Technology Enhanced Substance Use and HIV Service Navigation for Justice-Involved Young Adults

技术增强了对参与正义的年轻人的药物使用和艾滋病毒服务导航

• 批准号: 10327137
• 负责人: Emily F Dauria
• 金额: $ 17.55万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10327137
• 关键词: AIDS prevention; Adherence; Adult; Awareness; Case Management; Characteristics; Communities; Community of Practice; Consolidated Framework for Implementation Research; Continuity of Patient Care; Criminal Justice; Development; Drug Compounding; Drug abuse; Effectiveness; Enhancement Technology; Feasibility Studies; Feedback; Focus Groups; Future; Goals; HIV; HIV Seropositivity; Health; Health Technology; Healthcare; Imprisonment; Improve Access; Individual; Intervention; Interview; Justice; Lead; Learning; Link; Mental Health; Modeling; Movement; Participant; Persons; Phase; Pilot Projects; Population; Prevention strategy; Prevention trial; Process; Provider; Publishing; Randomized Controlled Trials; Reporting; Research; Research Personnel; Risk; Risk Behaviors; San Francisco; Services; Substance Use Disorder; Supervision; System; Technology; Testing; Time; Translations; Underserved Population; United States; Woman; Work; acceptability and feasibility; aged; alcohol abuse prevention; behavioral health; behavioral health intervention; design; disorder prevention; effective intervention; efficacy testing; evidence base; feasibility testing; follow-up; health care availability; high risk; implementation process; improved; innovation; interest; intervention delivery; minority children; multidisciplinary; navigator intervention; pandemic coronavirus; parole; pilot trial; pre-exposure prophylaxis; prevention service; preventive intervention; primary outcome; probation; programs; racial and ethnic; racial and ethnic disparities; satisfaction; service intervention; standard of care; study population; substance use; substance use treatment; tool; treatment services; trial comparing; uptake; young adult

Project Summary/Abstract There is a strong scientific premise for the study of integrated substance use disorders (SUDs) and HIV- prevention interventions for criminal justice-involved (CJI) populations. SUDs lead to increased rates of justice involvement as well as increased risk for HIV-acquisition. Estimates of the proportion of the CJI-population with a SUD reach 72%, and ~150,000 persons with HIV pass through a correctional facility annually. Although pre- exposure prophylaxis (PrEP), is a proven effective intervention for HIV-prevention, its maximal impact depends on uptake, and adherence among those at high risk. To date, few published studies have examined PrEP uptake among CJI populations. Our ongoing work with CJI women (San Francisco, CA) has identified high rates of risk behaviors (including substance use), low levels of PrEP awareness, and high levels of interest in PrEP once learning of it. Participants reported a strong interest in participating in a navigator-led intervention to screen and link them to PrEP-related services; younger participants (i.e., those aged 18 to 29 years) were eager to incorporate electronic health (eHealth) into navigation services. Navigator models use a one-on-one relationship to promote the timely movement of an individual through a health care continuum by eliminating barriers and have successfully increased healthcare access for CJI HIV-positive adults and individuals with SUDs. eHealth approaches to SUD and HIV prevention also hold promise because they improve access to effective intervention services, particularly for younger people. As a multidisciplinary team with expertise in behavioral health (substance use and HIV prevention) among justice-involved populations, and eHealth supported and navigator- led healthcare access and engagement interventions, we propose to develop and test an eHealth enhanced, navigator-led substance use and HIV-prevention referral and linkage intervention for CJI-young adults. Study aims are to: 1) Adapt an existing evidence-based navigator model (The Navigation Project) to incorporate codeveloped eHealth technology, to refer and link CJI young adults (aged 18 to 29 years) to substance use treatment and HIV-prevention services; 2) Refine and test the adapted, eHealth enhanced, navigator-led substance use treatment and HIV prevention intervention for CJI-young adults for fidelity, satisfaction, and appropriateness; 3) Assess the feasibility, acceptability, and impact of the adapted eHealth enhanced, navigator program to refer and link CJI-young adults substance use treatment and HIV-prevention services. The proposed study has the potential to: 1) reduce HIV-acquisition and improve access to substance use treatment among a high-risk, underserved group of young adults in the US; 2) test the feasibility, acceptability, fidelity, effectiveness, appropriateness, and satisfaction of implementing an eHealth enhanced, navigator-led substance use and HIV- prevention intervention, and 3) create an intervention suitable for large-scale efficacy testing and translation to other criminal justice settings.

项目概要/摘要 综合物质使用障碍 (SUD) 和 HIV 的研究有强有力的科学前提 针对刑事司法相关人群（CJI）的预防干预措施。 SUD 提高了正义率 的参与以及感染艾滋病毒的风险增加。具有以下特征的 CJI 人群比例估计 SUD 达到 72%，每年约有 150,000 名艾滋病毒感染者进入惩教机构。虽然预 暴露预防（PrEP）是一种被证明有效的艾滋病毒预防干预措施，其最大影响取决于 关于高风险人群的吸收和坚持。迄今为止，很少有已发表的研究检查 PrEP 的吸收情况 在 CJI 人群中。我们与 CJI 女性（加利福尼亚州旧金山）的持续合作发现了高风险率 行为（包括物质使用）、PrEP 意识水平较低以及对 PrEP 的兴趣较高 学习它。参与者表示对参与导航员主导的干预措施表现出浓厚的兴趣，以筛选和 将它们与 PrEP 相关服务联系起来；年轻的参与者（即 18 至 29 岁）渴望 将电子医疗 (eHealth) 纳入导航服务。导航器模型使用一对一关系 通过消除障碍和促进个人通过医疗保健连续体及时流动 成功地增加了 CJI HIV 阳性成人和 SUD 患者的医疗保健机会。电子医疗 SUD 和 HIV 预防方法也有希望，因为它们可以改善获得有效干预的机会 服务，特别是针对年轻人的服务。作为一个在行为健康方面拥有专业知识的多学科团队 （药物使用和艾滋病毒预防）在涉及司法的人群中，以及电子卫生保健的支持和导航 主导医疗保健获取和参与干预措施，我们建议开发和测试增强的电子医疗， 针对 CJI 年轻人的导航员主导的药物使用和艾滋病毒预防转诊和联系干预。学习 目标是： 1) 调整现有的基于证据的导航器模型（导航项目）以纳入 共同开发电子健康技术，将 CJI 年轻人（18 至 29 岁）与药物滥用联系起来 治疗和艾滋病毒预防服务； 2) 完善和测试适应的、电子医疗增强的、导航员主导的 针对 CJI 年轻人的药物滥用治疗和艾滋病毒预防干预，以提高忠诚度、满意度和 适当性； 3) 评估适应性电子医疗增强导航器的可行性、可接受性和影响 转介和链接 CJI 年轻人药物滥用治疗和艾滋病毒预防服务的计划。拟议的 研究有潜力：1）减少艾滋病毒感染并改善艾滋病毒使用治疗的可及性 美国高风险、服务不足的年轻人群体； 2）测试可行性、可接受性、保真度、有效性， 实施电子卫生强化、导航员主导的药物使用和艾滋病毒防治的适当性和满意度 预防干预，3) 创建适合大规模功效测试和转化的干预措施 其他刑事司法环境。