanta Using an Implementation Science Approach
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Mental Health Disorder
- Sponsor
- RTI International
- Enrollment
- 333
- Locations
- 2
- Primary Endpoint
- Provider-Level Outcome: Adoption of the YouRx Decision Prescribing Platform
- Last Updated
- 3 years ago
Overview
Brief Summary
This project consists of a pilot trial to assess the preliminary impact of a stigma-reduction training to reduce clinic-level stigma and the You℞ Decision prescribing platform to increase HIV care providers' self-efficacy related to prescribing psychiatric medication for depression, post-traumatic stress disorder (PTSD), and bipolar disorder as well as naltrexone for alcohol use disorder (AUD).
Detailed Description
The study will pilot test a two-level strategy to improve integration of pharmacotherapy for serious mental health and alcohol use disorders among people living with HIV (PLHIV) in Ryan White-funded healthcare centers in Atlanta, Georgia. A small pilot trial will be conducted in the two clinic study sites to assess the acceptability, feasibility, adoption, and preliminary impact of a stigma-reduction training and the You℞ Decision prescribing platform. The researchers will fulfill the purpose of this study through the following aims: Aim 1: To conduct formative activities with PLHIV, HIV care providers, and our Community Collaborative Board (CCB) to adapt a stigma-reduction training to address mental health and substance abuse-related stigma among clinic staff and engage HIV care providers and an expert panel to develop the You℞ Decision prescribing platform to support HIV care providers to offer pharmacotherapy to treat depression, PTSD, bipolar disorder, and AUD (completed). Aim 2: To assess the acceptability of the stigma-reduction training among clinic staff and the feasibility, acceptability, and adoption of the You℞ Decision prescribing platform during clinical encounters among providers in HIV care settings. Aim 3: To use idiographic methods to conduct a pilot trial to assess the preliminary impact of the stigma-reduction training on clinic-level stigma and of the You℞ Decision prescribing platform on HIV care providers' self-efficacy to prescribe psychiatric medications and naltrexone as well as the impact of the stigma-reduction training and platform to increase the percentage of eligible patients who receive and accept prescriptions to treat depression, PTSD, bipolar disorder, and AUD. This implementation science study aims to reduce HIV-associated comorbidities by improving the integration of mental health and AUD treatment into Ryan White-funded care sites. If the findings indicate that the stigma-reduction training and prescribing platform are feasible, this study will be the impetus for the scale up these strategies to additional Ryan White-funded care sites in Georgia.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Stigma Reduction Training
- •be 18 years of age or older
- •be a staff member at the clinic study site randomized for the stigma-reduction training
- •Clinic Staff Survey
- •work at one of the two clinic study sites
- •be 18 years of age or older
- •Patient Survey
- •18 or older
- •report being HIV positive
- •have received care from a clinic study site recently
Exclusion Criteria
- •Stigma Reduction Training
- •Have been part of the formative activities
- •Clinic Staff Survey
- •Have been part of the formative activities.
- •Patient Survey
- •HIV negative
- •Have not attended a study clinic site recently
- •Have participated in the formative activities
- •Pilot Trial
- •Not a prescribing provider
Outcomes
Primary Outcomes
Provider-Level Outcome: Adoption of the YouRx Decision Prescribing Platform
Time Frame: Weekly (12 weeks)
Provider use of the You℞ Decision prescribing platform
Provider-Level Outcome: Feasibility of the YouRx Decision Prescribing Platform
Time Frame: 3 months follow-up
4-item measure to assess provider perception that the You℞ Decision platform can be integrated into usual care
Provider-Level Outcome: Acceptability of the YouRx Decision Prescribing Platform
Time Frame: 3 months follow-up
4-item measure to assess provider satisfaction with the You℞ Decision platform
Clinic Staff-Level Outcome: Observed Stigma Reduction
Time Frame: 3 months follow-up
Clinic staff observed stigmatizing behaviors toward those with serious mental health and/or substance use disorders
Provider-Level Outcome: Provider Self-Efficacy
Time Frame: 3 months follow-up
11-item survey to assess providers confidence to treat serious mental health disorders and AUD
Clinic-Level Outcome: Adoption of Psychiatric Medication and Naltrexone
Time Frame: 3 months follow-up
Percentage of eligible patients who receive a prescription for psychiatric medication or naltrexone or an in-house referral for psychiatric treatment from their HIV care provider.
Clinic Staff-Level Outcome: Acceptability of Stigma Reduction Training
Time Frame: Immediately post-training
4-item self-report measure to assess clinic staff's satisfaction with the stigma reduction training
Health Consumer-Level Outcome: Observed Stigma Reduction
Time Frame: 3 months follow-up
Experienced or observed stigma and discrimination from clinic staff based on serious mental health or substance use disorder
Provider-Level Outcome: Usability of the YouRx Decision Prescribing Platform
Time Frame: 3 months follow-up
21-item survey to assess the ease of use of the You℞ Decision prescribing platform
Clinic-Level Outcome: Reach of Prescription of Psychiatric Medication and Naltrexone
Time Frame: 3 months follow-up
Percentage of eligible patients who fulfill a prescription for a psychiatric medication or naltrexone or in-house referrals at the clinic level Percentage of eligible patients who fill a prescription for psychiatric medication or naltrexone or attend an intake appointment with an in-house mental health or substance use provider.