Feasibility of SBIRT-PN

Florida State University

Status: Completed

Conditions: Substance Use; Older Adults; Infectious Disease; Behavioral Intervention; HIV/AIDS

Treatments: Behavioral: Psycho-educational content (5 Minutes); Behavioral: Readiness Assessment (10 minutes); Behavioral: Explanation of Peer Navigator and Session wrap (5 minutes); Behavioral: Identifying and prioritizing needs (5 minutes); Behavioral: Goal-Setting (5 minutes)

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03057119

IRB201701252 - N

OCR25582 (Other Identifier)

1K23DA039769-01 (U.S. NIH Grant/Contract)

KL2TR001429 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

Substance misuse is a common problem among HIV+ individuals. Research suggests that a Screening, Brief Intervention, and Treatment (SBIRT) model can be effective in reducing substance misuse in the general older adult population; however these findings have not been verified in the more vulnerable HIV+ older adult population. The present study seeks to address the problem of substance misuse in older HIV+ adults by piloting a SBIRT model for older HIV+ adults in a in a primary care setting. Individual reductions in alcohol and drug use can have significant effects on public health and safety when observed over a large population at risk for substance use problems. With wider dissemination statewide, a relatively low-cost intervention such as SBIRT could offer demonstrated benefits in this population.

Full description

The current project will pilot SBIRT with a peer navigator (SBIRT-PN) versus treatment at usual (TAU) to increase substance use treatment engagement among HIV-positive adults aged 50 years and older. The investigators will recruit patients from the Southern HIV and Alcohol Research Consortium (SHARC) HIV primary care clinic network.

In order to develop effective substance use intervention models for HIV care settings the specific aims of the current project are:

Aim1: Examine the feasibility of the SBIRT-PN model at the UF Health Infectious Disease-Medical Specialties Clinic. The investigators hypothesize that the SBIRT-PN model will demonstrate high feasibility within the UF Health Infectious Disease - Medical Specialties Clinic.

Aim2a: Assess the acceptability of SBIRT-PN. The investigators hypothesize that SBIRT-PN will demonstrate high acceptability among patients enrolled in this condition.

Aim2b: Assess the acceptability of SBIRT-PN among HIV-positive individuals by age cohort (younger vs older). The investigators hypothesize that SBIRT-PN will demonstrate higher acceptability among older HIV-positive patients enrolled in this condition.

Aim3: Assess influence of SBIRT-PN model on treatment engagement and substance use compared to enhanced treatment as usual (TAU).The investigators hypothesize that those in the SBIRT-PN condition will evidence greater treatment engagement and a reduction in substance use.

Enrollment: 86 patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Receiving care at an Infectious disease Medical Clinic
• HIV-positive (seropositive confirmed by medical records)
• have a substance misuse screening score indicating moderate or high risk.

Exclusion criteria

• lack fluency in English
• are unwilling to provide information for follow-up
• plan to leave the area within 6 months
• already have a referral to treatment from another provider
• unable to provide informed consent due to cognitive impairment.

Trial design

Primary purpose: Screening

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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86 participants in 2 patient groups

SBIRT Intervention

Experimental group

Description:

The interventionist will discuss substance use and misuse, HIV, and the interaction of aging and substance use; will give the patient feedback on their NM-ASSIST score and assess the patient's readiness to change based on Prochaska's stages of change; motivational interviewing techniques to identify the patients' most salient reasons for addressing substance use issues. Identifying and prioritizing need; problem-solving techniques to help patients identify which services may best help them work towards their goals; will use a referral resource guide to provide the contact information of agency representatives and help the patient formulate a plan for follow-up.

Treatment:

Behavioral: Goal-Setting (5 minutes)

Behavioral: Psycho-educational content (5 Minutes)

Behavioral: Readiness Assessment (10 minutes)

Behavioral: Explanation of Peer Navigator and Session wrap (5 minutes)

Behavioral: Identifying and prioritizing needs (5 minutes)

Treatment as Usual

No Intervention group

Description:

Participants in the enhanced care treatment as usual group will receive the same illustrated handout depicting their substance use screening score and the same referral resource guide provided to those in the control group. These will be provided with only a quick introduction by the research assistant to minimize intervention elements in the control condition and to resemble the notification and referral strategy that would be standard care.