IGHID 12230 - 预防艾滋病毒的体验式短期酒精干预实施试验 (EBAI)

有源比较器：仅协助 (FAC)

随机分配到 FAC 组的诊所将使用仅促进方法向 PWH 实施 BAI 交付。

其他：便利化（FAC）

促进方法将使用灵活的诊所层面实施策略，帮助诊所解决常见障碍，例如顾问技能、竞争优先事项和资源短缺。

实验性的：引导加体验式简短酒精干预 (EBAI+FAC)

随机分配到 EBAI+FAC 组的诊所将使用促进方法向 PWH 参与者实施 BAI 交付。 此外，诊所工作人员，无论其饮酒情况如何，都将在提供 BAI 之前自行获得 BAI。

其他：便利化（FAC）

促进方法将使用灵活的诊所层面实施策略，帮助诊所解决常见障碍，例如顾问技能、竞争优先事项和资源短缺。

行为的：体验式简短酒精干预 (EBAI)

在实施之前，诊所工作人员将获得体验式 BAI。 BAI 包括 2 场面对面会议和 2 场辅助电话会议。 负责向 PWH 参与者提供 BAI 的诊所工作人员将接受 3 次额外的巩固课程，以将他们接受 BAI 的经验与提供 BAI 的经验结合起来。

Fidelity Score

Fidelity is a clinic-level measure assessed as a composite of the recipients of the BAI. The timeframe of 15 months reflects individual recruitment over 12 months plus 3 months for completion of the BAI.

The score comprises successful completion of the 4 protocol-specified BAI sessions (2 in-person, 2 by phone) within 7 weeks of the initial session weighted by the central fidelity rater's quality rating of the in-person sessions. Fidelity will be assessed using a tailored selection of fidelity measures including the BAI Core Components Checklist. The clinic fidelity score ranges from 0-100. The score will be the percentage of counseling sessions completed, multiplied (weighted) by the combined average quality rating of counseling sessions. Higher scores indicate higher fidelity.

Viral Suppression

Viral suppression is defined as a viral load <1000 copies/mL on a dried blood spot (DBS) sample collected 12 months after enrollment of a participant.

BAI Acceptability Score - Clinic Staff: Acceptability of Intervention Measure (AIM) scale

Acceptability is the perception that the BAI intervention is agreeable, palatable, or satisfactory to clinic staff.

Acceptability among clinic staff will be assessed using the Acceptability of Intervention Measure (AIM), which consists of 4 items containing responses on a 5-point Likert scale, ranging from 1-4.

The AIM score will be the mean of the 4 item responses (range: 1-5). Higher AIM scores indicate higher acceptability.

BAI Acceptability score Counselors: Mental Health Implementation Science Tools (mhIST) Acceptability Scale for Providers

Acceptability is the perception that the BAI intervention is agreeable, palatable, or satisfactory to counselors delivering the BAI to patients.

Acceptability among counselor participants will be assessed using the Mental Health Implementation Science Tools (mhIST) Acceptability Scale for providers, which consists of 13 items containing responses on a 4-point Likert scale, ranging from 0-3. The mhIST score is calculated as the mean score of all responses (range: 0-39). Higher mhIST scores indicate higher acceptability.

BAI Acceptability PWH: Mental Health Implementation Science Tools (mhIST) Acceptability Scale for Consumers

Acceptability is the perception that the BAI intervention is agreeable, palatable, or satisfactory to PWH.

Acceptability among PWH participants will be assessed using the Mental Health Implementation Science Tools (mhIST) Acceptability Scale for consumers, which consists of 15 items containing responses on a 4-point Likert scale ranging from 0-3. The mhIST score is calculated as the mean score of all responses (range: 0-45). Higher mhIST scores indicate higher acceptability.

Penetration- Proportion of PWH Screened with the AUDIT-C

The first penetration metric will be the: proportion of PWH initiating or on ART who are screened with the AUDIT-C.

Penetration - Proportion of PWH who screen positive who receive at least one counseling session

The second penetration metric will be the proportion of PWH that screen positive who receive at least one BAI counseling session.

Costs

Investigators will use an "ingredients" or bottom-up approach, with comparison to "top-down" costing. The cost estimates will follow the investigators published conceptual framework for assessing implementation costs and cost analysis of health services. Investigators will include all types of measurable costs (e.g., staff, equipment, consumables, overheads, etc.) associated with key steps and component of the respective implementation strategy and BAI service delivery. Investigators will follow international conventions for all procedures including economic costing, discounting, and reporting.

Sustainability Score: Provider Support of Sustainment Scale (PRESS)

Sustainability will be measured among clinic staff, including directors, using the provider support of sustainment scale (PRESS), a brief, 3-item measure of sustainment that is pragmatic and useable across different evidence-based intervention (EBIs), provider types, and settings. Responses are recorded on a 5-point scale ranging from 0 (not at all) to 4 (to a very great extent) and the score is calculated as the mean of the 3 responses with higher scores indicating higher sustainability. The PRESS captures frontline staff's report of their clinic's continued use of an EBI.

AUDIT (total score) - Clinic staff

Investigators will assess the total Alcohol Use Disorders Identification Test (AUDIT) score. The AUDIT is a 10-item scale with summed responses ranging from 0-40; higher scores indicating more harmful alcohol consumption.

AUDIT (total score) - PWH

Investigators will assess the total Alcohol Use Disorders Identification Test (AUDIT) score. The AUDIT is a 10-item scale with summed responses ranging from 0-40; higher scores indicating more harmful alcohol consumption.

Fidelity (Extended Window)

Fidelity is a clinic-level measure assessed as a composite of the recipients of the BAI. The timeframe of 17 months reflects individual recruitment over 12 months plus 5 months for completion of the BAI.

The score comprises successful completion of the 4 protocol-specified BAI sessions (2 in-person, 2 by phone) within 4 months of the initial session weighted by the central fidelity rater's quality rating of the in-person sessions. Fidelity will be assessed using a tailored selection of fidelity measures including the BAI Core Components Checklist. The clinic fidelity score ranges from 0-100. The score will be the percentage of counseling sessions completed, multiplied (weighted) by the combined average quality rating of counseling sessions. Higher scores indicate higher fidelity.