The BARS Study: Building Agent Based Models of Racialized Justice System Study in Black MSM

Abstract:  Large disparities in HIV rates in black men who have sex with men (BMSM) are not explained by higher engagement in risky behaviors and are particularly high among younger MSM. Despite the efficacy of several prevention interventions, reducing these disparities requires approaches that maximally engage these men’s social and sexual networks. Because of frequently transient life circumstances, disruption of social and sexual networks and HIV transmission overlap with other groups, criminal justice involved (CJI) BMSM who use substances represent an important target for intervention. Although effective behavioral and structural interventions exist that target CJI populations, their successful implementation for CJI BMSM networks and communities has not been demonstrated. Furthermore, research to determine intervention impact at these larger social units is costly and does not readily lend itself to the randomized control trial approach. This proposal aims to utilize a systems dynamic approach using an agent-based model (ABM) to estimate the effectiveness of HIV prevention and substance-abuse interventions for CJI substance-using BMSM. Our project brings together investigators with a proven track record in the study of BMSM, criminal justice settings, substance-abuse intervention, social network analysis, ABMs and HIV clinical care provision. We will adapt a previously developed core open access ABM platform (using Repast Simphony) that includes baseline national data on people and households by geography, as well as the dynamic features of the target population such as incarceration, health center, and activity (time-use) data. We will scale the ABM to three counties: Harris TX, Los Angeles CA, and Cook IL where our team has collected data for model parameterization. Our approach will assess the interplay between social and behavioral variables and viral and host factors in a matter that will be adaptive to temporal, network and setting-specific changes. Our aims are to: 1) Build upon our flexible ABM by incorporating HIV transmission and suppression probabilities at the individual level, including host/viral factors and biologic/behavioral data from HIV prevention and substance-abuse intervention studies; 2) Parameterize this ABM with multiple network data sources available to investigators in each city on specific transition periods of BMSM from the community, to jail, and back to the community/ supervision; such “shocks” lead to social and sexual network formation and disruption. We will supplement these data with newly collected data (n=50/city) specifically on network shocks and HIV prevention and treatment utilization during these critical transition periods; 3) Simulate HIV prevention interventions within criminal justice contexts using the model parameterized in Aim 2. Because our open access Repast Simphony ABM platform is widely used, we will make model parameters, specifications and variables publicly available. This will allow for external validation of our findings and for additional use of the core model by others for context and community-specific integrated HIV prevention and treatment planning in at risk populations.

 

Project Number: 3R01DA039934-03S1 

https://reporter.nih.gov/search/t_ZFuN8IDEyXUzgwJWV1mg/project-details/9480136 

 

Contact PI/ Project Leader

NINA, HARAWA, CORE DIRECTOR, POLICY IMPACT CORE (nharawa@mednet.ucla.edu)

SCHNEIDER, JOHN,  ASSOCIATE PROFESSOR OF MEDICINE (jschnei1@medicine.bsd.uchicago.edu)

 

Organization

UNIVERSITY OF CHICAGO

 

PUBLIC HEALTH RELEVANCE: Large disparities in HIV rates in black men who have sex with men (BMSM) are not explained by higher engagement in risky behaviors and are particularly high among younger MSM. Because of frequent transient life circumstances, disruption of social and sexual networks and HIV transmission overlap with other groups, criminal justice (i.e., jail and community supervision) involved (CJI) BMSM who use substances represent an important target for intervention. This proposal aims to estimate the effectiveness of HIV prevention interventions and substance-abuse interventions for criminal justice (i.e., jail and community supervision) involved substance-using BMSM.

 

FOA: PA-12-281  / Study Section: Special Emphasis Panel[ZRG1-AARR-K(05)S]

 

Project Start Date: 01-July-2015

Project End Date: 30-April-2020

Budget Start Date: 01-May-2017

Budget End Date: 30-April-2018

 

NIH Categorical Spending

Funding IC: National Institute on Drug Abuse / FY Total Cost by IC: $38,102

A.S.K.-PrEP Program (Assistance Services Knowledge-PrEP)

