Zambia Alabama HIV Alcohol Comorbidities Program (ZAMBAMA)

赞比亚阿拉巴马州艾滋病毒酒精合并症计划 (ZAMBAMA)

• 批准号: 10303936
• 负责人: Karen L Cropsey
• 金额: $ 117.75万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-10 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10303936
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Adult; Africa South of the Sahara; Alabama; Alcohol consumption; Alcohols; Anxiety; Apache; Arizona; Back; Businesses; COVID-19 pandemic; Caring; Clinic; Clinical; Clinical effectiveness; Cognitive Therapy; Collaborations; Communities; Complex; Continuity of Patient Care; Data; Data Analyses; Data Collection; Data Element; Deep South; Disadvantaged; Educational Intervention; Elements; Enrollment; Epidemic; Evidence based intervention; Face; Funding; Gap Junctions; Gender; Geographic Locations; HIV; Health Personnel; Human Resources; Incidence; Infectious Diseases Research; Interpersonal Violence; Intervention; Knowledge; Mental Depression; Mental Health; Mental disorders; Methods; Modeling; Monitor; National Institute on Alcohol Abuse and Alcoholism; Outcome; Pain; Participant; Patients; Persons; Population Heterogeneity; Prevalence; Prevention; Professional counselor; Protocols documentation; Provider; Psychologist; Public Sector; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Research; Research Personnel; Research Project Grants; Resources; Rural Population; Southern Africa; Structure; Supervision; Telemedicine; Testing; Training; Translating; Treatment outcome; Underserved Population; United States; United States National Institutes of Health; Viral; Zambia; addiction; alcohol comorbidity; alcohol misuse; antiretroviral therapy; base; behavioral health; behavioral health intervention; brief alcohol intervention; brief intervention; common treatment; community clinic; comorbidity; compare effectiveness; contextual factors; cost; cost effective; data harmonization; design; effectiveness testing; implementation determinants; improved; low and middle-income countries; mortality; peer; population based; post-traumatic stress; post-traumatic symptoms; programs; reduce symptoms; response; screening; substance use; suicidal risk; synergism; therapy adherence; treatment as prevention; treatment effect; trial design

Project Summary/Abstract The overall aims of the Zambia Alabama HIV Alcohol Comorbidities Program (ZAMBAMA) are to (Aim 1) test the effectiveness of a transdiagnostic model, Common Elements Treatment Approach (CETA), to reduce unhealthy alcohol use and improve HIV clinical outcomes in under-resourced HIV clinics, (Aim 2) evaluate the mechanisms through which CETA impacts HIV outcomes, (Aim 3) investigate whether the treatment effect of CETA varies by clinical (e.g., presence of comorbidities), demographic (e.g., gender) and/or contextual factors (e.g., Zambia, Alabama), and (Aim 4) examine implementation factors, including cost, related to integrated delivery of alcohol reduction interventions to disadvantaged people with HIV and unhealthy alcohol use at front- line HIV clinics. The P01’s central theme is that, among people with HIV and unhealthy alcohol use, integrated screening and treatment of common behavioral and mental health comorbidities will lower unhealthy alcohol use and improve HIV treatment outcomes. ZAMBAMA will be implemented by a collaborative team that brings together groups of established and young investigators working to address scientific gaps at the nexus of HIV, substance use, and mental illness in priority geographical areas in the global HIV response: sub-Saharan Africa and the Southern U.S. Together, the team will implement two randomized controlled clinical trials in adults with HIV and unhealthy alcohol use to evaluate CETA’s effects on alcohol use, the HIV care continuum (antiretroviral therapy adherence, engagement and retention in HIV care, viral suppression), and common mental health and substance use comorbidities. Project 1 (CETA HIV Alcohol Reduction Trial in Zambia - CHARTZ) will be implemented at public sector primary HIV clinics in Zambia where existing HIV ‘peer educators’ (i.e., lay counselors) will be trained to provide an alcohol brief intervention (BI) and CETA to participants at in-person sessions. Project 2 (Telemedicine for Unhealthy Alcohol Use in Persons Living with HIV using CETA - TALC) will enroll participants receiving HIV care at community Ryan White HIV/AIDS program-funded clinics across Alabama that serve diverse and rural populations. Graduate-level providers (supervised by a licensed clinical psychologist) will provide the interventions (BI and CETA) remotely using telemedicine approaches that were rapidly expanded during the COVID-19 pandemic. Both research projects will also evaluate implementation factors, to enhance the impact of clinical effectiveness data, and both projects will be supported by 3 resource cores: a CETA core for clinical intervention training and oversight, a Methods and Analysis core to harmonize data elements across projects and create synergy in data analyses, and an Administrative core to manage business and regulatory requirements of the P01, monitor and manage overall progress, and promote bidirectional knowledge and idea exchange between Southern U.S.- and sub-Saharan Africa-focused investigators.

项目摘要/摘要 赞比亚阿拉巴马州HIV酒精合并症计划（Zambama）的总体目标是（AIM 1）测试 转诊模型，共同元素治疗方法（CETA）的有效性，以减少 不健康的饮酒并改善资源不足的艾滋病毒诊所的艾滋病毒临床结果，（AIM 2）评估 CETA影响艾滋病毒结局的机制，（目标3） 临床（例如合并症的存在），人口统计学（例如性别）和/或上下文因素的CETA品种 （例如赞比亚，阿拉巴马州）和（目标4）检查实施因素，包括成本，与综合有关 在前面向不利的艾滋病毒和不健康饮酒的患者提供饮酒干预措施 - 线艾滋病毒诊所。 P01的中心主题是，在艾滋病毒和不健康的酒精使用的人中 筛查和治疗常见的行为和心理健康合并症将降低不健康的酒精使用 并改善艾滋病毒治疗结果。 Zambama将由一个合作团队实施 一群成立的成群和年轻的研究人员，致力于解决艾滋病毒联系的科学差距， 全球艾滋病毒反应的优先地理区域中的药物使用和精神疾病：撒哈拉以南非洲 以及美国南部，团队将在成年人中实施两项随机对照临床试验 艾滋病毒和不健康的酒精使用，以评估CETA对酒精使用的影响，HIV Care Continuum（抗逆转录病毒） 治疗依从性，参与和保留艾滋病毒护理，病毒抑制）以及普通的心理健康和 物质使用合并症。项目1（赞比亚的CETA HIV减少饮酒试验 - Chartz）将为 在赞比亚的公共部门初级艾滋病毒诊所实施，现有的艾滋病毒“同伴教育者”（即 MANCELORS）将接受培训，以向亲自的参与者提供酒精简短干预（BI）和CETA 会议。项目2（使用CETA -TALC患有艾滋病毒的人不健康的饮酒远程医疗） 将在社区瑞安·怀特·艾滋病毒/艾滋病计划资助的诊所接受艾滋病毒护理的参与者 为潜水员和农村人口服务的阿拉巴马州。研究生级提供商（由持牌临床监督 心理学家）将使用远程医疗方法远程提供干预措施（BI和CETA） 在COVID-19-19大流行期间迅速扩张。这两个研究项目还将评估实施 因素，以增强临床有效性数据的影响，这两个项目都将得到3个资源的支持 核心：用于临床干预培训和监督的CETA核心，这是一种和谐的方法和分析核心 跨项目的数据元素，并在数据分析中创建协同作用，以及管理的管理核心 P01的业务和监管要求，监控和管理整体进度并促进 美国南部和以撒哈拉以南非洲为中心的双向知识和思想交流 调查人员。