Completed
Increasing HCV Knowledge and Service Use in Drug Treatment Programs (STOP HEP C Project)
Funding Source: National Institute on Drug Abuse
Funding Period: 2000-2010
Principal Investigator: Shiela M. Strauss, Ph.D.
CDUHR Co-Investigator(s): Don C. Des Jarlais, Ph.D; Marya V. Gwadz, Ph.D., Holly Hagan, Ph.D.; Andrew Osborne, M.S.Ed.
This is a competing continuation of the HCV Service Innovations in Drug Treatment Programs study. In the initial study, data collected from patients, staff, and managers in drug treatment programs showed that the hepatitis C virus (HCV) education provided to patients and staff is often inadequate, and HCV services are seriously underutilized. This is especially unfortunate because of the high prevalence of HCV among drug users, especially those co-infected with HIV, and their pressing need for information about, and services for HCV.
Drug treatment programs are uniquely situated to educate, counsel, and test drug users for HCV and HIV, and facilitate their access to medical treatment. However, there are gaps in drug treatment programs current provision of HCV services, and patients often do not use the limited services that do exist. Because communication with staff can affect patients health behaviors, staffs encouragement of the use of existing HCV services is essential. Few staff, however, know what to tell patients about HCV, how to help them deal with test results, and how to counsel them about medical treatment. The need is especially great when dealing with patients co-infected with HIV and HCV, whose medical management is significantly more complicated because of the dual infection.
By addressing the expressed need of treatment staff for an evidence-based HCV training, this study will assess whether such a training can improve staffs HCV and HCV/HIV knowledge, attitudes, intentions and behaviors, and if so, whether it will lead to benefits to patients and the drug treatment organization. (Click here for a description of the training.) Guided by Social Cognitive Theory and the Information-Motivation-Behavioral Skills Model, the Specific Aims are: (1) To develop a staff intervention that includes current HCV information and training in how to best communicate with patients about HCV and HIV/HCV co-infection issues; (2) To examine the interventions impact over time on staffs knowledge about HCV and HCV/HIV co-infection, and their attitudes, self-efficacy, intentions and behaviors to encourage their patients to use HCV services; and (3) To examine the impact of the intervention over time on: (a) Patients HCV/HIV knowledge, attitudes, intentions, and actual use of HCV services; and on (b) The drug treatment organizations intentions toward, and actual expansion of HCV services, as well as its climate toward dealing with HCV and HCV/HIV co-infection.
The intervention will be delivered to staff in 24 drug treatment programs in the four U.S. census regions, equally divided among drug-free and methadone programs: 16 programs will be randomly assigned to an intervention condition, and 8 to a control group (delayed intervention). The interventions effectiveness will be examined by analyzing qualitative and quantitative data collected from the director, staff, and patients in the intervention and control condition programs.
Successful elements of the training will be disseminated to programs nationwide.
Project Fact Sheet Stop Hep C Project Fact Sheet
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Munoz-Plaza, C., Strauss, S. M., Tiburcio, N., Astone-Twerell, J., Des Jarlais, D. C., Gwadz, M., Hagan, H., Osborne, A., & Rosenblum, A. (2010). Perspectives on the hierarchy of HIV and hepatitis C disease: Consequences for drug treatment program patients. Journal of Drug Issues, 40 (2), 517-536.
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Munoz-Plaza, C. E., Strauss, S., Astone-Twerell, J., Des Jarlais, D., Gwadz, M., Hagan, H., Osborne, A., & Rosenblum, A. (2008). Exploring drug users' attitudes and decisions regarding hepatitis C (HCV) treatment in the U.S.. International Journal of Drug Policy, 19 (1), 71-78.
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Strauss, S. M., Munoz-Plaza, C., Tiburcio, N. J., Astone-Twerell, J., Des Jarlais, D. C., Gwadz, M., Hagan, H., Osborne, A., & Rosenblum, A. (2008). Barriers and facilitators to undergoing hepatitis C virus (HCV) testing through drug treatment programs. Journal of Drug Issues, 38 (4), 1161-1185.
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Strauss, S. M., Astone-Twerell, J. M., Munoz-Plaza, C., Des Jarlais, D. C., Gwadz, M., Hagan, H., Osborne, A., & Rosenblum, A. (2007). Correlates of drug treatment program staff's self efficacy to support their clients' hepatitis C virus (HCV) related needs. American Journal of Drug and Alcohol Abuse, 33 (2), 245-251.
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Strauss, S. M., Astone-Twerell, J., Munoz-Plaza, C. E., Des Jarlais, D. C., Gwadz, M., Hagan, H., Osborne, A., & Rosenblum, A. (2007). Drug treatment program patients' hepatitis C virus (HCV) education needs and their use of available HCV education services. BMC Health Services Research, 7, 39.
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Astone-Twerell, J. M., Strauss, S. M., Hagan, H., & Des Jarlais, D. C. (2006). Drug treatment programs’ HCV service delivery to their HCV positive clients. Addiction Research and Theory, 14 (3), 289-302.
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Astone-Twerell, J., Strauss, S. M., & Munoz-Plaza, C. (2006). Stigma2: Hepatitis C and drug abuse. HCV Advocate - Medical Writers' Circle.
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Munoz-Plaza, C. E., Strauss, S. M., Astone-Twerell, J., Des Jarlais, D. C., & Hagan, H. (2006). Staff perspectives on facilitating the implementation of hepatitis C services at drug treatment programs. Journal of Psychoactive Drugs, 38 (3), 233-241.