Abstract: The A.S.K.-PrEP (Assistance Services Knowledge-PrEP) program works with extremely high-risk HIV-negative trans women and men who have sex with men to link participants into PrEP medical services. A.S.K.-PrEP consists of individualized, client-centered PrEP navigation sessions to assess PrEP readiness, assess barriers to PrEP initiation and/or adherence, assess readiness for adherence, and to plan for PrEP persistence. Additionally, through the five-session A.S.K.-PrEP intervention, the PrEP navigator works with each participant to remove structural barriers to PrEP initiation/adherence (mental health, substance use [including injection drug use], intimate partner violence, STDs, housing, hormones, sex work), insurance enrollment/patient assistance), link participants into needed ancillary services, all with the ultimate goal of linkage to PrEP and persistent daily PrEP adherence. Discussions of PrEP readiness and individual and structural barriers to PrEP linkage and adherence occur throughout the five sessions. Throughout the duration of the project, participants can opt-in/opt-out of receiving culturally competent, theory-based PrEP adherence support text messages. Each text message has a theoretical conceptual foundation based on Social Support Theory (to provide informational, emotional or instrumental PrEP support), Health Belief Model (to identify or reduce HIV risks) or Social Cognitive Theory (to increase self-regulation skills and self-efficacy for PrEP persistence). A.S.K.-PrEP partners with three local clinics to provide culturally appropriate PrEP medical services.

HPTN 085: The AMP Study

The AMP Study (also known as HVTN 704/HPTN 085) tests an experimental antibody against HIV. AMP stands for Antibody Mediated Prevention. This is the idea of giving people antibodies that fight HIV to see if they will protect people from becoming HIV infected.

The AMP study tests an antibody called VRC01, a manufactured antibody against HIV. This is a new idea for HIV prevention that is related to what has been done in HIV vaccine research. In traditional HIV vaccine studies, people get a vaccine and researchers wait to see if their bodies will make antibodies against HIV in response to the vaccine. In this study, we will skip that step, and give people the antibodies directly.

VRC01 will be given using intravenous infusions. This is more commonly known as getting an IV, or getting a drip. The IV is given to the study participant every eight weeks for 30-60 minutes. To get an IV, a sterile needle is used to place a small plastic tube into a vein in the participant’s arm. A bag of fluid is hung from a pole and connected to a pump, which controls how quickly the contents of the bag flow through the tube into the participant’s arm.

There will be 3 different groups in this study. One third of study participants will get a higher dose of the antibody in their IV. One third will get a lower dose of the antibody in their IV. One third will get an infusion of sterile salt water without any antibody in it. This is called a placebo. Participants will be enrolled in the study for about two years.

Hope Social Media Intervention for HIV Testing and Studying Social Networks

Abstract: In a randomized controlled trial, with 6-month and 1-year follow-up, this application aims to evaluate whether the Harnessing Online Peer Education (HOPE) social media intervention can be used to increase HIV self- testing among African American and Latino men who have sex with men (MSM), and to analyze the changing social network characteristics of participants in this intervention. Innovative approaches to HIV prevention and treatment are critical in the attempt to control the spread of HIV, especially among African American and Latino men who have sex with men (MSM), who are at the highest risk for HIV. Community-based HIV prevention strategies, such as peer leader diffusion models, have been successful in spreading HIV-risk behavior reductions, but require time and economic resources. With the recent increase in social media usage among African American and Latino MSM, social media and online social networks such as Facebook might be used to efficiently and cost-effectively deliver evidenced-based, peer-led HIV prevention interventions. Advances in testing technology, such as home-based HIV testing, can be integrated into an online HIV prevention intervention to allow participants to anonymously test for HIV without risking the stigmatization associated with in-person testing. Because social networking interventions provide rich data on social network characteristics (e.g., the number of friends participants make over time, content of health communication within online networks), this information can be recorded and used to improve intervention delivery. Results from our Los Angeles HOPE pilot study have already demonstrated a) the feasibility and acceptability of using social networking technologies to deliver peer-led HIV prevention among African American and Latino MSM, b) interest in home-based HIV testing among these populations, and c) the relationship between social network dynamics and HIV prevention behavior change. However, additional research is needed with a larger sample to determine the large-scale effectiveness of using social media to increase HIV testing and linkage to care among African American and Latino MSM. In this study, HIV negative African-American and Latino MSM will be invited to join an online (private) Facebook group related to HIV prevention and interact with peer leaders trained in HIV prevention over 12 weeks, with 6-month and 1-year follow-up. Compared to control group participants receiving 12 weeks of peer- delivered general health information over Facebook groups, we predict that participants receiving 12 weeks of peer-delivered HIV prevention information will be more likely to take a home-based HIV test. We will also measure participants’ social network data to assess the relationship between changing social network dynamics (e.g., density, network size) and intervention effects.

