HIV + Service Delivery and Telemedicine Through Effective PROs

Not Applicable

Withdrawn

Brief Summary: This study will examine the impact of using a multicomponent intervention (patient reported outcomes, training, and telemedicine) to assist with the management of Mental Health (MH) and Substance Use Disorders (SUD) among people living with HIV (PLWH) engaged in care at UAB HIV Clinic, University of Alabama Family Clinic (Birmingham, AL), Thrive Federally Qualified Health Services Center (Huntsville), Health Services Center (Anniston), and Medical Advocacy and Outreach (Montgomery). The study will employ a hybrid type 2 implementation design. Because this intervention will be employed as the new standard of care at participating sites, all PLWH receiving care at the sites will receive this intervention. Patient-reported outcomes (PROs) will be integrated into routine care to screen PLWH for substance use and mental health disorders during routine clinical encounters. Training will be delivered to frontline clinicians so that they receive targeted knowledge on best practices for treatment of MH and SUD along with clinic-specific protocols for response to PROs on MH and SUD including treatment and referrals. Telemedicine services for MH and SUD will be offered to patients in need of expanded access to services due to a lack of clinic-level resources or additional barriers to traditional clinic visits such transportation, stigma, or substance using behaviors.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
+STEP Implementation	+STEP Implementation	All patients will receive +STEP as new standard of care at their clinic. This intervention will include staff training, PROs as part of routine care to screen for substance use and mental health disorders, and telemedicine for health care delivery.

Primary Outcome Measures

Name	Time	Method
Percentage of patients receiving a referral to a mental health or substance use service	Year 4 through Year 5	We will use EMR and scheduling data to determine the number of referrals generated
Percentage of patients completing PROs	Year 4 through Year 5	We will quantify the percentage of patients completing a PRO related to mental health or substance use
Percentage of staff participating in training	Year 4 through Year 5	We will use attendance logs to determine how many staff at each site complete training
Percentage of patients receiving mental health or substance use service based on attendance	Year 4 through Year 5	We will use EMR and scheduling data to determine the number of visits attended

Secondary Outcome Measures

Name	Time	Method
Number of Patients Achieving a Viral Load Suppression	Year 4 through Year 5	We will determine the number of participants who have achieved Viral Load suppression, s defined by a Viral load of \<20 copies per milliliter
Percentage engaged in HIV care	Year 4 through Year 5	We will determine the number of participants engage in HIV care
Percentage receiving antiretroviral therapy for HIV	Year 4 through Year 5	We will determine the number of participants receiving HIV treatment

Locations (5): Health Services Center
🇺🇸
Anniston, Alabama, United States
University of Alabama Family Clinic
🇺🇸
Birmingham, Alabama, United States
Unity Wellness Center
🇺🇸
Opelika, Alabama, United States
Medical Advocacy and Outreach (MAO)
🇺🇸
Montgomery, Alabama, United States
Thrive Federally Qualified Health Services Center
🇺🇸
Huntsville, Alabama, United States