Addressing risk through Community Treatment for Infectious disease and Opioid use disorder Now (ACTION) among justice-involved populations

通过立即对参与司法的人群进行传染病和阿片类药物使用障碍社区治疗（行动）来解决风险

• 批准号: 10307439
• 负责人: KEVIN KNIGHT
• 金额: $ 8.83万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10307439
• 关键词: AIDS prevention; Address; Adherence; Appointment; Caring; Chlamydia; Communities; Community Services; Connecticut; County; Criminal Justice; Diagnosis; Disease Management; Effectiveness of Interventions; HIV; HIV Infections; HIV risk; Harm Reduction; Health Services Accessibility; Hepatitis B Virus; Hepatitis C virus; Hybrids; Incidence; Individual; Injecting drug user; Intervention; Jail; Justice; Length; Link; London; Measures; Medical; Mobile Health Units; Modeling; Navigation System; Outcome; Overdose; Participant; Patients; Pharmaceutical Preparations; Population; Prevention; Prisons; Provider; Randomized; Recording of previous events; Risk; Risk Behaviors; Service delivery model; Services; Sexually Transmitted Diseases; Syphilis; Testing; Texas; Time; Use Effectiveness; Viral; base; care outcomes; care systems; community based service; community reentry; compare effectiveness; cost; effectiveness-implementation RCT; evidence base; geographic risk; health care service utilization; implementation outcomes; improved; infectious disease treatment; injection drug use; member; opioid injection; opioid use; opioid use disorder; pre-exposure prophylaxis; prevent; prevention service; response; satisfaction; scale up; screening; secondary outcome; service delivery; service providers; stimulant use; treatment services

Project Abstract Improving HIV and Opioid Use Disorder (OUD) management and implementation for criminal justice (CJ)- involved individuals requires effective approaches to screening, linkage and adherence to integrated services across community agencies and service providers. Community reentry represents a critical opportunity to link individuals to HIV prevention and treatment and OUD service providers. In response to RFA DA-20-028, our proposed study called Addressing risk through Community Treatment for Infectious disease and Opioid use disorder Now (ACTION) among justice-involved populations, is a 5-year Hybrid Type 1 Effectiveness- Implementation RCT that compares two models [Patient Navigation (PN) or Mobile Health Unit (MHU) service delivery] of linking individuals recently released from prison and jail to the continuum of community-based HIV and OUD prevention and treatment service cascades of care. A total of 864 CJ-involved individuals who are being released to 2 CT communities (New London and Windham/Tolland Counties) & 2 TX communities (Dallas and Tarrant Counties) with pre-arrest histories of opioid/injection drug use and are living with or at-risk of HIV will be randomized to receive at post-release either: a) a PN system for care, wherein patient navigators will link study participants to community-based service providers during the 6-month post-release intervention period; those without HIV will be provided access to PrEP services, and those living with HIV will receive access to ART services, or b) services delivered via a MHU, wherein study participants will be linked to a MHU within their community where they will receive integrated PrEP/ART, MOUD, harm reduction services on the MHU during the 6 month post-release intervention period. There are 2 specific aims: Aim 1 (Intervention Effectiveness): To compare the effectiveness of the use of PN vs. MHU service delivery on participant length of time to taking initial post-release PrEP (prevention)/ART (treatment) medication within 6 months following release from custody. Secondary outcomes will examine the continuum of PrEP and HIV care outcomes, including (but not limited to) the following additional measures: HIV viral suppression for PLH, PrEP adherence, HIV risk behaviors; HCV measures such as HCV testing & linkage to treatment; sexually transmitted infection (STI) incidence (GC/ Chlamydia/ Syphilis and HBV); and primary medical care appointments. Importantly, we will also assess OUD and SUD-related measures: OUD/ SUD diagnoses, MOUD prescription receipt &retention, opioid & stimulant use, & overdose incidents. Aim 2 (Implementation): To evaluate PN and MHU feasibility, acceptability, and costs. Primary implementation outcomes include feasibility (health care utilization impact among released individuals, contributions of interagency workgroup members on outcomes); acceptability (participant satisfaction, perceived usefulness); sustainment (continued utilization), and costs required to implement and sustain the approaches as well as to scale-up in additional communities. Barriers to service access across the community provider spectrum will be assessed as well.

项目摘要 改善艾滋病毒和阿片类药物使用障碍（OUD）的管理和刑事司法实施（CJ） - 涉及个人需要有效的筛查，联系和遵守综合服务的方法 跨社区机构和服务提供商。社区重新进入是链接的关键机会 个人进行艾滋病毒预防和治疗以及OUD服务提供商。为了回应RFA DA-20-028，我们的 拟议的研究称，通过社区治疗的传染病和阿片类药物的使用来解决风险 现在，在涉及正义的人群中（行动）的疾病（行动）是5年的杂种1型有效性 - 实施RCT比较了两个模型[患者导航（PN）或移动健康部门（MHU）服务 链接的个人最近从监狱和监狱释放到基于社区的艾滋病毒的连续性 和OUD预防和治疗服务级联护理。共有864个CJ涉及的人 被释放到2个CT社区（新伦敦和温德姆/托兰县）和2个TX社区 （达拉斯和塔兰特县）具有阿片类药物/注射药物使用的预先逮捕历史 艾滋病毒的释放后将随机接收：a）PN护理系统，其中患者导航员 将在6个月的释放后干预期间将研究参与者与基于社区的服务提供商联系起来 时期;那些没有艾滋病毒的人将获得预备服务的访问权限，患有艾滋病毒的人会收到 访问艺术服务或b）通过MHU提供的服务，其中研究参与者将与MHU链接 在他们的社区中，他们将在他们的社区中获得综合的准备/艺术，穆德，减少伤害服务 MHU在释放后6个月内。有2个特定目的：目标1（干预 有效性）：比较PN使用PN与MHU服务交付在参与者长度上的有效性 在后6个月内服用初始释放后准备（预防）/ART（治疗）药物的时间 从监护权中释放。次要结果将检查PREP和HIV护理结果的连续性， 包括（但不限于）以下其他措施：PLH的HIV病毒抑制，准备 依从性，艾滋病毒风险行为； HCV措施，例如HCV测试和连接到治疗；性 传播感染（STI）发病率（GC/衣原体/梅毒和HBV）；和初级医疗 约会。重要的是，我们还将评估与SUD相关的措施：OUD/ SUD诊断， MOUD处方收据和保留，阿片类药物和兴奋剂的使用以及过量事件。 AIM 2（实施）： 评估PN和MHU的可行性，可接受性和成本。主要实施结果包括 可行性（释放个人的医疗保健利用影响，机构间工作组的贡献 成员的成员）；可接受性（参与者满意，感知的有用性）；维持（继续 利用）以及实施和维持这些方法所需的成本以及扩大额外的规模 社区。也将评估整个社区提供商范围内服务访问的障碍。