Actively Recruiting
Practice Facilitation as a Strategy to Improve Alcohol Treatment Adoption and Implementation in HIV Care
Led by Johns Hopkins University · Updated on 2025-07-20
300
Participants Needed
3
Research Sites
189 weeks
Total Duration
On this page
Sponsors
J
Johns Hopkins University
Lead Sponsor
N
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Collaborating Sponsor
AI-Summary
What this Trial Is About
Despite availability of evidence-based alcohol reduction interventions (EBI), unhealthy alcohol use remains a barrier to HIV medication adherence, viral suppression and retention in HIV care and consequently HIV treatment as prevention (TASP). Guided by complementary implementation and evaluation frameworks-the Consolidated Framework for Implementation Research (CFIR) and RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance), The investigators will conduct a Hybrid Type 3 effectiveness-implementation evaluating implementation trial testing whether practice facilitation, an evidence-based multifaceted implementation strategy increases reach, adoption, implementation, and maintenance of stepped care for unhealthy alcohol use in three Center for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) HIV clinics located in Boston, San Diego, and Chapel Hill. The investigators will secondarily test whether practice facilitation is associated with decreased unhealthy alcohol use, and improved Antiretroviral Therapy (ART) adherence and viral suppression at the patient level. In practice facilitation, a practice coach will offer tools, resources, hands-on guidance, and content expertise to assist sites in offering a stepped care model of alcohol treatment to patients with unhealthy alcohol use. Stepped care will include brief intervention, cognitive behavioral therapy, and alcohol pharmacotherapy. The practice facilitation intervention will be rolled out sequentially across sites. There will be three phases at each site: pre-implementation planning, implementation with formative evaluation, and post-implementation summative evaluation. Using mixed methods, The investigators specifically propose to meet the following specific aims: (Aim 1) Tailor the practice facilitation intervention to each site using mixed methods (pre-implementation); (Aim 2a) Determine the effects of practice facilitation on implementation of stepped care (primary) and alcohol use and HIV-related outcomes (secondary) using interrupted time series analysis with synthetic controls (summative evaluation); (Aim 2b) Determine the effect of practice facilitation on reach, adoption, and maintenance of evidence-based alcohol treatment using mixed methods (formative evaluation); and (Aim 3) Describe barriers and facilitators to implementation of alcohol-related interventions at each site to describe maintenance and inform widespread sustainable implementation.
CONDITIONS
Official Title
Practice Facilitation as a Strategy to Improve Alcohol Treatment Adoption and Implementation in HIV Care
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Clinic staff aged over 18 years
- Clinic staff in clinical or administrative roles
- Clinic staff who speak English
- Clinic staff cognitively able to complete surveys or interviews
- People with HIV receiving care at one of the three clinic sites
- People with HIV scoring AUDIT-C 3 or higher for women, or 4 or higher for men or transgender individuals indicating unhealthy alcohol use
- People with HIV aged 18 years or older
- People with HIV who speak English
- People with HIV cognitively able to participate in stepped care for unhealthy alcohol use
You will not qualify if you...
- Clinic staff unable to speak English
- People with HIV scoring AUDIT-C less than 3 for women, or less than 4 for men or transgender individuals
- People with HIV younger than 18 years old
- People with HIV cognitively unable to participate in stepped care for unhealthy alcohol use
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Trial Site Locations
Total: 3 locations
1
University of California, San Diego
San Diego, California, United States, 92103
Actively Recruiting
2
Fenway Community Health
Boston, Massachusetts, United States, 02114
Not Yet Recruiting
3
University of North Carolina
Chapel Hill, North Carolina, United States, 27599-7215
Not Yet Recruiting
Research Team
J
JoAnna Mathena
CONTACT
G
Geetanjali Chander
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SINGLE_GROUP
Primary Purpose
TREATMENT
Number of Arms
1
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