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Testing the effectiveness of a graphic novel health education curriculum for patients with addiction
Investigator (PI): Brooks, Adam
Performing Organization (PO): (Current): Treatment Research Institute (TRI) / (215) 399-0980
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2014
Final Year: 2019
Record Source/Award ID: PCORI/CDR-1310-07308
Funding: Total Award Amount: $1,351,616
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Background: There are significant barriers to implementing evidence-based treatments in community-based substance abuse treatment settings. As a result, patients with substance use disorders may not be exposed to counseling approaches supported by research, and they typically have minimal access to medication-assisted treatments (MAT), creating a significant gap in the treatment options patients receive. To address this problem, our team has developed and evaluated multimedia group counseling toolkits as a low-cost strategy to introduce the workforce to approaches that research has shown to be effective. Our pilot work has demonstrated that brief training with our counseling toolkits is sufficient to achieve very large improvements in counselor adherence, and these improvements last over time. Furthermore, preliminary data indicate measurable impact of the toolkits on patient substance use. Objectives: This proposal aims to develop a patient-centered health education toolkit that will introduce patients with alcohol use disorders to early recovery content and assist patients in evaluating the need for MAT. The toolkit, presented in a graphic novel format, will employ a shared decision making approach. We will conduct a six-month follow-up study to assess the impact of the toolkit on substance use, treatment initiation and engagement, and HIV risk behaviors. Methods: In phase 1, we will work with a team of patients and counselors to develop a four-volume graphic novel curriculum, and we will expand access to MAT in a local federally qualified health center. In phase 2, we will conduct a clinical trial of the health education toolkit. We will randomize 60 counselors in community treatment agencies to 1) the toolkit (TK) condition in which counselors will receive brief training on how to use the toolkit in groups, or 2) treatment as usual (TAU) in which counselors will receive brief training to cover comparable topic areas (without the toolkit). After training, TK counselors will use the toolkit to conduct a four-week group series, and TAU counselors will conduct a four-week series on similar topic areas using standard counseling approaches. We will screen and recruit 5-7 patients per counselor (N=350) with active alcohol use disorders to participate in a follow-up study. We will collect assessments of substance use through self-report and urinalysis at baseline, and at 6-week, 12-week, and 24-week follow-up points. A Patient and Counselor Team will meet regularly throughout the project to guide the design and implementation. Outcomes: Patients treated by counselors trained in the two conditions will be compared on days of substance use, as well as rates of treatment engagement, MAT initiation, and reduction in HIV risk behaviors. If successful, this project can demonstrate an efficient strategy to equip the counseling workforce to employ shared decision making in a group counseling curriculum that treatment providers are immediately prepared to implement.
MeSH Terms:
  • Alcoholism /*therapy
  • Cartoons as Topic
  • Counseling
  • * Curriculum
  • Decision Making
  • Follow-Up Studies
  • * Health Communication
  • * Health Education
  • HIV Infections /prevention & control
  • Humans
  • Mental Health Services /organization & administration
  • Patient-Centered Care
  • Randomized Controlled Trials as Topic
  • Risk-Taking
  • Substance-Related Disorders /*therapy
  • Time Factors
  • United States
Country: United States
State: Pennsylvania
Zip Code: 19106
UI: 20152097
CTgovId: NCT02378181
Project Status: Completed
Record History: ('2019: Project extended to 2019 ',) ('2017: Project extended to 2018',)