Project Khanya: a randomized, hybrid effectiveness-implementation trial of a peer-delivered behavioral intervention for ART adherence and substance use in Cape Town, South Africa

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dc.contributor.authorMagidson, Jessica F
dc.contributor.authorJoska, John A
dc.contributor.authorMyers, Bronwyn
dc.contributor.authorBelus, Jennifer M
dc.contributor.authorRegenauer, Kristen S
dc.contributor.authorAndersen, Lena S
dc.contributor.authorMajokweni, Sybil
dc.contributor.authorO’Cleirigh, Conall
dc.contributor.authorSafren, Steven A
dc.date.accessioned2020-04-15T08:22:47Z
dc.date.available2020-04-15T08:22:47Z
dc.date.issued2020-03-04
dc.date.updated2020-03-08T04:19:01Z
dc.description.abstractAbstract Background Substance use is prevalent in South Africa and associated with poor HIV treatment outcomes, yet, it is largely unaddressed in HIV care. Implementing an evidence-based, task-shared intervention for antiretroviral therapy (ART) adherence and substance use integrated into HIV care may be a feasible and effective way to improve HIV treatment outcomes and reduce substance use in this population. Methods Guided by the RE-AIM framework, a randomized, hybrid type 1 effectiveness-implementation trial (n = 60) is being used to evaluate a peer-delivered intervention that integrates evidence-based intervention components, including Life-Steps (problem solving and motivational skills for HIV medication adherence), behavioral activation to increase alternative, substance-free rewarding activities in one’s environment, and relapse prevention skills, including mindfulness. The comparison condition is enhanced standard of care, which includes facilitating a referral to a local substance use treatment clinic (Matrix). Participants are followed for a period of 6 months. Implementation outcomes are defined by Proctor’s model for implementation and include mixed methods evaluations of feasibility, acceptability, and fidelity, and barriers and facilitators to implementation. Primary patient-level effectiveness outcomes are ART adherence (Wisepill) and substance use (WHO-ASSIST and urinalysis); viral load is an exploratory outcome. Discussion Results of this trial will provide important evidence as to whether peer delivery of an integrated intervention for ART adherence and substance use is feasible, acceptable, and effective. Implementation outcomes will provide important insight into using peers as an implementation strategy to extend task sharing models for behavioral health in resource-limited settings globally. Trial registration ClinicalTrials.gov identifier: NCT03529409. Trial registered on May 18, 2018.en_US
dc.identifier.apacitationMagidson, J. F., Joska, J. A., Myers, B., Belus, J. M., Regenauer, K. S., Andersen, L. S., ... Safren, S. A. (2020). Project Khanya: a randomized, hybrid effectiveness-implementation trial of a peer-delivered behavioral intervention for ART adherence and substance use in Cape Town, South Africa. <i>Implementation Science Communications</i>, 1(1), 23. en_ZA
dc.identifier.chicagocitationMagidson, Jessica F, John A Joska, Bronwyn Myers, Jennifer M Belus, Kristen S Regenauer, Lena S Andersen, Sybil Majokweni, , and Steven A Safren "Project Khanya: a randomized, hybrid effectiveness-implementation trial of a peer-delivered behavioral intervention for ART adherence and substance use in Cape Town, South Africa." <i>Implementation Science Communications</i> 1, 1. (2020): 23. en_ZA
dc.identifier.citationMagidson, J.F., Joska, J.A., Myers, B., Belus, J.M., Regenauer, K.S., Andersen, L.S., Majokweni, S. & et al. 2020. Project Khanya: a randomized, hybrid effectiveness-implementation trial of a peer-delivered behavioral intervention for ART adherence and substance use in Cape Town, South Africa. <i>Implementation Science Communications.</i> 1(1):23. en_ZA
dc.identifier.ris TY - Journal Article AU - Magidson, Jessica F AU - Joska, John A AU - Myers, Bronwyn AU - Belus, Jennifer M AU - Regenauer, Kristen S AU - Andersen, Lena S AU - Majokweni, Sybil AU - O’Cleirigh, Conall AU - Safren, Steven A AB - Abstract Background Substance use is prevalent in South Africa and associated with poor HIV treatment outcomes, yet, it is largely unaddressed in HIV care. Implementing an evidence-based, task-shared intervention for antiretroviral therapy (ART) adherence and substance use integrated into HIV care may be a feasible and effective way to improve HIV treatment outcomes and reduce substance use in this population. Methods Guided by the RE-AIM framework, a randomized, hybrid type 1 effectiveness-implementation trial (n = 60) is being used to evaluate a peer-delivered intervention that integrates evidence-based intervention components, including Life-Steps (problem solving and motivational skills for HIV medication adherence), behavioral activation to increase alternative, substance-free rewarding activities in one’s environment, and relapse prevention skills, including mindfulness. The comparison condition is enhanced standard of care, which includes facilitating a referral to a local substance use treatment clinic (Matrix). Participants are followed for a period of 6 months. Implementation outcomes are defined by Proctor’s model for implementation and include mixed methods evaluations of feasibility, acceptability, and fidelity, and barriers and facilitators to implementation. Primary patient-level effectiveness outcomes are ART adherence (Wisepill) and substance use (WHO-ASSIST and urinalysis); viral load is an exploratory outcome. Discussion Results of this trial will provide important evidence as to whether peer delivery of an integrated intervention for ART adherence and substance use is feasible, acceptable, and effective. Implementation outcomes will provide important insight into using peers as an implementation strategy to extend task sharing models for behavioral health in resource-limited settings globally. Trial registration ClinicalTrials.gov identifier: NCT03529409. Trial registered on May 18, 2018. DA - 2020-03-04 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Implementation Science Communications KW - RE-AIM KW - Hybrid design KW - Global mental health KW - HIV KW - Substance use KW - Antiretroviral therapy (ART) adherence LK - https://open.uct.ac.za PY - 2020 T1 - Project Khanya: a randomized, hybrid effectiveness-implementation trial of a peer-delivered behavioral intervention for ART adherence and substance use in Cape Town, South Africa TI - Project Khanya: a randomized, hybrid effectiveness-implementation trial of a peer-delivered behavioral intervention for ART adherence and substance use in Cape Town, South Africa UR - ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s43058-020-00004-w
dc.identifier.urihttps://hdl.handle.net/11427/31629
dc.identifier.vancouvercitationMagidson JF, Joska JA, Myers B, Belus JM, Regenauer KS, Andersen LS, et al. Project Khanya: a randomized, hybrid effectiveness-implementation trial of a peer-delivered behavioral intervention for ART adherence and substance use in Cape Town, South Africa. Implementation Science Communications. 2020;1(1):23. .en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDepartment of Psychiatry and Mental Healthen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceImplementation Science Communicationsen_US
dc.source.journalissue1en_US
dc.source.journalvolume1en_US
dc.source.pagination23en_US
dc.source.urihttps://implementationsciencecomms.biomedcentral.com/
dc.subjectRE-AIMen_US
dc.subjectHybrid designen_US
dc.subjectGlobal mental healthen_US
dc.subjectHIVen_US
dc.subjectSubstance useen_US
dc.subjectAntiretroviral therapy (ART) adherenceen_US
dc.titleProject Khanya: a randomized, hybrid effectiveness-implementation trial of a peer-delivered behavioral intervention for ART adherence and substance use in Cape Town, South Africaen_US
dc.typeJournal Articleen_US
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