Alcohol
Conditions
Brief summary
This will be a pilot study of an alcohol screening, brief intervention, and referral to treatment (SBIRT) program conducted within existing HIV prevention and treatment services for adolescents and young adults (AYA) in Lusaka, Zambia. The screening component of the program will feature both a self-report and a urine biomarker (ethyl glucuronide; EtG) to evaluate recent alcohol use. We will recruit 60 AYA to participate in the pilot. The specific aims of this pilot are to: Specific aims: 1. Explore implementation factors of the SBIRT program within HIV prevention and treatment services through a process evaluation. We will quantitatively track the number of AYA in the SBIRT care cascade: 1) the number screened who have recent alcohol use; 2) the number of those with recent alcohol use who receive the brief intervention (BI); 3) the number of those who are referred for additional treatment; and 4) among those who are referred, the number who successfully link and complete treatment. We will collect time use data from clinic staff and counselors to estimate the time burden required for the SBIRT program. We will conduct 30 in-depth interviews with AYA three months after the screening. The sample will include adolescents who: (1) did not recently use alcohol; (2) received BI due to recent alcohol use that was low/moderate risk; and (3) were referred for treatment due to higher risk alcohol use. Interviews will focus on: (1) implementation factors (e.g., acceptability, feasibility) of the SBIRT program and (2) barriers and facilitators to the program's implementation. Focus group discussions and in-depth interviews will also be conducted with program staff (e.g., counselors, clinic staff) and other stakeholders (e.g., community leaders, policy-makers). 2. Evaluate the preliminary impact of the SBIRT program on AYA alcohol use. Among AYA who have recent alcohol use at screening, we will measure change in use at a three-month follow-up visit.
Interventions
The intervention will consist of a 30 minute alcohol brief intervention based on CETA' substance use reduction element; if warranted, referral will be made for the full CETA intervention, which consists of 6-12 weekly cognitive behavioral therapy-based sessions.
Sponsors
Centre for Infectious Disease Research in Zambia
Columbia University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
16 Years to 24 Years
Healthy volunteers
No
Inclusion criteria
* 16-24 years of age * Residing in Lusaka, Zambia * Meets definition of HIV-affected as evidenced as being involved in HIV testing and treatment and Adolescent Friendly Spaces Programs at the three sites (we will not ask adolescents direct questions about HIV during screening; see Recruitment section).
Exclusion criteria
• Unable or unwilling to provide informed assent/consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) | Baseline, 3-month follow-up |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Ethyl glucuronide rapid dip stick | Baseline, 3-month follow=up | EtG urine dipstick test provides positive/negative result for any alcohol use in past 2-3 days |
Countries
Zambia
Outcome results
None listed