Working with HIV clinics to adopt addiction treatment using implementation facilitation (WHAT-IF?): Rationale and...

Area of Science:

• Implementation Science
• Public Health
• Addiction Medicine

Background:

• Substance misuse (tobacco, alcohol, opioids) significantly impacts morbidity and mortality in people with HIV (PWH).
• Evidence-based addiction treatments are underutilized in HIV clinics, posing a care gap.
• The Working with HIV clinics to adopt Addiction Treatment using Implementation Facilitation (WHAT-IF?) study addresses this implementation challenge.

Purpose of the Study:

• To conduct a formative evaluation of barriers and facilitators to implementing addiction treatment in HIV clinics.
• To evaluate the impact of Implementation Facilitation (IF) on the adoption of addiction treatments.
• To assess the effect of IF on clinical outcomes for PWH receiving addiction treatment.

Main Methods:

• Hybrid type 3 effectiveness-implementation stepped wedge design across four Northeast US HIV clinics.
• Guided by the Promoting Action on Research Implementation in Health Services Research (PARiHS) framework.
• Mixed-methods approach to identify barriers/facilitators and tailor IF, followed by evaluation of IF's impact on implementation and effectiveness outcomes.

Main Results:

• Implementation Facilitation (IF) was evaluated for its impact on the provision of addiction treatment (primary outcome).
• Assessed organizational and clinician readiness for adopting addiction treatment and changes in care delivery models.
• Examined IF's effect on HIV-related outcomes among patients eligible for addiction treatment.

Conclusions:

• Results will provide crucial information on the impact of IF as a reproducible strategy.
• Demonstrates the potential of IF to enhance addiction treatment integration within HIV care settings.
• Highlights IF's role in improving both implementation and effectiveness outcomes for PWH with substance use disorders.