 

Project Number: 5R01MH106415-03

https://reporter.nih.gov/search/PAZ4BFXiRUWUpX1Uq9YqZA/project-details/9211389 

 

Contact PI/ Project Leader

YOUNG, SEAN, ASSOCIATE PROFESSOR (syoung5@hs.uci.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

PUBLIC HEALTH RELEVANCE: The ability to rapidly deliver community-based HIV interventions is critical to controlling the spread of HIV in high-risk populations in Los Angeles and the rest of the world. This project is particularly significant because it 1) deals with groups who are the most impacted by HIV, African American and Latino men who have sex with men (MSM), 2) deals with MSM who are particularly important to reach due to the fact that many use the Internet to find sex partners, and 3) seeks to use social network analysis as an additional innovative tool for enhancing the effectiveness of social media-based HIV prevention intervention among high-risk population.

 

FOA: PA-14-132 / Study Section: Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section[BSPH]

 

Project Start Date: 08-April-2015

Project End Date: 31-January-2020

Budget Start Date: 01-February-2017

Budget End Date: 31-January-2018

 

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE OF MENTAL HEALTH / FY Total Cost by IC: $556,208

Engaging Seronegative Youth to Optimize HIV Prevention Continuum

Abstract: Young people at highest risk for HIV in the U.S. will be gay, bisexual transgender youth (GBTY) and homeless youth (HY) in communities with high HIV incidence and overwhelmingly Black and Latino. Focusing on Los Angeles and New Orleans, seronegative youth at highest risk for HIV will be screened in homeless shelters and gay-identified community-based organizations (CBO). A cohort of 1500 seronegative youth will be recruited that is 82% male (79% GBTY), 66% Black, 16% Latino, and 18% white, non-Hispanic. About 27% will be 12-17 and 73% between 18-24 years old. All youth will be followed longitudinally over 24 months at four month intervals and tested for HIV, STI, serious substance abuse, health care utilization, and comorbid conditions – a Prototypical Retention/Prevention (R/P) Strategy. Over 24 months, acutely HIV infected youth will be triaged to Study 1. This Prototypical R/P Strategy operationalizes the CDC’s recommendations for the engagement of GBTY in repeat HIV testing, linkage to care, and options for combination prevention (PrEP, PEP – with behavioral interventions). Building on this team’s extensive experience with behavioral and mobile/social media interventions, a randomized controlled trial (RCT) will be conducted with four intervention conditions: 1) an Automated Messaging and Monitoring Intervention (AMMI), which will use texts to diffuse prevention messages daily and to monitor risk behaviors weekly (n=900); 2) a Peer Support intervention on a social media platform (i.e., Facebook) in which young people will post messages and stories about their experiences preventing HIV, plus the AMMI (n=200); 3) an eNavigator intervention in which a B.A.-level staff supports youth, primarily through texting and social media, but also in-person meetings, to provide support in crisis situations, refer to treatment, and assist in gaining access to health care and other services, plus Peer Support and AMMI (n=200); and, 4) a combined intervention of eNavigator, Peer Support, and AMMI (n=200). A single outcome will be composed of six key behaviors (access to medical care, accessing and adherence to PrEP or PEP, treatment of all STI, and 100% condom use). In addition to evaluating the added benefit of increasing levels of intervention, the brief 7- item weekly text-messaging monitoring surveys will provide approximately 100,000 weekly reports of indicators of primary and secondary outcomes that can inform our understandings about the relationships between risk and comorbid states. This study will have policy implications for the allocation of resources to HIV testing resources in local communities, the uptake and scalability of text and social media interventions, and the models for diffusing evidence-based interventions (EBI) globally (without requiring replication with fidelity to a manual).

Project Number: 5U19HD089886-02

Developing a PreP Screening Instrument for Identification/Referral of High-Risk MSM in Primary Care

