The goal of this Mentored Patient-Oriented Research Career Development Award (K23) is to support Dr. Nicole Ennis Whitehead, a Clinical Psychologist, in developing the critical skills necessary to become an independent researcher in the implementation of substance use interventions in real world settings. She seeks to acquire skills in: 4 areas: substance use intervention science, implementation science, mixed methods, and research conduct Both the National Institute on Drug Abuse (NIDA) and the Office of AIDS Research (OAR) have prioritized research that promotes the uptake of evidence based interventions into real-world settings. Extant literature indicates that 20-50% of those aging with HIV misuse alcohol, illicit drugs or prescription medications. Interventions that reach this population are needed. To date many effective interventions do not translate into meaningful outcomes that improve patient care. Substance use interventions in particular have lagged in moving from research laboratories to real-world settings (primary care clinics, community treatments centers, etc.). The Screening, Brief Intervention and Treatment (SBIRT) model has been effective in decreasing high risk behaviors such as tobacco, alcohol, and illicit drug use. However, recent data suggests that brief intervention models alone may not be effective with vulnerable populations. The evidence supporting SBIRT indicates that other models such as SBIRT with a peer navigator (SBIRT-PN) should be examined for this population. Therefore, the training goal for this K23 is to advance the candidate's skills in implementing SBIRT-PN in HIV primary care clinics for HIV+ adults 50 and older. Training aims include: (1) Describe and differentiate optimal methods of substance use intervention with vulnerable populations; (2) Obtain skills to implement substance use interventions in real-world settings; and (3) Acquire skills in advanced intervention modeling and mixed methods research and use these methods to evaluate substance use interventions. Execution of these research aims along with a comprehensive training program will be led by Dr. Robert Cook, Dr. Linda B. Cottler and Dr. Xinguang Chen with additional collaborators to address training specific needs. The research project will use the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to pilot and evaluate the SBIRT-PN using the Southern HIV and Alcohol Research Consortium (SHARC) HIV primary care clinic network.
Aim 1 : Pilot effectiveness of SBIRT-PN versus treatment as usual in HIV primary care clinics to improve substance-use treatment engagement and HIV appointment adherence among adults aged 50 and older.
Aim 2 : Describe the influence of demographic factors, depression and pain on substance-use treatment engagement outcomes.
Aim 3 : Examine and enhance feasibility (recruitment, dose, retention) of intervention uptake for a larger trial. The proposed research will provide the preliminary data needed to support an R01 testing the implementation of this intervention (SBIRT-PN) across a broad clinical network serving older HIV+ adults. Completion of this plan will prepare me for a career as an independent clinical investigator trained to implement substance use interventions in real world settings.

Public Health Relevance

The proposed research is relevant to public health because it addresses the fact that many effective interventions do not translate into meaningful outcomes that improve patient care. Due to this gap both the National Institute on Drug Abuse (NIDA) and the Office of AIDS Research (OAR) have prioritized research that advances our knowledge of how interventions can be effective in real-world settings. The proposed study will pilot and evaluate an evidence based substance use intervention in the primary care setting.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DA039769-03
Application #
9460487
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Flournoy Floyd, Minnjuan Wyncephel
Project Start
2016-04-15
Project End
2021-03-31
Budget Start
2018-04-01
Budget End
2019-03-31
Support Year
3
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of Florida
Department
Other Health Professions
Type
Schools of Public Health
DUNS #
969663814
City
Gainesville
State
FL
Country
United States
Zip Code
32611
Jones, Abenaa Acheampong; Gerke, Travis; Striley, Catherine W et al. (2018) One Step at a Time: A Latent Transitional Analysis on Changes in Substance Use, Exposure to Violence, and HIV/AIDS Risk Behaviors among Female Offenders. Am J Crim Justice 43:471-485
Cook, Christa L; Canidate, Shantrel; Ennis, Nicole et al. (2018) Types and delivery of emotional support to promote linkage and engagement in HIV care. Patient Prefer Adherence 12:45-52
Mannes, Zachary L; Hearn, Lauren E; Zhou, Zhi et al. (2018) The association between symptoms of generalized anxiety disorder and appointment adherence, overnight hospitalization, and emergency department/urgent care visits among adults living with HIV enrolled in care. J Behav Med :
Kelso-Chichetto, Natalie E; Plankey, Michael; Abraham, Alison G et al. (2018) Association between alcohol consumption trajectories and clinical profiles among women and men living with HIV. Am J Drug Alcohol Abuse 44:85-94
Mannes, Zachary L; Bryant, Vaughn E; Burrell 2nd, Larry E et al. (2018) The prevalence and patterns of substance use by birth cohort among HIV-positive adults in Florida. Aging Ment Health :1-9
Mannes, Zachary L; Burrell 2nd, Larry E; Ferguson, Erin G et al. (2018) The association of therapeutic versus recreational marijuana use and antiretroviral adherence among adults living with HIV in Florida. Patient Prefer Adherence 12:1363-1372
Whitehead, Nicole Ennis (2017) Commentary on Des Jarlais et al. (2017): Robust public health policies as a way forward in the HIV epidemic. Addiction 112:299-300
Coatsworth, Ashley M; Scheidell, Joy D; Wohl, David A et al. (2017) HIV-Related Sexual Risk among African American Men Preceding Incarceration: Associations with Support from Significant Others, Family, and Friends. J Urban Health 94:136-148
Mannes, Zachary L; Burrell 2nd, Larry E; Dunne, Eugene M et al. (2017) Contextualizing Psychosocial Determinants of Alcohol Use by Age Cohorts of Adults Living With HIV, Ages 50 and Older. J Assoc Nurses AIDS Care 28:279-288
Cook, R L; Zhou, Z; Kelso-Chichetto, N E et al. (2017) Alcohol consumption patterns and HIV viral suppression among persons receiving HIV care in Florida: an observational study. Addict Sci Clin Pract 12:22

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