WHAT IF? Project

Integration of Addiction Treatments into HIV Care Using Implementation Facilitation (WHAT IF?) Project

Dr. Jessica Yager, Assistant Professor, Department of Medicine, Division of Infectious Diseases, will serve as the local Principal Investigator on a 5 year collaborative project with Yale University to integrate substance abuse treatment into HIV care in the STAR Health Center. Dr. Fiellin, PI of the parent grant at Yale, is Professor of Medicine in the Institute for Social and Policy Studies and of Public Health Professor, Investigative Medicine; Director, Community Research and Implementation Core, Center for Interdisciplinary Research on AIDS (CIRA).

While effective counseling and medication interventions exist for tobacco, alcohol and opioid use disorders, they are rarely integrated into HIV clinics. Implementation Facilitation (IF) is an established multi-component strategy to change health care systems that involves a baseline assessment of key stakeholders’ (patients, providers, administrators) needs and provides a tailored implementation strategy that uses an external facilitator, local champions, provider education (academic detailing), stakeholder engagement, performance monitoring and feedback, formative evaluations, learning collaboratives and program marketing to effect durable change in organizational and provider provision of evidence-based treatments.

The goal of the proposed implementation-effectiveness study is to conduct a formative evaluation and then tailor the IF to local site needs and to determine the impact of IF on the use of effective counseling and medications for tobacco, alcohol and opioid use disorders in large HIV clinics.  The study will compare pre-implementation to post-implementation measures of:  1) Organizational readiness to deliver effective addiction treatments, 2) Provider readiness to deliver effective addiction treatments, 3) Provision of effective addiction treatments, 4) Models of care for the provision of effective addiction treatments, and 5) HIV outcomes among those who are elibigle for addiction treatments. The proposed study, conducted by an experienced team of HIV and addiction researchers from four institutions, will help define the role of IF in the integration of addiction treatments in HIV clinics.