title: Mobile technology intervention to improve care coordination between HIV and substance use treatment providers: development, training, and evaluation protocol.
abstract: People living with HIV (PLWH) with a substance use disorder (SUD) tend to receive inadequate medical care in part because of a siloed healthcare system in which HIV and substance use services are delivered separately. Ideal treatment requires an interdisciplinary, team-based coordinated care approach, but many structural and systemic barriers impede the integration of HIV and SUD services. The current protocol describes the development and preliminary evaluation of a care coordination intervention (CCI), consisting of a tablet-based mobile platform for HIV and SUD treatment providers, an interagency communication protocol, and a training protocol. We hypothesize that HIV and SUD treatment providers will find the CCI to be acceptable, and that after receipt of the CCI, providers will: exhibit higher retention in dual care among patients, report increased frequency and quality of communication, and report increased rates of relational coordination.
  
  
  
  A three phase approach is used to refine and evaluate the CCI. Phase 1 consists of in-depth qualitative interviews with 8 key stakeholders as well as clinical audits of participating HIV and SUD treatment agencies. Phase 2 contains functionality testing of the mobile platform with frontline HIV and SUD treatment providers, followed by refinement of the CCI. Phase 3 consists of a pre-, post-test trial with 30 SUD and 30 HIV treatment providers. Data will be collected at the provider, organization, and patient levels. Providers will complete assessments at baseline, immediately post-training, and at 1-, 3-, and 6-months post-training. Organizational data will be collected at baseline, 1-, 3-, and 6-months post training, while patient data will be collected at baseline and 6-months post training.
  
  
  
  This study will develop and evaluate a CCI consisting of a tablet-based mobile platform for treatment providers, an interagency communication protocol, and a training protocol as a means of improving the integration of care for PLWH who have a SUD. Results have the potential to advance the field by bridging gaps in a fragmented healthcare system, and improving treatment efficiency, work flow, and communication among interdisciplinary providers from different treatment settings.
  
  
  
  NCT02906215.
authors.affiliation: Department of Medicine, Division of General Internal Medicine, Rhode Island Hospital, 111 Plain Street, Providence, RI, 02903, USA. kasey_claborn@brown.edu.|The Warren Alpert Medical School, Brown University, Box G-BH, Providence, RI, 02912, USA. kasey_claborn@brown.edu.
authors.forename: Kasey
authors.initials: K
authors.lastname: Claborn
authors.affiliation: The Warren Alpert Medical School, Brown University, Box G-BH, Providence, RI, 02912, USA.|Center for Alcohol and Addiction Studies, Brown University School of Public Health, 121 South Main Street, Box G-121-5, Providence, RI, 02912, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Becker
authors.affiliation: Department of Medicine, Division of General Internal Medicine, Rhode Island Hospital, 111 Plain Street, Providence, RI, 02903, USA.|The Warren Alpert Medical School, Brown University, Box G-BH, Providence, RI, 02912, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Ramsey
authors.affiliation: The Warren Alpert Medical School, Brown University, Box G-BH, Providence, RI, 02912, USA.|Miriam Hospital, Providence, RI, 02906, USA.
authors.forename: Josiah
authors.initials: J
authors.lastname: Rich
authors.affiliation: Office of Research, Department of Medicine, University of Massachusetts - Baystate and Baystate Health, Springfield, MA, USA.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Friedmann
mesh_terms: D002985:Clinical Protocols; D005260:Female; D015658:HIV Infections / Q000628:therapy*; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration*; D008297:Male; D009936:Organizational Innovation; D010346:Patient Care Management; D018802:Patient-Centered Care / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration; D019966:Substance-Related Disorders / Q000628:therapy*; D017216:Telemedicine / Q000706:statistics & numerical data*
keywords: Addiction; Communication; HIV; Mobile technology; Treatment providers