Abstract: A significant public health development, pre-exposure prophylaxis (PrEP) is now being widely promoted as a prevention strategy for individuals in high-risk groups, such as men who have sex with men who report substance-use (past 6-month illegal drug use and/or heavy alcohol use). While this is an exciting development, rapid identification of these high-risk patients and the ability to provide brief consultation and prescription or referral for PrEP services by primary care staff remains a major concern. The proposed mixed methods study aims to develop and pilot-test a PrEP screening instrument for facilitating PrEP uptake among substance-using MSM that will be integrated into clinic workflow based on provider-identified barriers and facilitators to sexual-health screening. The study will take place in a single primary care clinic contained within a larger integrated healthcare delivery system, Kaiser Permanente Southern California (KPSC). Identification of both the provider- and patient-level barriers to PrEP uptake among high-risk substance-using MSM within a large integrated healthcare system will inform future intervention efforts aimed at mitigating HIV health disparities. The proposed 2-year pilot study will involve the collection of preliminary data to inform the development of a larger formal evaluation study. This project is significant in that it seeks to develop and test a screening instrument that will be administered to patients during appointment check-in and made available to their primary care provider for the rapid identification of substance-using MSM at high-risk for HIV acquisition in order to facilitate PrEP prescription/referral. This project is innovative in its focus on the identification of potential provider-, patient-, and system-level barriers to PrEP uptake among these patients.

 

 

Project Number: 1R03DA043402-01

https://reporter.nih.gov/search/o-PR-udfZUu9CeZXDB01GQ/project-details/9269815

 

 

Contact PI/ Project Leader

STORHOLM, ERIK D, ASSISTANT PROFESSOR (estorholm@sdsu.edu)

 

 

Organization

RAND CORPORATION

 

 

 

 

Project Start Date: 01-May-2017

Project End Date: 30-April-2019

Budget Start Date: 01-May-2017

Budget End Date: 30-April-2018

 

 

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE ON DRUG ABUSE / FY Total Cost by IC: $171,422

Investigating Resiliency in Preventing Binge Drinking and Stimulant Use Among Black Men at High-Risk for HIV

Abstract: There is a profoundly disproportionate HIV burden that exists among young black men who have sex with men (YBMSM). Substance use has been inextricably linked to HIV transmission since the beginning of the epidemic. Black Americans report the highest levels of discrimination due to race/ethnicity, poverty, and substance use and these discriminatory experiences are likely to increase their risk for HIV infection. Informed by Minority Stress Theory (Meyer, 1995), the proposed 1-year study will support additional data analyses to test the minority stress model for alcohol and other drug use among 1565 YBMSM at high-risk for HIV. Aim 1: Examine the relationship between stressful experiences of racism, homophobia, and internalized homophobia and the use of alcohol and other drugs among YBMSM. Aim 2: Determine if resiliency, gay pride/self-esteem, and social support moderate the relationship between stressful experiences of racism, homophobia, and internalized homophobia and the use of alcohol and other drugs among YBMSM. Aim 3: Assess for the moderating effect of gay pride/self-esteem, resiliency and social support on the relationship between stressful experiences of racism, homophobia, and internalized homophobia and sexual risk behavior. The proposed study will have important scientific, clinical, and public health implications. a) Scientific: This study will advance our basic understanding of resiliency processes that are relevant to preventing/reducing substance use among YBMSM. b) Clinical: Findings from this study will inform our efforts to adapt substance abuse interventions so that they focus on increasing resiliency among YBMSM. c) Public Health: Resiliency factors that may combat the negative affect that arises from multiple discriminatory could inform the implementation of substance abuse prevention campaigns. Findings will also support the provision of resiliency based mental health and substance abuse treatment to address the elevated prevalence of substance use among this most vulnerable sub-group of MSM.

 

Project Number: 1R03DA042660-01A1

https://reporter.nih.gov/search/o-PR-udfZUu9CeZXDB01GQ/project-details/9269815

 

 

Contact PI/ Project Leader

STORHOLM, ERIK D, ASSISTANT PROFESSOR (estorholm@sdsu.edu)

 

 

Organization

RAND CORPORATION

 

 

 

 

Project Start Date: 15-Feburary-2017

Project End Date: 31-Janurary-2019

Budget Start Date: 15-Feburary-2017

Budget End Date: 31-Janurary-2019

 

 

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE ON DRUG ABUSE / FY Total Cost by IC: $138,653

MSM and Substances Cohort at UCLA Linking Infections Noting Effects (Masculine)

