Working With HIV Clinics to Adopt Addiction Treatments Using Implementation Facilitation

Summary

Tobacco, alcohol and opioid use disorders threaten the health of HIV-infected patients. What if evidence-based counseling and medication treatments for tobacco, alcohol and opioid use disorders (herein refered to as addiction treatments) were routinely provided in HIV clinics? Implementation Facilitation is an established strategy to increase the uptake of evidence-based treatments. Our goal is to evaluate the impact of Implementation Facilitation on the use of addiction treatments in four large HIV clinics.

The purpose of the WHAT-IF study is:

Aim 1. Among key stakeholders, to use quantitative and qualitative (mixed) methods to identify the site-specific evidence, context and facilitation-related barriers and facilitators to the integration of addiction treatments to help tailor an Implementation Facilitation for each clinic.

Aim 2. To evaluate the impact of Implementation Facilitation on:

2a: Organizational readiness to deliver addiction treatments 2b: Provider readiness to deliver addiction treatments 2c: Provision of addiction treatments 2d: Changes in organizational models of care used to deliver addiction treatments

Aim 3. To evaluate the impact of Implementation Facilitation on antiretroviral therapy receipt, HIV viral suppression, VACS Index, and retention in HIV care among patients eligible for addiction treatment.

Conditions

• Substance-related Disorders

Interventions

BEHAVIORAL

Implementation Facilitation

Implementation Facilitation is an evidence-based strategy tailored to the specific needs of the clinic, designed to increase uptake of evidence based treatments for tobacco, alcohol and opioid use disorders. Will include provider education and academic detailing. * External Facilitator: Outside content expert who assists site * Local Champion: Site stakeholder who promotes change * Provider Education and Academic Detailing: Provision of unbiased peer education * Stakeholder Engagement: Aligning goals of implementation and those impacted * Tailor Program to Site: Addressing site specific needs based on Aim 1 * Performance Monitoring and Feedback: Assess implementation of screening and treatment efforts and inform site of results * Formative Evaluation: Quant. and qual. determination of impact * Establish a Learning Collaborative: Shared learning opportunities tailored to stakeholders * Program Marketing: Increase attention to availability of on-site addiction treatment services

Sponsors & Collaborators

• National Institute on Drug Abuse (NIDA)

  collaborator NIH

• Yale University

  lead OTHER

Principal Investigators

• David Fiellin, MD · Yale University

• Jennifer Edelmen, MD · Yale University

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

CROSSOVER

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2016-09-30

Primary Completion

2021-09-30

Completion

2021-09-30

Countries

• United States

Study Locations