Depression Clinical Trial
— Latino-SMARTOfficial title:
An Adaptive Treatment Intervention for Depression and Engagement in HIV Care Among Latinos Living With HIV
Verified date | August 2022 |
Source | University of California, San Francisco |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This study will use a pilot sequential multiple assignment randomized trial (SMART) design to build an adaptive treatment strategy (ATS) for depression and engagement in HIV among Latinos living with HIV. The ATS is the sequencing of treatments, which are a behavioral activation therapy (BAT), a cognitive-behavioral therapy (CBT), and mobile health (mHealth) tool. The outcomes are to assess the feasibility of the SMART and ATS in the HIV care site and acceptability of the SMART and ATS to patients and clinic staff.
Status | Completed |
Enrollment | 13 |
Est. completion date | August 28, 2022 |
Est. primary completion date | August 28, 2022 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - HIV positive - 18 years of age and older - Self identifies as Latino/Hispanic - Fluent in English or Spanish - Receives HIV care at study site clinic - Has a moderate depression severity score or higher (Patient Health Questionnaire-9 score >9; PHQ) - Agrees to discuss depression, treatment preferences, and mobile health - Owns a mobile phone that can send/receive short-message service (SMS) text messages - Agrees to participate in the intervention that lasts three months - Agrees to have medical and clinical data abstracted one year after baseline - Able and willing to consent to participate Exclusion Criteria: - Not HIV positive - Under 18 years of age - Does not self-identify as Latino/Hispanic - Not fluent in English or Spanish - Does not receive primary HIV care at the study site - Has a less than moderate depression severity score (Patient Health Questionnaire-9 score =9; PHQ) - Does not agree to discuss depression, treatment preferences, and mobile health - Does not owns a mobile phone that can send/receive short-message service (SMS) text messages - Does not agree to participate in the intervention that lasts three months - Does not agree to have medical and clinical data abstracted one year after baseline - Not able and willing to consent to participate |
Country | Name | City | State |
---|---|---|---|
United States | Ward 86 HIV Clinic, Zuckerberg San Francisco General Hospital | San Francisco | California |
Lead Sponsor | Collaborator |
---|---|
University of California, San Francisco | National Institute of Mental Health (NIMH) |
United States,
Almirall D, Compton SN, Gunlicks-Stoessel M, Duan N, Murphy SA. Designing a pilot sequential multiple assignment randomized trial for developing an adaptive treatment strategy. Stat Med. 2012 Jul 30;31(17):1887-902. doi: 10.1002/sim.4512. Epub 2012 Mar 22. — View Citation
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Pfeiffer PN, Bohnert KM, Zivin K, Yosef M, Valenstein M, Aikens JE, Piette JD. Mobile health monitoring to characterize depression symptom trajectories in primary care. J Affect Disord. 2015 Mar 15;174:281-6. doi: 10.1016/j.jad.2014.11.040. Epub 2014 Nov 28. — View Citation
Safren SA, O'Cleirigh C, Tan JY, Raminani SR, Reilly LC, Otto MW, Mayer KH. A randomized controlled trial of cognitive behavioral therapy for adherence and depression (CBT-AD) in HIV-infected individuals. Health Psychol. 2009 Jan;28(1):1-10. doi: 10.1037/a0012715. — View Citation
Simoni JM, Wiebe JS, Sauceda JA, Huh D, Sanchez G, Longoria V, Andres Bedoya C, Safren SA. A preliminary RCT of CBT-AD for adherence and depression among HIV-positive Latinos on the U.S.-Mexico border: the Nuevo Día study. AIDS Behav. 2013 Oct;17(8):2816-29. doi: 10.1007/s10461-013-0538-5. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Composite measure of feasibility for the adaptive treatment strategy (ATS) | This is one composite measure. Feasibility of the adaptive treatment strategy (ATS) will be measured to assess whether the ATS is appropriate for further testing, relevant and sustainable. Feasibility of the ATS will be reported as a composite score of the following measures taken at the end of the second-stage treatment: Total number of participants screened, eligible and enrolled; At least 80% of all BAT & CBT sessions completed; 80% retention of participants across all "outcome groups". |
4 months | |
Primary | Composite measure of acceptability for the adaptive treatment strategy (ATS) | This is one composite measure. Acceptability of the adaptive treatment strategy will be measured to determine the tolerability or appropriateness of the SMART intervention from the perspective of both participants and clinicians.Acceptability of the ATS will be reported as a composite score of the following measures taken at the end of the second-stage treatment: Greater than 90% adherence to the BAT & CBT session schedule; Responsiveness to text-messages: a) >80% of all two-way messages replied back to study line during the set of blocked hours; b) >90% of participants reporting direct benefit from one-way text messages; Acceptability responses coded from post-intervention exit interview transcripts; Limited number of barriers to participation reported by participants in exit interviews; Responses to a brief survey (to be developed) assessing clinic staff acceptability of the intervention. |
4 months | |
Secondary | Self-reported Adherence to Antiretroviral Therapy (ART) | Self-reported adherence will be measured using the the visual analog scale (VAS), a 10-cm line on which participants indicate the percentage of doses (intervals of 10 percentage points indicated from 0% to 100%) of all HIV medications taken in the past 30 days (Amico et al., 2006). This measure will be used for descriptive purposes. | 12 months | |
Secondary | Viral Load | Viral load measures the amount of HIV virus in the blood. Viral load data abstracted from patient medical records will act as a descriptive measure of HIV-related clinical outcomes. | 12 months | |
Secondary | Patient Health Questionnaire-9 (PHQ-9) | The PHQ-9 is a survey tool used to screen, diagnose, monitor and measure self-reported depressive symptoms. The tool rates the frequency of symptoms in order to score the severity of symptoms. Changes in PHQ-9 scores from baseline will be used for descriptive purposes. | 12 months | |
Secondary | Engagement in HIV Care | Engagement in care will be measured utilizing the multidimensional index of engagement in HIV care, a 10-item unit-dimensional patient-centered scale that assesses provider, clinic, and patient-level characteristics associated with being engaged in HIV care. This measure will be used for descriptive purposes. | 12 months |
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