The Quit Using Drugs Intervention Trial (QUIT) will be the first randomized controlled trial in the U.S. that is powered to detect the effect of a primary care clinician delivered brief intervention protocol for reducing `at risk'drug use and drug-related harm among low-income adult patients (ages 18 and older) at 2 safety net clinics in Los Angeles County. For this small trial, we will sample patients with `at risk'use of stimulants (cocaine or amphetamines), the most commonly used serious drugs among patients at our clinic sites. """"""""At risk"""""""" stimulant use is defined in this study as current use (past 90 days) of stimulants measured as a self-reported total score of 4 to 26 on the WHO Alcohol Substance Involvement Screening Test (ASSIST). A total of 8,000 patients will be approached for screening to yield a 12-month effective sample size of 200 eligible patients per condition (1) an intervention condition or (2) a control condition involving care as usual. In the intervention condition, very brief (less than 5 minutes) clinician advice regarding quitting stimulants use will be followed by two 2 and 6 week post-visit drug health education sessions on quitting stimulant use and cautioning against use of other `at risk'substance use such as alcohol and tobacco. Patients assigned to the control condition will receive standard care for drug use at the baseline visit with their clinician, which will be followed by two post-visit telephone health education sessions that will be of equal duration as the intervention sessions but will address healthy eating, physical activity, and seat belt use. Follow- up assessments will be conducted at 6 and 12 months post-randomization. The framework for the QUIT project is the Social Action Theory, and the brief intervention protocol is based on NIDA's principles on prevention research and the utility of the 5 A's approach for assisting behavioral changes among patients (Ask, Advise, Assess, Assist, Arrange) in the clinic setting. If found to be effective in the community health center setting, this clinician and telephone stimulant-use health education program could become a model for health promotion activities. that would be expanded to all `at risk'substance use and shared between community health centers.

Public Health Relevance

The proposed study will address the critical need to reduce illegal drug use, in particular stimulant use, and the occurrence of drug-related harm in low-income racially diverse patient populations at urban primary care safety-net clinics. At risk for accelerated trajectories to drug dependence once drug use begins, low-income racially diverse populations pose particular concern for public health policy makers and drug-use prevention efforts. The study will be the first of its kind to standardize drug screening and physician brief intervention among racially diverse """"""""at risk"""""""" stimulant users, that is casual or frequent use without the physiological or psychological manifestations of dependence, and it may effectively interrupt their pathway to dependence.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
3R01DA022445-02S1
Application #
8082126
Study Section
Risk, Prevention and Intervention for Addictions Study Section (RPIA)
Program Officer
Lloyd, Jacqueline
Project Start
2008-09-01
Project End
2011-08-31
Budget Start
2010-06-07
Budget End
2010-08-31
Support Year
2
Fiscal Year
2010
Total Cost
$16,200
Indirect Cost
Name
University of California Los Angeles
Department
Family Medicine
Type
Schools of Medicine
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Bone, Curtis; Gelberg, Lilian; Vahidi, Mani et al. (2016) Under-reporting of Risky Drug Use Among Primary Care Patients in Federally Qualified Health Centers. J Addict Med 10:387-394
Richards, Christina M; Sharif, Faduma; Eischen, Sara et al. (2015) Retention of Homeless Smokers in the Power to Quit Study. Nicotine Tob Res 17:1104-11
Reddy, Anjani T; Andersen, Ronald M; Gelberg, Lillian (2015) Clinicians' Beliefs and Practices Regarding Drug Use Care of Their Community Health Center Patients. J Addict Med 9:447-53
Gelberg, Lillian; Andersen, Ronald M; Afifi, Abdelmonem A et al. (2015) Project QUIT (Quit Using Drugs Intervention Trial): a randomized controlled trial of a primary care-based multi-component brief intervention to reduce risky drug use. Addiction 110:1777-90
Gabrielian, Sonya; Yuan, Anita H; Andersen, Ronald M et al. (2014) VA health service utilization for homeless and low-income Veterans: a spotlight on the VA Supportive Housing (VASH) program in greater Los Angeles. Med Care 52:454-61
Padwa, Howard; Ni, Yu-Ming; Barth-Rogers, Yohanna et al. (2014) Barriers to drug use behavior change among primary care patients in urban United States community health centers. Subst Use Misuse 49:743-51
Baumeister, Sebastian E; Gelberg, Lillian; Leake, Barbara D et al. (2014) Effect of a primary care based brief intervention trial among risky drug users on health-related quality of life. Drug Alcohol Depend 142:254-61
Gabrielian, Sonya; Yuan, Anita; Andersen, Ronald M et al. (2013) Chronic disease management for recently homeless veterans: a clinical practice improvement program to apply home telehealth technology to a vulnerable population. Med Care 51:S44-51
Okuyemi, Kolawole S; Goldade, Kate; Whembolua, Guy-Lucien et al. (2013) Motivational interviewing to enhance nicotine patch treatment for smoking cessation among homeless smokers: a randomized controlled trial. Addiction 108:1136-44
Gabrielian, Sonya; Yuan, Anita; Rubenstein, Lisa et al. (2013) Serving homeless veterans in the VA Desert Pacific Healthcare Network: a needs assessment to inform quality improvement endeavors. J Health Care Poor Underserved 24:1344-52

Showing the most recent 10 out of 11 publications