Multilevel Integration Strategies to Enhance Service Provider Networks in Vietnam

NCT03293355 | Completed DMC

• 1 other identifier: R01DA041008
• Study Type: interventional
• Target: 320
• Locations: 1 country
• Sites: 4

Brief Summary

There is an urgent need for treatment service integration for People Living with HIV (PLH) because many PLH have comorbid conditions, including substance use disorders and psychiatric disorders, among others. Although providing integrated services to PLH who use drugs (PLHWUD) has been proven to produce positive outcomes, multilevel challenges must be addressed, including barriers at the policy, structural, and provider levels. Many countries, including Vietnam, face challenges in the pursuit of multilevel integration of combination treatment services and care. In Vietnam, injecting drug use accounts for nearly two-thirds of HIV infection, and methadone maintenance therapy (MMT) services have rapidly expanded to 135 clinics with over 25,000 clients since 2008. There is a timely call as well as an opportunity to identify, implement and evaluate new strategies to provide MMT and HIV treatment as an integrated service system for PLHWUD. The study will take advantage of this window of opportunity to explore and pilot integration strategies to address the multilevel challenges associated with service integration in Vietnam.

Conditions

Linkage to Care

Keywords

People Living with HIV Who Use Drugs (PLHWUD); Community Health Workers (CHW); Multilevel Service Integration; HIV/AIDS; Vietnam

Outcome Measures

Primary Outcomes (2)

• PLHWUD's service utilization

  This will be measured by PLHWUD's utilization of health services including OPC and MMT. Both their access and adherence to treatments will be assessed.

  Changes from baseline to 3-, 6-, 9- and 12- month follow-ups

• CHW interaction with providers of other treatment agencies

  This will be measured by a multi-item scale on interaction with other treatment providers

  Changes from baseline to 3-, 6-, 9- and 12- month follow-ups

Secondary Outcomes (3)

• PLHWUD's service satisfaction

  Changes from baseline to 3-, 6-, 9- and 12- month follow-ups

• CHW's patient-provider interaction with PLHWUD

  Changes from baseline to 3-, 6-, 9- and 12- month follow-ups

• CHW's service provision

  Changes from baseline to 3-, 6-, 9- and 12- month follow-ups

Study Arms (2)

Control

NO INTERVENTION

Standard of care

Intervention

EXPERIMENTAL

The VPN intervention has 2 in-person sessions: 1\) Providing training on service integration and team building for CHW and tools for them to network more effectively with OPC and MMT treatment providers as well as reach out to their patients; and 2) Learning to use effective communication tools such as motivational ruler and decision balance sheet to work more effectively with their patients and use Facebook group to facilitate collaboration among providers and e-chat for patient engagements. Sessions will occur once a week for two weeks, with each session featuring a different set of themes and relevant activities.

Behavioral: VPN

Interventions

VPN BEHAVIORAL

Two in-person sessions will take place one week apart for the VPN intervention targeting CHW. The intervention contents aim to utilize traditional communications tools and the latest technology to tackle challenges faced by service providers working in commune health centers and the impact of these challenges on their patients' treatment initiation, retention, and adherence. In addition, booster sessions will be offered once every month during the first three months and once every three months thereafter. The booster sessions will focus on participants' reports of their experiences, reinforcement of efforts, and continued skill building for problem solving.

Intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• CHW:
• Age 18 or over
• Be a service provider to PLHWUD attending commune health centers in one of the 40 communes selected selected for the study
• Voluntary written informed consent
• PLHWUD:
• Age 18 or over
• HIV positive (self-report)
• Currently using opiates or has a history of opiate use (self-report) and seeking services at the commune health centers in one of 40 communes selected from the study
• Has not received treatment services from OPC or MMT clinics (i.e., is treatment naive).
• Voluntary written informed consent

You may not qualify if:

• CHW:
• Inability to give informed consent
• PLHWUD:
• Inability to give informed consent

Sponsors & Collaborators

• University of California, Los Angeles: lead
• National Institute of Hygiene and Epidemiology, Vietnam: collaborator

Study Sites (4)

Commune Health Centers

Hải Dương, Hải Dương, Vietnam

Location

Commune Health Centers

Nghi An, Nghệ An Province, Vietnam

Location

Commune Health Centers

Bắc Giang, Vietnam

Location

Commune Health Centers

Nam Định, Vietnam

Location

MeSH Terms

Conditions

Acquired Immunodeficiency Syndrome

Condition Hierarchy (Ancestors)

HIV Infections; Blood-Borne Infections; Communicable Diseases; Infections; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; Lentivirus Infections; Retroviridae Infections; RNA Virus Infections; Virus Diseases; Slow Virus Diseases; Genital Diseases; Urogenital Diseases; Immunologic Deficiency Syndromes; Immune System Diseases

Study Officials

• Li Li, PhD

  University of California, Los Angeles

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor in Residence

Study Record Dates

• First Submitted: September 20, 2017
• First Posted: September 26, 2017
• Study Start: March 1, 2018
• Primary Completion: May 31, 2020
• Study Completion: May 31, 2020
• Last Updated: July 23, 2020

Record last verified: 2018-10

Locations

VN (4)