- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05733442
Counseling for Harm Reduction and Retention in Medication-assisted Treatment - Cherokee Nation (CHaRRM-CN)
The goal of this randomized clinical trial is to test the efficacy of a program meant to enhance Counseling for Harm Reduction and Retention in MAT in Cherokee Nation (CHaRRM-CN). The main questions it aims to answer are whether CHaRRM-CN: improves retention of patients in MAT, decreases substance-related harm and illicit opioid use, and increases cultural connectedness.
After providing written, informed consent, participants will attend a baseline assessement and will then be randomized to either the CHaRRM-CN or treatment as usual group. For 6 months after randomization, participants will be exposed to CHaRRM-CN or treatment as usual. During that time, participants will also attend the 1-month, 3-month and 6-month follow-ups to track their progress through the programs.
After the 6 months of either treatment condition, investigators will compare the groups to see if they differ on retention, substance-use outcomes and Native enculturation.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Lonnie A Nelson, PhD
- Phone Number: 5734240888
- Email: lonnie.nelson@wsu.edu
Study Contact Backup
- Name: Susan E Collins, PhD
- Phone Number: 2068327885
- Email: collinss@uw.edu
Study Locations
-
-
Oklahoma
-
Tahlequah, Oklahoma, United States, 74464
- Recruiting
- Cherokee Nation Health Services
-
Contact:
- Terrence K Kominsky, PhD
- Phone Number: (918) 207-4984
- Email: terrence-kominsky@cherokee.org
-
Sub-Investigator:
- Terrence Kominsky, PhD
-
Contact:
- Ashley Lincoln, MSW
- Phone Number: 539-234-3519
- Email: ashley-lincoln@cherokee.org
-
Principal Investigator:
- Ashley Lincoln, MSW
-
-
Washington
-
Seattle, Washington, United States, 98195
- Active, not recruiting
- University of Washington School of Medicine
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- At least 18 years of age
- Must be newly registered (within 4 weeks) in the CNHS MAT Program. (Prior patients can participate as long as their most recent treatment course was at least 6 months prior).
- Must be willing to provide written informed consent to enroll in this study
Exclusion Criteria:
- Refusal or inability to consent to participation in research. (The latter is assessed using the UCSD Brief Assessment of Capacity to Consent.)
- Refusal or inability to consent and constituting a risk to the safety and security of other patients or staff
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Treatment as Usual (TAU)
The TAU condition will entail the current CNHS MAT program for OUD.
|
TAU entails medication to support patients' recovery (i.e., the partial opioid agonist, buprenorophine + naloxone/ Suboxone gel films), in-person case management and behavioral health intervention (i.e., in-person group and individual counseling), and referrals to other health care and behavioral health services.
|
Experimental: CHaRRM-CN
The CHaRRM-CN condition comprises changes and additions to TAU codesigned with a community advisory board and taking into account suggestions from MAT patients and community members impacted by OUD with the goal of improving MAT retention in culturally aligned and community-driven ways.
|
The CHaRRM-CN intervention includes changes and additions to TAU to make MAT more culturally aligned (i.e., offering regular community-based, cultural programming; offering culturally aligned healing groups in the MAT program, such as Talking Circles and beading group) as well as lower barrier and incentivized (i.e., offering medication and behavioral health appointments via in-person, videoconference or telephone; offering harm-reduction groups in addition to abstinence-based groups; providing mailed and in-person pick-up options for buprenorphine prescriptions; conducting weekly chart reviews to ensure prescriptions and basic needs are continuously met; bimonthly, automated text outreach; contingency management supporting attendance at in-person or telehealth appointments).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
MAT retention
Time Frame: Month 6
|
MAT program retention is defined by an active prescription for buprenorphine+naloxone with no gaps ≥ 30 days at month 6.
This measure will dichotomously indicate whether participants have been retained in the MAT program (1) or not (0) at month 6.
|
Month 6
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Substance-related harm
Time Frame: Baseline, month 1, month 3, month 6
|
The Short Inventory of Problems will be used to collect data on substance-related harm in the past month.
The range of possible scores on the single summary score is 0-45, and higher scores indicate a greater experience of substance-related harm.
Change will be measured across the 4 points listed in the time frame.
|
Baseline, month 1, month 3, month 6
|
Native enculturation
Time Frame: Baseline, month 1, month 3, month 6
|
The Cultural Connectedness Scale - Short Version is a 10-item Likert type measure consisting of 3 dimensions: identity, traditions, and spirituality.
Criterion validity was demonstrated with cultural connectedness dimensions adequately correlating with other indicators of wellness.
Greater scores indicate greater cultural connectedness.
Change will be measured across the 4 points listed in the time frame.
|
Baseline, month 1, month 3, month 6
|
Native self-reliance
Time Frame: Baseline, month 1, month 3, month 6
|
The Cherokee Self-Reliance Questionnaire includes 24, Likert-scale items that have been psychometrically validated in previous research.60,61
Consistent with the Cherokee self-reliance concept, the instrument comprises 3 factors: being responsible, disciplined, and confident.
The higher the scale scores the higher the Native self-reliance.
Change will be measured across the 4 points listed in the time frame.
|
Baseline, month 1, month 3, month 6
|
Illicit Opioid Use
Time Frame: Baseline, month 1, month 3, month 6
|
The Timeline Followback (TLFB) uses calendars for a retrospective evaluation of daily substance use.
Meta-analyses have indicated the TLFB is a psychometrically sound way to detect substance use, including opioid use, across various populations and study designs.
In the proposed study, the TLFB will be primarily used to assess use of illicit opioids.
Change will be measured across the 4 points listed in the time frame.
|
Baseline, month 1, month 3, month 6
|
ED visits
Time Frame: Baseline, month 6
|
CNHS ED administrative data to assess number of visits to the ED both 6-months pre- and post-study enrollment.
Change will be measured between the 2 points listed in the time frame.
|
Baseline, month 6
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Health-related quality of life (HR-QoL)
Time Frame: Baseline, month 1, month 3, month 6
|
The EuroQoL-5 Dimensional-5 Level (EQ-5D-5L) is a standardized 5-item, 5-point Likert-type measure of health-related QoL.
This widely used, easily administered and psychometrically sound measure comprises 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
Additionally, a single, 100-point vertical visual analogue scale serves as a quantitative measure of participants' self-reported overall health status.
The higher the scores, the higher the HR-QoL.
This is an exploratory measure.
Change will be measured across the 4 points listed in the time frame.
|
Baseline, month 1, month 3, month 6
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Lonnie A Nelson, PhD, Washington State University
- Principal Investigator: Susan E Collins, PhD, University of Washington
- Principal Investigator: Ashley Lincoln, MSW, Cherokee Nation Health Services
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CNIRB 337
- R33DA049376 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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