Preventing Drug Use in Low Income Clinic Populations
Paraules clau
Resum
Descripció
The Quit Using Drugs Intervention Trial (QUIT) will be the first randomized controlled trial in the U.S. that is powered to detect the effect of a primary care clinician delivered brief intervention protocol for reducing 'at risk' drug use and drug-related harm among low-income adult patients (ages 18 and older) at multiple safety net clinics in Los Angeles County. For this small trial, we will sample patients with 'at risk' use of drugs (marijuana, crack/cocaine, amphetamines/methamphetamines, inhalants, sedatives or sleeping pills, hallucinogens, and opiates), the most commonly used serious drugs among patients at our clinic sites. "At risk" drug use is defined in this study as current use (past 90 days) of drug measured as a self-reported total score of 4 to 26 on the WHO Alcohol Substance Involvement Screening Test (ASSIST). A total of 7,000-8,000 patients will be approached for screening to yield a 3-month effective sample size of 245 eligible patients per condition (1) an intervention condition involving drug use health education or (2) a control condition involving care as usual. In the intervention condition, very brief (less than 5 minutes) clinician advice regarding quitting drug use will be followed by two 2 and 6 week post-visit drug health education sessions on quitting drug use and cautioning against use of other 'at risk' substance use such as alcohol and tobacco. Patients assigned to the control condition will receive standard care for drug use at the baseline visit with their clinician. Follow-up assessments will be conducted at 3 month post-randomization. The framework for the QUIT project is the Social Action Theory, and the brief intervention protocol is based on NIDA's principles on prevention research and the utility of the 5 A's approach for assisting behavioral changes among patients (Ask, Advise, Assess, Assist, Arrange) in the clinic setting. If found to be effective in the community health center setting, this clinician and telephone drug-use health education program could become a model for health promotion activities. that would be expanded to all 'at risk' substance use and shared between community health centers.
Dates
| Darrera verificació: | 10/31/2016 |
| Primer enviat: | 09/05/2013 |
| Inscripció estimada enviada: | 09/09/2013 |
| Publicat per primera vegada: | 09/15/2013 |
| Última actualització enviada: | 11/15/2016 |
| Publicació de l'última actualització: | 11/17/2016 |
| Data d'inici de l'estudi real: | 12/31/2010 |
| Data estimada de finalització primària: | 01/31/2013 |
| Data estimada de finalització de l’estudi: | 01/31/2013 |
Condició o malaltia
Intervenció / tractament
Behavioral: Intervention
Behavioral: Control
Fase
Grups de braços
| Braç | Intervenció / tractament |
|---|---|
| Experimental: Intervention The Quit Using Drugs Intervention Trial (QUIT) experimental arm includes: screening, very brief clinician advice, and telephone drug-use health education to reduce 'at risk' drug use and thus interrupt progression from casual or episodic abuse to dependence. | Behavioral: Intervention The goal of the Quit Using Drugs Intervention Trial (QUIT) is to conduct a small RCT of a primary care clinic-based very brief intervention protocol for reducing the use of illegal drugs and the occurrences of drug-related harm in low-income, racially-diverse patient populations at two 'safety-net' clinics in Los Angeles. The design will emphasize screening, very brief clinician advice, and telephone drug-use health education to reduce 'at risk' drug use and thus interrupt progression from casual or episodic abuse to dependence. |
| Sham Comparator: Control This arm will receive a sham telephone intervention of equivalent duration on health behavior maintenance. | Behavioral: Control This attention-control arm will receive a sham telephone intervention of equivalent duration on health behavior maintenance. |
Criteris d'elegibilitat
| Edats elegibles per estudiar | 18 Years Per a 18 Years |
| Sexes elegibles per estudiar | All |
| Accepta voluntaris saludables | Sí |
| Criteris | Inclusion Criteria: - ages 18 and older - report of drug use in the previous 90 days (i.e., (marijuana, crack/cocaine, amphetamines/methamphetamines, inhalants, sedatives or sleeping pills, hallucinogens, and opiates) - an ASSIST score between 4 and 26 indicating 'at risk' drug use - English or Spanish speaking - able (not cognitively impaired) and willing to cooperate with data collection and research procedures, including 2 telephone counseling sessions and 3 month follow-up assessments Exclusion Criteria: - Pregnant - Drug or alcohol dependence |
Resultat
Mesures de resultats primaris
1. Change from Baseline of Self-reported number of drug-free days at 3 month [past 30 and 90 days]
Mesures de resultats secundaris
1. Decrease in drug-related harm (e.g., unemployment and job absenteeism, poor social support, poor health-related quality of life, HIV risk behaviors, motor vehicle accidents, and inpatient health services utilization). [6 and 12 months post randomization]