Abstract: This application in response to NIDA PAR 12-222 Cohort Studies of HIV/AIDS and Substance Use (U01) seeks to leverage extensive existing infrastructure and cohorts at the University of California, Los Angeles to launch a new cohort of substance using minority (Black or Hispanic) men who have sex with men (MMSM). The epidemic of HIV among MMSM in the US and locally in Los Angeles County (LAC) may be driven by effects of substance use on adherence to treatment regimens and bio-behavioral prevention and enhanced by high prevalence networks. Proposed investigators lead the science on studying associations between non-injection drug use, risk behaviors and infectious disease among MSM, and contribute a broad portfolio of inter-disciplinary work from immunology and basic science to epidemiology, prevention and treatment. The work proposed leverages existing cohorts including the Multicenter AIDS Cohort (MACS) and existing repositories and builds on preliminary work to guide assembly of a cohort for the study of basic and behavioral factors in younger MMSM who actively use substances and engage transmission risks. Establishing a cohort of young active substance users, particularly stimulant users, who have poor histories of antiretroviral treatment (ART) adherence as marked by measurable and clinically relevant Plasma Viral Load (PVL) will enable important tests of biological influences of substances on immune function in MMSM. This cohort is central to prevention and treatment efforts and will provide well-characterized, extensive repository samples for leveraged use with other cohorts, networks’ and individual’s studies. The MMSM will be: (i) HIV-positive with viral load >5000 copies/ml or (ii) HIV-negative at high risk for HIV infection (unprotected anal intercourse in the past 6 months). This unique cohort will facilitate studies on interactions between substance use and HIV progression and/or transmission, which are of critical public health significance. This cohort of MMSM will characterize: (i) effects substance use on behavioral and network level risk in exposed and infected MMSM on acquisition of HIV and other sexually transmitted infections (STIs: gonorrhea, Chlamydia, syphilis, Hepatitis C (HCV)); and (ii) the extent to which substance use in MMSM facilitates behaviors that transmit HIV compared to non-drug using MMSM. The application also proposes to develop and maintain a bio repository that is HIPAA-compliant, technologically-current and DAIDS Network interfaced that includes a scientific advisory committee. This cohort will comprise 620 MMSM with repeated data visits (from 1,080 MMSM). At least half of these MMSM will be active substance users and younger than age 30.

 

 

Project Number: 5U01DA036267-05

https://reporter.nih.gov/search/tyATmmCktE-kfQBMC4JEpA/project-details/9267958

 

 

Contact PI/ Project Leader

SHOPTAW, STEVEN J, PROFESSOR (SSHOPTAW@MEDNET.UCLA.EDU)

GORBACH, PAMINA MAE, PROFESSOR (PGORBACH@UCLA.EDU)

 

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: The public health significance of the work described is very high in that the project seeks to establish a cohort of minority men who have sex with men who are active substance users who are either HIV-positive and have measurable viral load (indicating intermittent antiretroviral medication adherence) or who are HIV-negative and engage high risk sexual transmission behaviors for sexually transmitted infections, including HIV, gonorrhea, Chlamydia, syphilis and Hepatitis C. It is the composition of this cohort that confers outstanding impact. Establishing the cohort and the corresponding UCLA Bio repository for storing samples from these cohort members will provide a matchless platform to investigate basic, biological and behavioral effects of active substance use, especially stimulant use (i.e., cocaine, crack, methamphetamine, amphetamine and Ecstasy) in minority MSM who are sexually active (i.e., younger than existing cohort members) and who are inconsistent with antiretroviral medications. Findings from the proposed set of specific aims and from future research that will be made possible by establishment of the cohort and the UCLA Biorepository will enable important tests of biological influences of substances, especially stimulants, on immune function and HIV infection in very high risk MMSM, both HIV positive and HIV negative. This novel cohort will optimize our chances to clarify fundamental questions that have challenged NIDA/NIAID in curtailing infections in these populations.

 

 

FOA: PAR-12-222Study Section: ZDA1-NXR-B(15)S

 

Project Start Date: 30-September-2013

Project End Date: 31-May-2018

Budget Start Date: 01-June-2017

Budget End Date: 31-May-2018

 

 

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE ON DRUG ABUSE / FY Total Cost by IC: $1,488,949

Theory-Based Text Messaging to Reduce Methamphetamine Use and HIV Risks Among MSM

