National Institute on Drug Abuse (NIDA)
The aim of this project is to study the effectiveness of the modified SBIRT, where instead of offsite psychiatric referral, depression is treated onsite using SSRIs. Also, we will use ECHO (Extension for Community Healthcare Outcomes), a collaborative learning process, to facilitate mSBIRT activities and reinforce integration of COD services in OAT clinics.To enhance ECHO implementation, evidence-based pay-forperformance (P4P) intervention, aligned with Ukraine’s health reform, will be added to determine if incremental benefits are derived from this EBP, in an effort to strengthen and support ongoing healthcare reform efforts in Ukraine.
1. To compare both service-level (screening and brief intervention adoption and penetration) and patient-level (SSRI initiation, OAT drop-out and psychiatric quality of life) outcomes in 1,350 patients with opioid use disorders receiving OAT from 4 regions (clusters) and 12 clinical settings using a randomized, cluster-controlled design over 24 months. Before site randomization, all OAT clients at each participating site will have baseline assessments followed by site randomization to receive standard of care (N=450) versus integrated care using ECHO-COD facilitation with (N=450) or without (N=450) P4P incentives;
2. Using a multi-level implementation science framework, to examine the contribution of client, clinician and organizational factors that contribute to the primary and secondary outcomes;
3. To conduct a cost-effectiveness analysis (CEA) of integrating COD services into OAT clinics, with or without P4P, compared to a control group of OAT sites.
Machavariani E., Bromberg D., Dumchev K., Dvoriak S., Zeziulin O., Morozova O., Esserman D., Pykalo I., Saichuk N., Ivasiy R., Haddad M., Altice F. Design, implementation and preliminary results of a type-2 hybrid cluster-randomized trial of integrating screening and treatment for major depressive disorder into specialty clinics providing opioid agonist therapies in Ukraine. Contemporary Clinical Trials, 2023 May 30
Centers for Disease Control and Prevention (CDC)
This study assesses the effectiveness of the MARTAS - Modified effective “Anti-Retroviral Treatment and Access to Services” (ARTAS) intervention. This is a case management - based individual-level, multi-session intervention for people who are recently diagnosed with HIV in narcology, TB, and STIs clinics in order to help them link to and be retained in HIV care.
Our study aims to examine alcohol consumption and the prevalence of alcohol use disorders, as well as comorbidities including smoking, substance use, and mental health of people living with HIV and TB co-infection in Ukraine. This study will also provide data on participants’ willingness to engage in treatment for these comorbidities and explore participants’ readiness for reduction of alcohol intake, addiction treatment and depression treatment.
The Global Fund to Fight AIDS, Tuberculosis and Malaria
Identifying the main mechanisms and ways to involve injecting drug users and men who have sex with men to receive primary care services.
- To find out the general perception of PWID and MSM to family doctors and the readiness to receive medical services, including those related to HIV, at the primary care;
- Identify existing and in-demand primary care services for PWID and MSM;
- Identify the main barriers and factors that contribute to the treatment of PWID and MSM for the primary care services;
- Identify existing and in-demand sources and channels of information about the primary care services for PWID and MSM (including potential messages, topics, etc.);
- Determine the perception and willingness of NGO representatives to work with family physicians to provide services to PWID and MSM in the prevention and treatment of HIV, hepatitis C, tuberculosis and other socially dangerous diseases;
- To find out the existing and demanded role of family doctors in providing services to PWID and MSM in the prevention and treatment of HIV, hepatitis C, tuberculosis and other socially dangerous diseases;
- To identify the existing mechanism of interaction between PWID/MSM, NGOs and family doctors in the context of receiving medical services, including those related to HIV prevention;
- To identify the optimal model of interaction between PWID/MSM, NGOs and family doctors in the context of receiving medical services, including those related to HIV prevention;
- Provide recommendations for increasing the demand for PWID and MSM to receive primary care services, communication strategy for it and establishing a process of interaction between PWID / MSM, NGOs and family physicians.
World Health Organization
The study will look at the feasibility and impact of expanding the availability and accessibility of community management of opioid overdose (including training and take-home naloxone) in participating countries/sites.
The study will produce evidence on the implementation barriers and facilitators for community management of opioid overdose, including trainings, outreach activities and settings that are better placed to reach many people at risk to prevent opioid overdose. The initiative's targets include saving lives by making naloxone and training on overdose management available to all people likely to witness an overdose, including peers and family members. The initiative sets a global implementation target of 90-90-90 as a joint point of reference:
1) 90 per cent of the relevant target population should be trained in overdose risk and emergency management;
2) 90 per cent of those trained should carry take-home naloxone;
3) 90 per cent of those who have been given a naloxone supply should use naloxone at overdoses they witness.
The Providence/Boston (Center for AIDS Research) CFAR
Retrospective assessment of pediatric TB in Ukraine. Prospective assessment of active TB among children in Ukraine.
1. To define real mortality from TB among children (HIV-positive and HIV-negative) in 2 regions of Ukraine.
2. To document the number of bacteriologically confirmed and clinically diagnosed cases of TB among children in 2 regions of Ukraine.
World Health Organization
Evaluation of changes of clinical practice of those primary health care workers who completed Essential Training on the Integrated Management of Hypertension and Diabetes in 7 pilot regions.
- To understand how the training was able to influence changes in PHC clinical practice in pilots in order to plan further improvements/adjustments of training’s content and teaching approaches, but also to identify other factors that need to be strengthened at PHC level for better NCDs prevention, early detection, care and support.;
- The evaluation of the project is planned to be carried out using three data collection approaches. Changes in risk assessment and treatment practices and outcomes will be evaluated by collecting information from patient records. Organizational changes in clinics and changes in division of tasks will be assessed performing observations of patient pathways. Focus group interview will be carried out to assess professionals’ opinions on effects of training in changing the practice and related possibilities and challenges.
Using qualitative interviews with HIV care providers and with 50yo+ patients diagnosed with HIV in the last 6 months, to explore diverse factors that shape HIV risk and HIV care engagement for HIV+ 50yo+, and challenges experienced by HIV care providers in reaching and servicing this population.
1) Explore HIV care providers’ views on what factors shape (dis-)engagement with HIV care for their 50yo+ clients newly diagnosed with HIV, what challenges they experience when working with this population group, and how they respond to these challenges.
2) Describe the patient-level factors that shape HIV risk practices and health expectations for 50 yo+ newly diagnosed with HIV.
3) An additional strength of this study is to further quantitative study of 100 patients views on how the pandemic coronavirus and quarantine affected the life and behavior of 50+ patients with HIV-positive diagnosis, including their understanding of the risks СOVID-19, HIV and other diseases during the quarantine and how patients cope with these difficulties.