This study will examine the impact of using a multicomponent intervention (patient reported outcomes, training, and telemedicine) to assist with the management of Mental Health (MH) and Substance Use Disorders (SUD) among people living with HIV (PLWH) engaged in care at UAB HIV Clinic, University of Alabama Family Clinic (Birmingham, AL), Thrive Federally Qualified Health Services Center (Huntsville), Health Services Center (Anniston), and Medical Advocacy and Outreach (Montgomery). The study will employ a hybrid type 2 implementation design. Because this intervention will be employed as the new standard of care at participating sites, all PLWH receiving care at the sites will receive this intervention. Patient-reported outcomes (PROs) will be integrated into routine care to screen PLWH for substance use and mental health disorders during routine clinical encounters. Training will be delivered to frontline clinicians so that they receive targeted knowledge on best practices for treatment of MH and SUD along with clinic-specific protocols for response to PROs on MH and SUD including treatment and referrals. Telemedicine services for MH and SUD will be offered to patients in need of expanded access to services due to a lack of clinic-level resources or additional barriers to traditional clinic visits such transportation, stigma, or substance using behaviors.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SCREENING
Masking
NONE
All patients receiving care at five RWHAP-funded clinics will receive the intervention (+STEP), in which patient-reported outcomes (PROs) on mental health and substance use disorder (SUD) will be integrated into routine care, targeted training will be provided for frontline clinicians on best practices for mental health and SUD treatment, and telemedicine for mental health and SUD will be offered to patients in need of expanded access to services.
Health Services Center
Anniston, Alabama, United States
University of Alabama Family Clinic
Birmingham, Alabama, United States
Thrive Federally Qualified Health Services Center
Huntsville, Alabama, United States
Medical Advocacy and Outreach (MAO)
Montgomery, Alabama, United States
Unity Wellness Center
Opelika, Alabama, United States
Percentage of patients completing PROs
We will quantify the percentage of patients completing a PRO related to mental health or substance use
Time frame: Baseline through Year 1
Percentage of patients completing PROs
We will quantify the percentage of patients completing a PRO related to mental health or substance use
Time frame: Year 1 through Year 2
Percentage of patients completing PROs
We will quantify the percentage of patients completing a PRO related to mental health or substance use
Time frame: Year 2 through Year 3
Percentage of patients completing PROs
We will quantify the percentage of patients completing a PRO related to mental health or substance use
Time frame: Year 3 through Year 4
Percentage of patients completing PROs
We will quantify the percentage of patients completing a PRO related to mental health or substance use
Time frame: Year 4 through Year 5
Percentage of staff participating in training
We will use attendance logs to determine how many staff at each site complete training
Time frame: Baseline through Year 1
Percentage of staff participating in training
We will use attendance logs to determine how many staff at each site complete training
Time frame: Year 1 through Year 2
Percentage of staff participating in training
We will use attendance logs to determine how many staff at each site complete training
Time frame: Year 2 through Year 3
Percentage of staff participating in training
We will use attendance logs to determine how many staff at each site complete training
Time frame: Year 3 through Year 4
Percentage of staff participating in training
We will use attendance logs to determine how many staff at each site complete training
Time frame: Year 4 through Year 5
Percentage of patients receiving a referral to a mental health or substance use service
We will use EMR and scheduling data to determine the number of referrals generated
Time frame: Baseline through Year 1
Percentage of patients receiving a referral to a mental health or substance use service
We will use EMR and scheduling data to determine the number of referrals generated
Time frame: Year 1 through Year 2
Percentage of patients receiving a referral to a mental health or substance use service
We will use EMR and scheduling data to determine the number of referrals generated
Time frame: Year 2 through Year 3
Percentage of patients receiving a referral to a mental health or substance use service
We will use EMR and scheduling data to determine the number of referrals generated
Time frame: Year 3 through Year 4
Percentage of patients receiving a referral to a mental health or substance use service
We will use EMR and scheduling data to determine the number of referrals generated
Time frame: Year 4 through Year 5
Percentage of patients receiving mental health or substance use service based on attendance
We will use EMR and scheduling data to determine the number of visits attended
Time frame: Baseline through Year 1
Percentage of patients receiving mental health or substance use service based on attendance
We will use EMR and scheduling data to determine the number of visits attended
Time frame: Year 1 through Year 2
Percentage of patients receiving mental health or substance use service based on attendance
We will use EMR and scheduling data to determine the number of visits attended
Time frame: Year 2 through Year 3
Percentage of patients receiving mental health or substance use service based on attendance
We will use EMR and scheduling data to determine the number of visits attended
Time frame: Year 3 through Year 4
Percentage of patients receiving mental health or substance use service based on attendance
We will use EMR and scheduling data to determine the number of visits attended
Time frame: Year 4 through Year 5
Percentage engaged in HIV care
We will determine the number of participants engage in HIV care
Time frame: Baseline through Year 1
Percentage engaged in HIV care
We will determine the number of participants engage in HIV care
Time frame: Year 1 through Year 2
Percentage engaged in HIV care
We will determine the number of participants engage in HIV care
Time frame: Year 2 through Year 3
Percentage engaged in HIV care
We will determine the number of participants engage in HIV care
Time frame: Year 3 through Year 4
Percentage engaged in HIV care
We will determine the number of participants engage in HIV care
Time frame: Year 4 through Year 5
Percentage receiving antiretroviral therapy for HIV
We will determine the number of participants receiving HIV treatment
Time frame: Baseline through Year 1
Percentage receiving antiretroviral therapy for HIV
We will determine the number of participants receiving HIV treatment
Time frame: Year 1 through Year 2
Percentage receiving antiretroviral therapy for HIV
We will determine the number of participants receiving HIV treatment
Time frame: Year 2 through Year 3
Percentage receiving antiretroviral therapy for HIV
We will determine the number of participants receiving HIV treatment
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Time frame: Year 3 through Year 4
Percentage receiving antiretroviral therapy for HIV
We will determine the number of participants receiving HIV treatment
Time frame: Year 4 through Year 5
Number of Patients Achieving a Viral Load Suppression
We will determine the number of participants who have achieved Viral Load suppression, s defined by a Viral load of \<20 copies per milliliter
Time frame: Baseline through Year 1
Number of Patients Achieving a Viral Load Suppression
We will determine the number of participants who have achieved Viral Load suppression, s defined by a Viral load of \<20 copies per milliliter
Time frame: Year 1 through Year 2
Number of Patients Achieving a Viral Load Suppression
We will determine the number of participants who have achieved Viral Load suppression, s defined by a Viral load of \<20 copies per milliliter
Time frame: Year 2 through Year 3
Number of Patients Achieving a Viral Load Suppression
We will determine the number of participants who have achieved Viral Load suppression, s defined by a Viral load of \<20 copies per milliliter
Time frame: Year 3 through Year 4
Number of Patients Achieving a Viral Load Suppression
We will determine the number of participants who have achieved Viral Load suppression, s defined by a Viral load of \<20 copies per milliliter
Time frame: Year 4 through Year 5