Abstract: Methamphetamine use among men who have sex with men (MSM) is deeply integrated into socio-sexual networks including physical risk venues such as circuit parties, sex clubs, and bathhouses and digital spaces such as cell phone applications, websites, and digital chat rooms to “hook up” for sex. Thus, methamphetamine use is highly associated with HIV infection due specifically to concomitant high-risk sexual behaviors that occur while using the drug. Text-messaging is a novel, feasible, and sustainable approach for targeting high-risk, out-of-treatment MSM; particularly, MSM who fail to attend face-to-face or site-based interventions. A real-time text-messaging intervention capitalizes on a communication channel to which this population will attend at the exact time they are most likely to make high-risk sexual decisions. This application is in response to PA-10-012 for technologically enhanced Stage II research. Consistent with the specific research interest of the PA, this application builds on findings from an open-label Stage I study that developed and piloted a HIV prevention intervention to reduce methamphetamine use and high-risk sexual behaviors among out-of-treatment, methamphetamine-using MSM. During the pilot study, text messages – based on established behavioral change theories and specifically tailored to urban, out-of-treatment, methamphetamine-using MSM – were developed and tested. The proposed Stage II trial will assess the impact of an 8-week, gay-specific, theory-based text-messaging intervention designed to decrease methamphetamine use and HIV sexual risk behavior and, for the HIV-infected participants, simultaneously increase HIV antiretroviral treatment/adherence in out-of-treatment, methamphetamine-using MSM (N = 285). Participants will receive text messages that are personally tailored to fit their risk profile; the theory-based text messages serve as the mechanisms of behavior change. Participants will be randomized into one of three conditions: Group 1: culturally relevant theory-based text messages interactively transmitted by peer health educators (TXT-PHE); or, Group 2: the same culturally relevant theory-based text messages transmitted by automation (TXT-Auto); or, Group 3: assessment-only (AO) control with no theoretically based text messages. Participants will receive brief weekly text-message assessments on their methamphetamine use and HIV sexual behaviors in the previous seven days. The specific aims of this research are: 1) To determine differential immediate and sustained effects of transmitting theory-based text messages by PHE (TXT-PHE) versus by automation (TXT- Auto), compared to an assessment-only (AO) control condition among out-of-treatment, methamphetamine- using MSM for reductions of methamphetamine use and HIV sexual risk behaviors; and, 2) To determine the cost-effectiveness of TXT-PHE vs. TXT-Auto compared to AO for reducing methamphetamine use and HIV sexual risk behaviors. The randomized three-group design uses repeated assessments at baseline, at the end of the intervention, and at 3-, 6-, and 9-month post-randomization follow-up.

 

 

Project Number: 4R01DA035092-04

https://reporter.nih.gov/search/Qh9D4Tpmqk6QOQbxOJSWcw/project-details/9012056

 

 

Contact PI/ Project Leader

REBACK, CATHY J , (reback@friendsresearch.org)

 

Organization

FRIENDS RESEARCH INSTITUTE, INC.

 

PUBLIC HEALTH RELEVANCE: Methamphetamine use among MSM is highly associated with HIV infection due specifically to the concomitant high-risk sexual behaviors that occur while using the drug. The “real-time” theoretically based text-messaging HIV prevention intervention will reach out-of-treatment, methamphetamine-using MSM while they are in the contexts of greatest risk and interrupt both drug use and HIV sexual risk behaviors. The proposed research will determine differential immediate and sustained effects and cost effectiveness of the text-messaging intervention to reduce methamphetamine use and concomitant HIV sexual risk behaviors and, for the HIV- infected participants, increase HIV antiretroviral treatment/adherence.

 

 

 

Project Start Date: 01-Feburary-2013

Project End Date: 31-Janurary-2019

Budget Start Date: 01-Feburary-2016

Budget End Date: 31-Janurary-2019

 

 

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE ON DRUG ABUSE / FY Total Cost by IC: $464,688

Resiliency Education to Reduce Depression Disparities

Abstract: Depression is the leading cause of adult disability and common among lesbian, gay, bisexual (LGB) adults. Primary care depression quality improvement (QI) programs can improve outcomes for minorities more significantly than for nonminorities, but they are seldom available in safety-net systems. We build on findings from Community Partners in Care (CPIC) and Building Resiliency and Increasing Community Hope (B-RICH). CPIC compared depression QI approaches across healthcare and social /community services in communities of color. CPIC included healthcare and “community-trusted” programs (e.g., homeless, faithbased) to work as a network to address depression, compared to individual-program technical assistance. In CPIC, both conditions improved mental wellness, mental health quality of life, and depression over 12 months. B-RICH, a randomized study, evaluated lay delivery of a seven-session, CBTinformed resiliency education class versus case management on patients’ depressive symptoms over three months, in unpublished but completed analyses. The proposed demonstration supplements the resiliency class with a mobile/interactive voice response case management tool to reinforce class content and depression care reminders (BRICH+).