STRIVES: Status-Neutral TeleHealth Concierge Intervention for Unhoused People Who Use Drugs Via Engagement Through Street Medicine
This study is testing a novel telehealth-based, status-neutral care model for integrating HIV prevention/treatment and substance use disorder services into street-based primary care for people experiencing homelessness who use drugs.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Tyler S Bartholomew, PhD
- Telefonnummer: 305-243-4625
- E-Mail: tsb61@miami.edu
Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
- Age 18 or older
- Able to speak English or Spanish
- Willing and able to sign informed consent, provide locator information, and complete medical records release
- Meets the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for current alcohol or substance use disorder
- Meets study-defined criteria for homelessness or housing instability by self-report
- Interested in initiating or continuing Antiretroviral therapy (ART) or pre-exposure prophylaxis (PrEP), as applicable based on HIV status
- Planning to stay in the area for 12 months
Exclusion Criteria:
- Investigator discretion
- Currently in prison or jail
- Does not meet DSM-5 criteria for current alcohol or substance use disorder
- Does not meet study-defined criteria for homelessness or housing instability by self-report
- Not interested in initiating or continuing ART or PrEP, as applicable based on HIV status
- Current enrollment in PROTECT or CHARIOT
- Planning to leave the area within 12 months
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
|
Aktiver Komparator: Standard of Care Group (Off-site clinic referral and patient navigation)
Participants in this arm receive standard patient navigation and referral services for healthcare and social support needs for one year. |
Participants receive standard patient navigation and referral services, including linkage to community healthcare and social services, transportation assistance, case management, wound care, and referrals for HIV care, pre-exposure prophylaxis (PrEP), substance use treatment, mental health services, and primary care |
|
Experimental: Status-Neutral Telehealth Concierge (SN-THR) Group
Participants in this arm receive the SN-THR intervention, a multidisciplinary street medicine and telehealth program providing integrated medical care, behavioral health services, care coordination, and social support for one year. |
SN-THR is a multidisciplinary street medicine and telehealth intervention that provides medical care, behavioral health services, peer support, care coordination, street-based laboratory services, and social services. Participants receive telehealth technology, motivational interviewing, medication support, and assistance addressing housing, food insecurity, and insurance barriers during the 12-month intervention period. |
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Antiretroviral Adherence for Treatment/Prevention
Zeitfenster: Baseline, 3, 6, 9, and 12 months
|
Proportion of participants adherent to Antiretroviral Therapy (ART) for HIV treatment/prevention. HIV treatment adherence (ART adherence) will be defined by HIV RNA level <200 copies/mL for PWH. PrEP adherence will be defined by any of the following: Dried Blood Spot (DBS) tenofovir diphosphate (TFV-DP) level of 700 fmol/punch for tenofovir disoproxil fumarate (TDF); DBS TFV-DP level of 950 fmol/punch for tenofovir alafenamide (TAF); or documentation of long-acting ART/PrEP (cabotegravir injection in the previous 8 weeks or lenacapavir injection in the previous 6 months) via EHR abstraction. |
Baseline, 3, 6, 9, and 12 months
|
Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Engagement in Substance Use Disorder (SUD) Treatment
Zeitfenster: Baseline, 3, 6, 9, and 12 months
|
Engagement in Substance Use Disorder (SUD) treatment will be assessed as the proportion of participants who engage in treatment services. Engagement will be defined by any of the following: Documentation in the electronic health record (EHR) of an evaluation for medications for opioid use disorder (MOUD) or prescription of psychotropic medications for other substance use disorders; Attendance at individual psychotherapy or group psychotherapy sessions documented in the EHR; or self-reported attendance at Narcotics Anonymous (NA) or Alcoholics Anonymous (AA) meetings. |
