2014 — 2017 |
Hatch-Maillette, Mary Akiko Wells, Elizabeth A |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Maximizing the Patient-Counselor Relationship to Reduce Sexual Risk Behavior @ University of Washington
DESCRIPTION (provided by applicant): Achieving sexual risk reduction among people suffering from substance use disorders (SUDs) has proven challenging but not impossible. Substance abuse treatment presents an opportunity to intervene, and there is a need for continued development of sexual risk reduction interventions that can be integrated into treatment settings. Our research group developed the Being Safe in Treatment (BEST) sexual risk assessment and feedback tool with funds from an R21 grant Computerized assistance for treatment professionals in the assessment of sexual risk (Donald Calsyn, PI; DA022940). The BEST uses the audio computer-assisted self- interviewing (ACASI) method to determine sexual risk in substance abuse treatment patients. It provides a personalized feedback report for the patient and the patient's counselor that summarizes the assessment and offers suggestions for reducing sexual risk. The primary goal of the BEST tool is to assist patients in reducing sexual risk behavior or maintaining low risk behavior. The hypothesized change mechanism is enhanced communication between counselor and patient about sexual risk. We seek funding for next steps in testing this intervention. In the R21 BEST development studies, we obtained qualitative feedback about the BEST from potential consumers (substance abuse treatment patients and their counselors) and conducted a brief pilot study on the impact of using the BEST in a methadone maintenance clinic. From these studies we received and then incorporated suggestions on ways to improve the BEST, such as reducing the time needed to take the BEST and adjusting the feedback report to better incorporate the reduced risk associated with long term monogamy. In the pilot study, receiving a BEST feedback report was associated with increased counselor knowledge about patient sexual risk behavior and an increase in patient-counselor discussions about sexual issues. However, many counselors felt unprepared to discuss sexual issues with their patients, suggesting a need for counselor training and providing the impetus for the current proposal. We propose to conduct a 2 x 2 clinical trial in which half of study counselors are randomly assigned to 1) a control condition (a 2 hour training on utilizing a BEST feedback report or 2) the same 2 hour training plus an 8 hour workshop on discussing sexual issues followed by twice monthly coaching. Patients of participating counselors will complete the BEST assessment and will be randomly assigned to receive no feedback or the BEST feedback which includes a personalized report for them and a report to their counselor. Data collection will occur for patients at baseline, 3-months, and 6-months, and for counselors at baseline, post-workshop and 3-months. The primary outcome is the number of unprotected sexual occasions in the prior 3 months and number of counseling sessions in which sexual issues were addressed. Counselor level outcomes of interest include change in counselor sexual knowledge, self-efficacy for addressing sexual matters, and skills for addressing sexual issues in counseling sessions.
|
0.955 |
2018 — 2021 |
Donovan, Dennis [⬀] Hatch-Maillette, Mary Akiko |
UG1Activity Code Description: To support single project applications conducting clinical evaluation of various methods of therapy and/or prevention (in specific disease areas). Substantial federal programmatic staff involvement is intended to assist investigators during performance of the research activities, as defined in the terms and conditions of the award. NOTE: The UG1 is the single-component companion to the U10 which is used for multi-project applications only. |
Clinical Trials Network: Pacific Northwest Node @ University of Washington
PROJECT SUMMARY/ABSTRACT Changes in the healthcare delivery system have been brought about nationally by the Affordable Care Act and the Mental Health Parity and Addiction Equity Act and locally by a number of Washington State initiatives. As part of these changes substance use disorder (SUD) treatment is being expanded beyond specialty care and integrated into primary care and acute care medical settings where SUD prevalence rates are high. These initiatives have led to an increased focus on SUD screening, brief intervention, and referral to treatment (SBIRT) in these settings. These integrative initiatives are based on collaborative care and chronic disease management approaches. There is an increased need for future research to develop and test the effectiveness of SUD interventions implemented in healthcare settings and linked to specialty SUD treatment programs. This viewpoint also reflects the future direction of the NIDA National Drug Abuse Treatment Clinical Trials Network (CTN) as it expands its research focus beyond community-based specialty treatment programs (CTPs). In order to contribute to the CTN's expanded objectives and research priorities, the Pacific Northwest (PNW) Node proposes the following Specific Aims: (1) Increase the capacity of the PNW Node research team by adding investigators with demonstrated practical and research expertise in developing and coordinating primary care practice-based research networks and collaborative care models, integrating behavioral health and SUD treatment components into primary and acute care settings, and harmonizing and using electronic medical record systems across multiple health care systems; (2) Expand the scope, population, diversity, and focus of research and clinical practice settings affiliated with the PNW Node by adding to our current CTPs a number of large state-wide and regional practice-based primary care clinical and research networks and programs involved in integrated behavioral health collaborative care; (3) Design and conduct pragmatic, comparative effectiveness, registry, and other types of innovative studies, informed bidirectionally by SUD researchers and clinicians and primary and acute care providers, that evaluate SBIRT, integrated behavioral and pharmacological treatments, and components of collaborative care for tobacco, alcohol, illicit drugs, and misused prescription opioid medications; and (4) Through the CTN National Dissemination Library, the Northwest and the Central Rockies Addiction Technology Transfer Centers, and resources within the Alcohol and Drug Abuse Institute provide training to health care and SUD providers about SUDs, collaborative care and chronic disease management models, the integration process, and methods of effective linkage between primary care and specialty SUD CTPs. Such training also provides opportunities for dissemination research.
|
0.955 |