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Sergii Dvoriak
01.07.2018 - 31.05.2023

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.

Tetiana Kiriazova
01.06.2017 - 31.05.2022

Fogarty International Center

The aim of this project is to strengthen UIPHP research and training capacity in the areas that are relevant to HIV epidemics in Ukraine. Some topic areas may be in HIV and infectious disease epidemiology; biostatistics; and implementation science, which may include program evaluation and health behavior as relates to HIV/HCV/TB/substance use.

Sergii Dvoriak
15.09.2016 - 30.06.2021

National Institute on Drug Abuse (NIDA)

The aim of this project is to study the effectiveness of the integrated model of health care services in primary care clinics and the interventions for quality improvement of health care services by means of training of physicians and their financial motivation

1. Introduction opiate agonist maintenance treatment in primary healthcare facilities;
2. Setting up a system of tele-education for physicians of primary care clinics - "Improving the effectiveness of community-based health services" (Intervention with Proven Efficiency - Extension for Community Healthcare Outcome);
3. Working out of the model of increase of payment for quality (P4P);
4. Assess of cost-effectiveness of treatment based on comparing the cost of treatment and its efficacy in specialized institutions and in primary care clinics using a modern methodology of cost-effectiveness calculation.
Olena Makarenko
15.10.2020 - 14.10.2021

Providence/Boston CFAR

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.

Kostyantyn Dumchev
28.08.2020 - 28.08.2021

The Western-Eastern European Partnership Initiative on HIV, Viral Hepatitis and TB

Evaluate feasibility and effectiveness of a simplified HCV care and treatment model integrated into OAT programs in Ukraine.

- To develop SHIM and demonstrate its feasibility.

- Using a multi-level implementation science framework, to examine the client, clinician and organizational factors that contribute to SHIM adoption and clinical outcomes.

Tetiana Kiriazova
01.01.2019 - 30.04.2021

Johns Hopkins University

1. Empirically identify and characterize patterns of layered stigma (HIV, drug use, and gender-based) among drug using WLWH in Ukraine.

2. Examine the relationship between patterns of layered stigma identified through LCA and mental health outcomes and engagement in HIV care.

3. Qualitatively explore the association between layered stigma class, mental health, and engagement in HIV care.

Oleksandr Zeziulin
01.10.2018 - 30.06.2021

National Institute of Health

To develop and test a two-step shared decision-making (SDM) aid, with a focus on HIV+ PWID, to promote OAT entry and retention in PWID who have previously or never been prescribed OAT.

Sergii Dvoriak
01.08.2016 - 30.09.2021

Centers for Disease Control and Prevention (CDC)

The purpose of the project is to develop a coherent system of evaluation and quality improvement which can be used by institutions implementing opioid substitution therapy, as well as by national agencies responsible for the implementation and effectiveness of the program.

1. Development of the Adapted clinical guidelines and the Unified clinical protocol of healthcare services.
2. Development of the standard of healthcare services provision.
3. Development, recording and dissemination of video-trainigs for treatment of opioid dependence and comorbid diseases, provision of psychosocial support.
4. Development and piloting of the quality improvement system.
During the project period, the Adapted Clinical Guideline, the Unified Clinical Protocol of healthcare services and the Standard of healthcare services provision "Treatment of Mental and Behavioral Disorders due to the Use of Opioids" were developed. The developed documents are submitted for approval to the Ministry of Health of Ukraine.
In 2017 4 video courses for physicians, nurses, psychologists, and social workers were developed and recorded: 1. Treatment of opioid dependence; 2. Integrated care to people with mental and behavioral disorders due to the use of opioids; 3. Organizational aspects of providing integrated services to people with mental and behavioral disorders due to the use of opioids; 4. Psychosocial support for patients with opioid dependence in accordance with international recommendations and national standards. More than 500 clinicians and other healthcare workers were trained on Public Health Center of Ukraine online platform. 1st and 2nd courses were updated.
The concept of the quality assessment system is developed. It consists of the following components:
1. Regular analysis of data obtained through centralized electronic reporting (the concept has been developed and agreed with donor, implementation has been started on pilot sites)
2. Periodic external evaluation of quality indicators (a monitoring form has been developed and piloted)
3. Periodic sample evaluation of patient satisfaction (the patient satisfaction assessment questionnaire was developed and piloted)
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