TALC

滑石

基本信息

批准号：
10685466
负责人：
Ellen Florence Eaton
金额：
$ 30.87万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
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/10685466
关键词：
Achievement Address Adult Alabama Alcohol consumption Alcohols Anxiety Apache Area Arizona Back Behavior Therapy COVID-19 pandemic Caring Clinic Clinical Clinical Research Cognitive Therapy Collaborations Communities Community Healthcare Complex Continuity of Patient Care Deep South Diagnostic Diagnostic Procedure Disease Progression Elements Eligibility Determination Enrollment Epidemic Funding Geographic Locations Goals Government HIV HIV Infections HIV disparities HIV/AIDS Health Personnel Health Services Human immunodeficiency virus test Incidence International Intervention Low income Measures Mental Depression Mental Health Mental disorders Modeling NIH Office of AIDS Research Opioid Outcome Outcome Measure Participant Patient Outcomes Assessments Patient Self-Report Patients Persons Population Poverty Prevalence Prevention Professional counselor Protocols documentation Provider Randomized Reporting Research Research Activity Resource-limited setting Rural Schedule Services Site Specialist Stimulant Substance Use Disorder Suicide prevention Symptoms Talc Telemedicine Testing Training Translating Transportation United States National Institutes of Health United States Public Health Service Viral Viral Load result Visit Washington Zambia alcohol comorbidity alcohol misuse alcohol testing alcohol use disorder arm behavioral health brief alcohol intervention brief intervention community clinic comorbidity cost cost effective cost effective treatment cost effectiveness depressive symptoms design disease transmission effectiveness evaluation effectiveness testing epidemic response evidence base experience health related quality of life implementation determinants implementation evaluation implementation study improved low and middle-income countries poor health outcome post-traumatic stress programs psychosocial randomized trial reduce symptoms routine care substance use telephone delivery tool transmission process underserved area

项目摘要

Project Abstract Alcohol use disorders, substance use disorders, and mental health comorbidities are a major threat to ending the HIV epidemic. This is especially the case in Alabama and other priority states within the U.S. ‘Ending the HIV Epidemic’ initiative. Addressing unhealthy alcohol use and mental health comorbidities in the Deep South is made difficult by poverty and lack of public health services. Because of the similar challenges in low-resource settings, interventions developed for low and middle-income countries (LMIC) hold promise for reducing unhealthy alcohol use in people living with HIV (PLWH) in Alabama and improving psychosocial comorbidities that disproportionately impact this population. Designed to address the limited mental health workforce in LMIC, Common Elements Treatment Approach (CETA) is a promising treatment for unhealthy alcohol use and mental health comorbidities in Alabama. CETA is a multi-session cognitive behavioral therapy-based intervention that employs transdiagnostic techniques to address comorbid alcohol use, other substance use, and mental health symptoms through a single provider. CETA has been proven effective in at least 7 LMICs, with specific support for reducing depressive symptoms and unhealthy alcohol misuse. The proposed study is a randomized trial, Telemedicine for unhealthy Alcohol use in persons Living with HIV using CETA (TALC study), to achieve the following aims: 1) Evaluate the effectiveness of T-CETA on unhealthy alcohol use among PLWH, 2) Evaluate the effectiveness of T-CETA on HIV outcomes, 3) Evaluate the effectiveness of T-CETA on SUD and mental health comorbidities, and 4) Evaluate implementation factors related to BI and T-CETA provision to people with HIV unhealthy alcohol use in care at community clinics in Alabama including feasibility, acceptability, cost and cost-effectiveness. PLWH (n = 308) from community-based HIV clinics in Alabama will be enrolled in the trial. Patients will be eligible if they self-report unhealthy alcohol use on a validated tool (AUDIT), which is assessed every 4-6 months as part of routine care. Participants will be randomized 1:1 to a brief alcohol intervention (BI) versus BI plus T-CETA (n = 154 per arm). This is one of two program projects aiming to test the effectiveness of CETA on unhealthy alcohol use, mental health comorbidities, and HIV outcomes among PLWH residing in underserved areas. If the project aims are achieved, it will significantly advance our understanding of strategies to reduce HIV disease progression and transmission in Alabama and advance the President’s Plan to End the HIV Epidemic. Following achievement of these aims, we plan to conduct a multi-site implementation study to address barriers identified in the implementation assessment (Aim 4) and translate study findings into routine community care in other priority states for reducing HIV across the Southern U.S.

项目摘要酒精使用障碍、物质使用障碍和心理健康合并症是结束生命的主要威胁艾滋病毒流行在阿拉巴马州和美国其他优先州尤其如此。 Epidemic 的倡议是解决南方腹地的不健康饮酒和心理健康合并症。由于资源匮乏方面的类似挑战，贫困和缺乏公共卫生服务造成了困难。为低收入和中等收入国家 (LMIC) 制定的干预措施有望减少阿拉巴马州艾滋病毒感染者 (PLWH) 的不健康饮酒和改善社会心理合并症旨在解决中低收入国家有限的心理健康劳动力问题。常见元素治疗方法 (CETA) 是治疗不健康饮酒和心理健康的一种有前途的治疗方法阿拉巴马州的健康合并症是一种基于多疗程认知行为治疗的干预措施。采用跨诊断技术来解决共病酒精使用、其他物质使用和心理健康问题在特定支持下，CETA 在至少 7 个中低收入国家中被证明是有效的。为了减少抑郁症状和不健康的滥用酒精，拟议的研究是一项随机试验，使用 CETA（TALC 研究）对 HIV 感染者的不健康饮酒情况进行远程医疗（TALC 研究），以实现以下目标：1) 评估 T-CETA 对 PLWH 中不健康饮酒的有效性，2) 评估 T-CETA 对 HIV 结果的有效性，3) 评估 T-CETA 对 SUD 和心理的有效性健康合并症，以及 4) 评估与向患有以下疾病的人提供 BI 和 T-CETA 相关的实施因素阿拉巴马州社区诊所护理中艾滋病毒不健康饮酒的情况，包括可行性、可接受性、成本和阿拉巴马州社区艾滋病毒诊所的 PLWH（n = 308）将参加该试验。如果患者使用经验证的工具 (AUDIT) 自我报告不健康的饮酒行为，则符合资格，该工具经过评估作为常规护理的一部分，每 4-6 个月将参与者按 1:1 的比例随机分配进行短暂的酒精干预 (BI)。与 BI 加 T-CETA（每组 n = 154）相比，这是旨在测试有效性的两个计划项目之一。关于居住在 PLWH 的不健康饮酒、心理健康合并症和艾滋病毒结果的 CETA 如果项目目标得以实现，将极大地增进我们对战略的理解。减少阿拉巴马州艾滋病毒疾病的进展和传播，并推进总统结束艾滋病毒的计划实现这些目标后，我们计划开展多地点实施研究，以实现艾滋病毒流行。解决评估实施中确定的问题（目标 4）并将研究障碍结果转化为日常工作在美国南部其他优先州减少艾滋病毒的社区护理