Baseline, 3, 6, 9, and 12 months
|
|
Receipt of Primary Care by U.S. Preventive Services Task Force (USPSTF) Recommended Services
Zeitfenster: Baseline, 3, 6, 9, and 12 months
|
Primary care preventive services will be assessed as the total number of applicable U.S. Preventive Services Task Force (USPSTF)-recommended preventive services received based on participant characteristics, as determined by electronic health record (EHR) abstraction. Preventive services may include, but are not limited to, cervical cancer screening, colorectal cancer screening, breast cancer screening, lung cancer screening, abdominal aortic aneurysm screening, hypertension screening, diabetes screening, and age- and risk-appropriate USPSTF-recommended vaccinations. |
Baseline, 3, 6, 9, and 12 months
|
|
Non-fatal overdose
Zeitfenster: Baseline, 3, 6, 9, and 12 months
|
Non-fatal overdose will be assessed as the number of self-reported count of non-fatal overdose experiences. |
Baseline, 3, 6, 9, and 12 months
|
|
Possession of Naloxone
Zeitfenster: Baseline, 3, 6, 9, and 12 months
|
Possession of Naloxone will be assessed as the proportion of participants having naloxone on person at the time of assessment. Documented naloxone possession via photo. |
Baseline, 3, 6, 9, and 12 months
|
|
Medications for Opioid Use Disorder (MOUD) Adherence
Zeitfenster: Baseline, 3, 6, 9, and 12 months
|
Medications for opioid use disorder (MOUD) adherence will be assessed as the proportion of participants using MOUD. Adherence is defined as detection of buprenorphine or methadone on point-of-care urine drug screening (UDS) or documentation of extended-release naltrexone or extended-release buprenorphine injection administration within the previous 4 weeks, as determined by electronic health record (EHR) abstraction. |
Baseline, 3, 6, 9, and 12 months
|
|
Hepatitis C virus (HCV) cure: Sustained Virologic Response
Zeitfenster: Baseline, 3, 6, 9, and 12 months
|
Hepatitis C virus (HCV) cure will be assessed as the proportion of participants with a positive hepatitis C virus ribonucleic acid (HCV RNA) result at baseline who receive direct-acting antiviral (DAA) therapy and achieve a negative hepatitis C virus ribonucleic acid polymerase chain reaction (HCV RNA PCR) result at least 4 weeks after treatment completion collected with blood samples. |
Baseline, 3, 6, 9, and 12 months
|
|
Treatment of Sexually Transmitted Infections (STIs)
Zeitfenster: Baseline, 3, 6, 9, and 12 months
|
Treatment of sexually transmitted infections (STIs) will be assessed as the number of STI infections that resolve during the 12- month follow-up period. Resolution is defined as a negative gonorrhea or chlamydia test following a prior positive test or a fourfold reduction in syphilis titers at least 6 months after a positive test. |
Baseline, 3, 6, 9, and 12 months
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Mitarbeiter
Mitarbeiter
Ermittler
Ermittler
- Hauptermittler: Tyler S Bartholomew, PhD, University of Miami
- Hauptermittler: Hansel E Tookes, MD, MPH, University of Miami
- Hauptermittler: Armen Henderson, MD, University of Miami
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Geschätzt)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
- Durch Blut übertragene Infektionen
- Psychische Störungen
- Infektionen
- RNA-Virusinfektionen
- Viruserkrankungen
- Erkrankungen des Verdauungssystems
- Leberkrankheiten
- Hepatitis, viral, menschlich
- Übertragbare Krankheiten
- Chemisch induzierte Störungen
- Flaviviridae-Infektionen
- Hepatitis
- Substanzbezogene Störungen
- Hepatitis C
- Verwaltung des Gesundheitswesens
- Qualität, Zugang und Bewertung im Gesundheitswesen
- Qualität der Gesundheitsversorgung
- Qualitätsindikatoren, Gesundheitsversorgung
- Sorgfalt
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- 20251386
- R01DA065187 (US NIH Stipendium/Vertrag)
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Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
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