title: Training and fidelity monitoring of alcohol treatment interventions integrated into routine tuberculosis care in Tomsk, Russia: the IMPACT Effectiveness Trial.
abstract: IMPACT (Integrated Management of Physician-Delivered Alcohol Care for Tuberculosis patients) is a randomized, controlled effectiveness trial based in Tomsk, Russia, that assesses the effect of oral naltrexone and brief behavioral counseling on tuberculosis outcomes and alcohol use in 200 patients. Tuberculosis physicians without addiction experience delivered interventions as part of routine care over a 6-month period, focusing on alcohol intake reduction to support successful tuberculosis treatment. We describe design, training, and fidelity monitoring using a Russian and American team of physicians, bilingual coders, and supervisors. Culturally appropriate adaptations, limitations, and implications for future trials are discussed. The clinical trial identification number is NCT00675961. Funding came from the National Institutes of Health and National Institute on Drug Abuse.
authors.affiliation: Alcohol and Drug Abuse Treatment Program, McLean Hospital, Belmont, Massachusetts 02478, USA. hconnery@mclean.harvard.edu
authors.forename: Hilary
authors.initials: H
authors.lastname: Connery
authors.forename: Shelly
authors.initials: S
authors.lastname: Greenfield
authors.forename: Viktoriya
authors.initials: V
authors.lastname: Livchits
authors.forename: Lana
authors.initials: L
authors.lastname: McGrady
authors.forename: Nickolette
authors.initials: N
authors.lastname: Patrick
authors.forename: Charmaine S
authors.initials: CS
authors.lastname: Lastimoso
authors.forename: Jessica H
authors.initials: JH
authors.lastname: Heney
authors.forename: Adrianne Katrina
authors.initials: AK
authors.lastname: Nelson
authors.forename: Alan
authors.initials: A
authors.lastname: Shields
authors.forename: Yekaterina P
authors.initials: YP
authors.lastname: Stepanova
authors.forename: Lidia Y
authors.initials: LY
authors.lastname: Petrova
authors.forename: Oleg V
authors.initials: OV
authors.lastname: Anastasov
authors.forename: Olga I
authors.initials: OI
authors.lastname: Novoseltseva
authors.forename: Sonya S
authors.initials: SS
authors.lastname: Shin
mesh_terms: D000437:Alcoholism / Q000150:complications / Q000188:drug therapy*; D019983:Guideline Adherence; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use; D010820:Physicians; D012426:Russia; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy*
chemical_list: D009292:Narcotic Antagonists; D009271:Naltrexone