Community-Based Intervention at Needle Exchange Sites

针交换场所的社区干预

• 批准号: 6767856
• 负责人: MICHAEL S KIDORF
• 金额: $ 65万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-04-01 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6767856
• 关键词: behavior therapy; behavioral /social science research tag; clinical research; community health services; drug abuse therapy; health care referral /consultation; health care service utilization; health services research tag; human subject; hypodermic needle; interview; intravenous drug abuse; longitudinal human study; motivation; self help; substance abuse related behavior; therapy compliance

DESCRIPTION (provided by applicant): Participation in needle exchange programs (NEPs) is associated with increased use of sterile syringes, reduction in high-risk drug injection behaviors, and lower incidence of HIV seroconversion. These settings can also operate as conduits to treatment centers dedicated to reducing drug use and risk of HIV and other infectious diseases. NEP participants have severe opioid dependence, yet many are ambivalent about entering treatment programs that emphasize reductions of drug use, and interest in treatment is hindered further by limited access to immediate treatment in many areas of the country. Our current NIDA grant (Community Based Intervention at Needle Exchange Sites) shows that a single motivational enhancement session increases the treatment seeking of needle exchangers. The proposed 5-year competing continuation study builds logically on our current work and on the research of others by integrating a number of proven interventions to promote the treatment enrollment of needle exchangers. An important new component of the intervention is a procedure for helping participants return to treatment following discharge. New needle exchange participants (n = 635) will be randomly assigned to one of three study conditions: 1) Motivated Referral Condition (MRC), 2) Motivated Referral Condition plus Incentives (MRC + Incentives), or 3) Standard Referral Condition (SRC). Participants assigned to MRC only condition will be referred to 8 motivational enhancement sessions to help encourage treatment interest, and to 16 treatment readiness groups to maintain motivation and provide information on finding treatment. Those referred to the MRC + Incentives condition will receive an identical referral procedure, and will be offered incentives for complying with each aspect of the referral process, and for entering treatment. SRC participants will receive updated lists of treatment programs admitting patients. All participants who leave treatment will be referred back to the BNEP. MRC and MRC + Incentives participants will be referred from the BNEP back to the treatment readiness group, while MRC + Incentives participants will also receive incentives for attending the group and re-entering treatment. SRC participants will not receive access to the treatment readiness group, nor will they receive incentives for treatment re-entry. All participants will be followed monthly for 16 months. The primary dependent measures are rates of drug abuse treatment enrollment and re-entry, speed of enrollment and re-entry, total days in treatment, use of community resources (including the BNEP), and self-reported rates of drug use and risky behavior. This study will continue our work by expanding and strengthening the impressive public health and therapeutic benefits already achieved by many needle exchange programs.

描述（由申请人提供）：参与针头交换计划（NEP）与无菌注射器的使用增加，高危药物注射行为的减少以及HIV血清转化的发病率降低有关。这些环境也可以作为用于减少毒品使用和艾滋病毒和其他传染病风险的治疗中心的管道。 NEP参与者具有严重的阿片类药物依赖性，但是许多人对加入强调毒品使用的治疗计划的态度矛盾，并且在该国许多地区接受立即治疗的机会进一步阻碍了对治疗的兴趣。我们目前的NIDA赠款（针头交换站点的基于社区的干预）表明，一次动机增强会议增加了寻求针头交换器的治疗。拟议的5年竞争持续研究以逻辑上的逻辑为基础，并通过整合了许多经过验证的干预措施来促进针头交换器的治疗入学，从而建立在我们当前的工作和他人的研究基础上。干预措施的一个重要新组成部分是帮助参与者出院后返回治疗的过程。新的针交换参与者（n = 635）将被随机分配到三个研究条件之一：1）动机转诊条件（MRC），2）动机转诊条件加激励措施（MRC +激励措施）或3）标准推荐条件（SRC）。分配给MRC的参与者只会转介到8个动机增强课程，以帮助鼓励治疗兴趣，并将16个治疗准备人群保持动力并提供有关寻找治疗的信息。那些提到MRC +激励措施条件的人将获得相同的推荐程序，并将获得遵守推荐过程的各个方面并进入治疗的激励措施。 SRC参与者将收到录取患者的治疗计划的最新清单。所有离开治疗的参与者都将转回BNEP。 MRC和MRC +激励措施将从BNEP转介给治疗准备小组，而MRC +激励措施参与者还将获得参加该组和重新进入治疗的激励措施。 SRC参与者将无法获得治疗准备人群的访问权，也不会获得治疗重新进入的激励措施。所有参与者将每月遵循16个月。主要的依赖措施是药物滥用治疗的入学率和重新入学率，入学速度和重新进入的速度，治疗的总天数，社区资源的使用（包括BNEP）以及自我报告的药物使用率和风险行为。这项研究将通过扩大和增强许多针交易计划已经获得的令人印象深刻的公共卫生和治疗益处来继续我们的工作。