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Strauss, S. M., Astone-Twerell, J. M., Munoz-Plaza, C., Des Jarlais, D. C., Gwadz, M., Hagan, H., Osborne, A., & Rosenblum, A. (2006). Hepatitis C knowledge among staff in U.S. drug treatment programs. Journal of Drug Education, 36 (2), 141-158.
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Strauss, S. M., Rindskopf, D. M., Astone-Twerell, J. M., Des Jarlais, D. C., & Hagan, H. (2006). Using latent class analysis to identify patterns of hepatitis C service provision in drug-free treatment programs in the US. Drug and Alcohol Dependence, 83 (1), 15-24.
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Astone, J. M., Strauss, S. M., Munoz-Plaza, C., Hagan, H., & Des Jarlais, D. C. (2005). Providing support to drug users infected with hepatitis C: The role of methadone maintenance treatment staff. Journal of Maintenance in the Addictions, 3 (1), 33-46.
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Hagan, H., Strauss, S. M., Astone, J. M., & Des Jarlais, D. C. (2005). Medical examinations to treatment for drug abuse as an opportunity to initiate care for hepatitis C virus infection. Clinical Infectious Diseases, 40 (Supplement 5), S297-S303.
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Munoz-Plaza, C. E., Strauss, S. M., Astone, J. M., Des Jarlais, D. C., & Hagan, H. (2005). Hepatitis C service delivery in prisons: Peer education from the "Guys in Blue". Journal of Correctional Health Care, 11 (4), 347-368.
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Munoz-Plaza, C. E., Strauss, S. M., Astone, J. M., Des Jarlais, D. C., & Hagan, H. (2005). HCV (hepatitis C virus) pre-test and post-test counseling services at drug treatment programs: Missed opportunities for primary prevention. Contemporary Drug Problems, 32 (4), 655-675.
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Strauss, S. M., Astone, J. M., Des Jarlais, D. C., & Hagan, H. (2005). Integrating hepatitis C services into existing HIV services: The experiences of a sample of U.S. drug treatment units. AIDS Patient Care and STDs, 19 (2), 78-88.
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Strauss, S. M., Astone, J. M., Munoz-Plaza, C., Hagan, H., & Des Jarlais, D. (2005). Residential substance user treatment programs as venues for HCV pharmacological treatment: Client and staff perspectives. Substance Use and Misuse, 40 (12), 1181-1829.
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Astone, J. M., Strauss, S. M., Hagan, H., & Des Jarlais, D. C. (2004). Outpatient drug treatment program directors’ hepatitis-C related beliefs and their relationship to the provision of HCV services. American Journal of Drug and Alcohol Abuse, 30 (4), 783-797.
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Munoz-Plaza, C. E., Strauss, S. M., Astone, J. M., Des Jarlais, D. C., & Hagan, H. (2004). Drug treatment programs as sites of opportunity for the delivery of hepatitis C prevention education: Client and staff perspectives. Journal of Drug Issues, 34 (4), 861-878.
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Strauss, S. M., & Astone, J. M. (2004). The importance of eliminating alcohol use if chronically infected with HCV. HCV Advocate - Medical Writers' Circle.
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Strauss, S. M., Astone, J. M., Des Jarlais, D., & Hagan, H. (2004). A comparison of HCV antibody testing in drug-free and methadone maintenance treatment programs in the United States. Drug and Alcohol Dependence, 73 (3), 227-236.
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Strauss, S. M., Astone, J. M., Hagan, H., & Des Jarlais, D. C. (2004). The content and comprehensiveness of hepatitis C education in methadone maintenance and drug-free treatment units. Journal of Urban Health, 81 (1), 38-47.
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Vassilev, Z. P., Strauss, S. M., Astone, J., & Des Jarlais, D. C. (2004). Injection drug users and the provision of hepatitis C-related services in a nationwide sample of drug treatment programs. Journal of Behavioral Health Services and Research, 31 (2), 208-216.
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Vassilev, Z. P., Strauss, S. M., Astone, J., Friedmann, P. D., & Des Jarlais, D. C. (2004). Provision of on-site medical care to patients with hepatitis C in drug treatment units. Journal of Health Care for the Poor and Underserved, 15 (4), 663-671.
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Astone, J., Strauss, S. M., Vassilev, Z. P., & Des Jarlais, D. C. (2003). Provision of hepatitis C education in a nationwide sample of drug treatment programs. Journal of Drug Education, 33 (1), 107-117.
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Strauss, S. M. (2003). HCV services offered by drug treatment programs in the United States. HCV Advocate - Medical Writers' Circle.
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Strauss, S. M., Astone, J., Vassilev, Z. P., Des Jarlais, D. C., & Hagan, H. (2003). Gaps in the drug-free and methadone treatment program response to hepatitis C. Journal of Substance Abuse Treatment, 24 (4), 291-297.
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Strauss, S. M., Des Jarlais, D. C., Astone, J., & Vassilev, Z. P. (2003). On-site HIV testing in residential drug treatment units: Results of a nationwide survey. Public Health Reports, 118 (1), 37-43.
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Strauss, S. M., Falkin, G. P., Vassilev, Z., Des Jarlais, D. C., & Astone, J. (2002). A nationwide survey of hepatitis C services provided by drug treatment programs. Journal of Substance Abuse Treatment, 22 (2), 55-62.
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