Community-engaged implementation strategies for acceptance interventions to improve access to care for people with HIV and injection drug use
Project Number5R03DA059341-02
Contact PI/Project LeaderLUNZE, KARSTEN
Awardee OrganizationBOSTON MEDICAL CENTER
Description
Abstract Text
PROJECT SUMMARY
Various barriers including stigma can limit access to HIV and substance use for people with HIV who
inject drugs. Acceptance and Commitment Treatment (ACT) empowers these people to cope with
stigma and other care barriers, leading to an increase in health services utilization. ACT is an
evidence-based intervention that uses acceptance, mindfulness, and behavior change processes to
improve psychological flexibility. In the SCRIPT randomized controlled trial, we showed that ACT
could increase antiretroviral therapy (ART) initiation and substance use care engagement for people
with HIV and active injection drug use. This study recruited participants at a community-based harm
reduction site and trained psychologists delivered the intervention at a community clinic, but
community-engaged implementation strategies have not yet been studied. Implementation strategies
for evidence-based care access interventions for people with HIV and injection drug use are rare.
This project will narrow this gap, assessing appropriate implementation outcomes and their relations
with trial outcomes. We will also explore implementation strategies, to be tested in future hybrid
effectiveness-implementation trials of ACT. Using the existing mixed-methods data from the SCRIPT
trial, this R03 proposes to assess implementation outcomes and identify implementation strategies
(including intervention adaptation, training, fidelity monitoring). The results from this project will aid in
access to health services for the stigmatized population of people with HIV who inject drugs and
provide the groundwork for future trials testing acceptance-based approaches to improve care access
for people with HIV, substance use and potentially other stigmatized conditions.
Public Health Relevance Statement
PROJECT NARRATIVE
We could recently show that an acceptance-based stigma intervention is effective in connecting people with
HIV who inject drugs to care, but strategies how to best engage communities of affected people to implement it
are unknown. This project uses an existing rich implementation dataset to narrow this gap by informing
methods of linking people with HIV who inject drugs to care, specifically by studying implementation strategies
for stigma interventions targeting this population. Results will help design subsequent effectiveness-
implementation trials engaging community partners to assess how to best make stigma interventions work for
people with HIV who inject drugs.
NIH Spending Category
No NIH Spending Category available.
Project Terms
AddressAdoptionAffectCaringChoice BehaviorCommunitiesDataData SetDimensionsDoseEpidemicEvidence based interventionFundingFutureGoalsHIVHarm ReductionHealth ServicesHealth Services AccessibilityHybridsImprove AccessInterventionInterviewLinkLived experienceMethodsModalityModelingMonitorNational Institute of Drug AbuseOutcomeOverdoseParticipantPatient RecruitmentsPerceptionPersonsPharmaceutical PreparationsPopulationProcessProctor frameworkProtocols documentationPsychologistPublishingQuality ControlQuality of CareRandomized, Controlled TrialsRecommendationSiteStigmatizationStructureSubstance Use DisorderSupervisionSurveysTarget PopulationsTechniquesTestingTrainingWorkadherence rateantiretroviral therapybehavior changeclinical implementationcommunity cliniccommunity engaged interventioncommunity engagementcommunity involvementcommunity partnerscopingdesigneffectiveness/implementation trialemotion regulationempowermentevidence baseflexibilityhealth care deliveryhealth care qualityhealth service useimplementation evaluationimplementation outcomesimplementation researchimplementation strategyimprovedinjection drug useinterestintervention participantsmeetingsmindfulnesspsychologicsatisfactionservice gapsocial stigmasubstance usetherapy designtreatment grouptreatment program
No Sub Projects information available for 5R03DA059341-02
Publications
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Patents
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Outcomes
The Project Outcomes shown here are displayed verbatim as submitted by the Principal Investigator (PI) for this award. Any opinions, findings, and conclusions or recommendations expressed are those of the PI and do not necessarily reflect the views of the National Institutes of Health. NIH has not endorsed the content below.
No Outcomes available for 5R03DA059341-02
Clinical Studies
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History
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