Advertisement

AIDS and Behavior

, Volume 17, Issue 9, pp 2902–2913 | Cite as

A Randomized Controlled Trial of the Community-Friendly Health Recovery Program (CHRP) Among High-Risk Drug Users in Treatment

  • Michael M. Copenhaver
  • I-Ching Lee
  • Patrick Baldwin
Original Paper

Abstract

Existing evidence-based HIV risk reduction interventions have not been designed for implementation within clinical settings, such as methadone maintenance programs, where many high-risk drug users seek treatment services. We therefore systematically developed an adapted, significantly shortened, version of a comprehensive evidence-based intervention called the Community-friendly Health Recovery Program (CHRP) which has demonstrated preliminary evidence of efficacy in a feasibility/acceptability study already published. In a randomized controlled trial reported here, we tested the efficacy of the CHRP intervention among high-risk drug users newly enrolled in drug treatment at an inner-city methadone maintenance program. The CHRP intervention produced improvements in drug risk reduction knowledge as well as demonstrated sex- and drug-risk reduction skills. Support was found for the IMB model of health behavior change. Implications for future intervention research and practice are considered.

Keywords

HIV risk reduction Behavioral intervention Drug use Intervention adaptation 

Resumen

Intervenciones riesgo del VIH existentes reducción del basada en la evidencia no han sido diseñadas para aplicación en contextos clínicos, tales como programas de mantenimiento con metadona, donde muchos usuarios de drogas de alto riesgo buscan servicios de tratamiento. Por lo tanto desarrollamos sistemáticamente una versión adaptada, acortada significativamente, de una intervención integral basada en la evidencia llamada la comunidad ambiente salud recuperación programa (CHRP) que ha demostrado la evidencia preliminar de eficacia en un estudio de viabilidad/aceptabilidad ya publicado. En un ensayo controlado aleatorio (ECA) divulgado aquí, hemos probado la eficacia de la intervención CHRP entre usuarios de drogas de altoriesgo recién matriculados en el tratamiento de drogas en un programa de mantenimiento con metadona del centro de la ciudad. La intervención CHRP produjeron mejorías en el conocimiento de reducción de riesgo de drogas así como había demostrado capacidades de reducción de riesgo de sexo y drogas. Apoyo encontró para el modelo IMB de cambio de comportamiento de salud. Implicaciones para futuras intervenciones investigación y la práctica se consideran.

Notes

Acknowledgments

Funding to support the design and conduct of this research and the preparation of this manuscript was provided by a National Institute on Drug Abuse (NIDA) Grants (R01-DA022122; K02DA033139) to Michael M. Copenhaver.

