Improving the Integration of Mental Health and Substance Use Treatment Into Ryan White-Funded Care Sites in Atlanta Using an Implementation Science Approach
试验速览
- 阶段
- 不适用
- 入组人数
- 333
- 试验地点
- 4
- 主要终点
- Provider-Level Outcome: Adoption of the YouRx Decision Prescribing Platform
研究概览
简要总结
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).
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •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
- •Pilot Trial
- •provide HIV care
- •be 18 years of age or older
- •be licensed to provide prescription medication
- •provide care at one of the two clinic study sites
排除标准
- •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
- •Not a provider at a study clinic site recently
- •Have been part of the formative activities
结局指标
主要结局
Provider-Level Outcome: Adoption of the YouRx Decision Prescribing Platform
时间窗: Weekly (12 weeks)
Provider use of the You℞ Decision prescribing platform
Provider-Level Outcome: Feasibility of the YouRx Decision Prescribing Platform
时间窗: 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
时间窗: 3 months follow-up
4-item measure to assess provider satisfaction with the You℞ Decision platform
Clinic Staff-Level Outcome: Observed Stigma Reduction
时间窗: 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
时间窗: 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
时间窗: 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
时间窗: 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
时间窗: 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
时间窗: 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
时间窗: 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.
次要结局
未报告次要终点