References

  1. 1.
    CDC. Estimated HIV incidence in the United States, 2007–2010. HIV Surveillance Supplemental Report 2012. http://www.cdc.gov/hiv/topics/surveillance/basic.htm#incidence. Accessed 12 June 2013.
  2. 2.
    Avants SK, Margolin A, Usubiaga MH, Doebrick C. Targeting HIV-related outcomes with intravenous drug users maintained on methadone: a randomized clinical trial of a harm reduction group therapy. J Subst Abuse Treat. 2004;26:67–78.PubMedCrossRefGoogle Scholar
  3. 3.
    Institute of Medicine. Bridging the gap between practice and research: forging partnerships with community-based drug and alcohol treatment. Washington: National Academy Press; 1998.Google Scholar
  4. 4.
    Sholomskas DE, Syracuse-Siewert G, Rounsaville BJ, Ball SA, Nuro KF, Carroll M. We don’t train in vain: a dissemination trial of three strategies of training clinicians in cognitive-behavioral therapy. J Consult Clin Psychol. 2005;73(1):106–15.PubMedCrossRefGoogle Scholar
  5. 5.
    Morgenstern J, Morgan TJ, McCrady BS, Keller DS, Carroll KM. Manual-guided cognitive behavioral therapy training: a promising method for disseminating empirically supported substance abuse treatments to the practice community. Psychol Addict Behav. 2001;15:83–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Copenhaver MM, Lee IC, Margolin A. Successfully integrating an HIV risk reduction intervention into a Community-Based Substance Abuse Treatment Program. Am J Drug Alcohol Abuse. 2007;33:109–20.PubMedCrossRefGoogle Scholar
  7. 7.
    Fisher JD, Fisher WA. Changing AIDS-risk behavior. Psychol Bull. 1992;111(3):455–74.PubMedCrossRefGoogle Scholar
  8. 8.
    Fisher JD, Amico KR, Fisher WA, Harman JJ. The information motivation-behavioral skills model of antiretroviral adherence and its applications. Curr HIV/AIDS Rep. 2008;5(4):193–203.PubMedCrossRefGoogle Scholar
  9. 9.
    Copenhaver MM, Lee IC. Optimizing a community-friendly HIV risk reduction Intervention for drug users in treatment: a structural equation modeling approach. J Urb Health. 2006;83(6):1132–42.CrossRefGoogle Scholar
  10. 10.
    Fisher JD, Cornman DH, Osborn CY, Amico KR, Fisher WA, Friedland GA. Clinician-initiated HIV risk reduction intervention for HIV-positive persons: formative research, acceptability, and fidelity of the OPTIONS project. J Acquir Immune Defic Syndr. 2004;37(2):S78–87.PubMedCrossRefGoogle Scholar
  11. 11.
    Margolin A, Avants SK, Warburton LA, Hawkins KA, Shi J. A randomized clinical trial of a manual-guided risk reduction intervention for HIV-positive injection drug users. Health Psychol. 2003;22(2):223–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Copenhaver M, Avants SK, Margolin A, Warburton LA. Intervening effectively with drug abusers infected with HIV: taking into account the potential for cognitive impairment. J Psychoact Drugs. 2003;35(2):209–18.CrossRefGoogle Scholar
  13. 13.
    Carroll KM, Nich C, Sifiy RL, Nuro KF, Frankforter TL, Ball SA, et al. A general system for evaluating therapist adherence and competence in psychotherapy research in the addictive disorders. J Drug Alcohol Depend. 2000;57:225–38.CrossRefGoogle Scholar
  14. 14.
    Fisher JD, Fisher WA, Shuper PA. The information–motivation–behavioral skills model of HIV preventive behavior. In: DiClemente RJ, Crosby RA, Kegler M, editors. Emerging theories in health promotion practice and research. San Francisco: Jossey-Bass; 2009. p. 21–64.Google Scholar
  15. 15.
    Bryan A, Schmiege SJ, Broaddus MR. Mediational analysis in HIV/AIDS research: estimating multivariate path analytic models in a structural equation modeling framework. AIDS Behav. 2007;11:365–83.PubMedCrossRefGoogle Scholar
  16. 16.
    Metzger DS, Navaline H, Woody G. Drug abuse treatment as AIDS prevention. Public Health Rep. 1998;113:97–106.PubMedGoogle Scholar
  17. 17.
    Kalichman SC, Stevenson LY. Psychological and social factors associated with histories of risk for human immunodeficiency virus infection among African-American inner-city women. J Women’s Health. 1997;6:209–17.CrossRefGoogle Scholar
  18. 18.
    Minnis, A. M., Muchini, A., Shiboski, S., Mwale, M., Morrison, C., Chipato, T., & Padian, N. S. (2007). Audio computer-assisted self-interviewing in reproductive health research: reliability assessment among women in Harare, Zimbabwe. Contraception, 75(1), 59–65. Retrived from, http://www.contraceptionjournal.org/.
  19. 19.
    Brener ND, Billy JOG, Grady WR. Assessment of factors affecting the validity of self-reported health-rish behavior among adolescents: evidence from the scientific literature. J Adolesc Health. 2003;33:436–57.PubMedCrossRefGoogle Scholar
  20. 20.
    Turner CF, Rogers SM, Hendershot TP, Miller HG, Thornberry JP. Improving representation of linguistic minorities in health surveys. Public Health Rep. 1996;111:276–9.PubMedGoogle Scholar
  21. 21.
    Peterson RA. A meta-analysis of Cronbach’s coefficient alpha. J Consum Res. 1994;21:381–91.CrossRefGoogle Scholar
  22. 22.
    Peterson RA, Kim Y. On the relationship between coefficient alpha and composite reliability. J Appl Psychol. 2013;98:194–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Michael M. Copenhaver
    • 1
  • I-Ching Lee
    • 2
    • 3
  • Patrick Baldwin
    • 4
  1. 1.Department of Allied Health SciencesUniversity of ConnecticutStorrsUSA
  2. 2.Department of PsychologyNational Chengchi UniversityTaipeiTaiwan
  3. 3.Center for Mind, Brain, & LearningNational Chengchi UniversityTaipeiTaiwan
  4. 4.APT Foundation, Inc.New HavenUSA

Personalised recommendations