Hybrid Type I Effectiveness-Implementation Trial of a Social Network Support Intervention

NCT ID: NCT05723653

Last Updated: 2025-09-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

900 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-02-13

Study Completion Date

2027-12-31

Brief Summary

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The goal of this Hybrid Type I effectiveness-implementation trial is to test an evidence-based, flexible, and tailored intervention that leverages existing social network members to promote retention in care and viral suppression among people living with HIV aged 18-49.

Detailed Description

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This study is a Hybrid Type I effectiveness-implementation trial of an evidence-based, flexible, and tailored intervention that leverages existing social network members to promote retention in care and viral suppression. The study will be conducted in Chicago, Illinois and Alabama, two high burden priority areas in the National Ending the HIV Epidemic Plan. Both retention in care and viral suppression are critical targets in ongoing efforts to eliminate HIV, as persons adherent to antiretrovirals are unlikely to transmit HIV, and retention in care allows for ongoing monitoring of viral load and the delivery of other important services, e.g., case management, mental health, and substance use treatment.

Most clinic-based strategies to improve Continuum of Care outcomes focus on newly created network members, e.g., support groups, peer navigators, or case managers. In contrast, we identify and activate organic Support Confidants (SC)-those people who can offer the types of social support that can help to navigate life's complexities, including the stressors of living with HIV. The intervention uses sociograms, highly engaging social network diagrams, to identify an ideally positioned Support Confidant. Once a Support Confidant is identified, the Index and their Support Confidant attend a single session, in-person intervention with a trained interventionist. The intervention uses the Information Motivation Behavioral Skills Model, Motivational Interviewing, and Cognitive Behavioral Theory to promote Continuum of Care-specific support in the Index-Support Confidant relationship.

This study will conduct a Hybrid Type I randomized controlled trial with N=600 participants living with HIV, who will be randomized to receive the intervention (n=300) or treatment as usual (n=300). In addition, 300 Support Confidants also will be enrolled. At 12-months post-intervention, we will re-randomize dyads to continue receiving mini-boosters (n=150) or return to treatment as usual (n=150). Data collection at baseline, 12, and 18 months will include surveys and electronic medical record (EMR) data. The study will be implemented in community-based clinics and academic-affiliated health centers in Chicago and in Birmingham and Huntsville, Alabama. To study implementation in each setting and geographic context, we will use the Consolidated Framework for Implementation Research as the determinant framework and Reach, Effectiveness, Adoption, Implementation, and Maintenance as the evaluation framework. The specific aims of the study are to:

Aim 1: Evaluate the (a) effectiveness of a social support intervention versus treatment as usual over 12 months with 600 people living with HIV ages 18-49 and (b) value of continuing to offer social support over another 6 months. The primary outcomes are retention in care and Viral Suppression, as measured by electronic medical record data on missed visit proportion and viral load.

Aim 2: Examine if intervention effects (a) vary between Chicago and Alabama, (b) are mediated by changes in the Index's level of motivational readiness, self-efficacy, and stigma expectancies, and (c) are moderated by mental health and substance use at the Index level.

Aim 3: Evaluate the implementation of the intervention using the Consolidated Framework for Implementation Research and the Reach, Evaluation, Adoption, Implementation and Maintenance frameworks. We will conduct surveys and focus groups with key stakeholders to assess the inner and outer settings, implementer and intervention characteristics, and multi-level process factors within the Consolidated Framework for Implementation Research. We will assess the following implementation outcomes for the study in each clinical setting and geographic context: Reach, Adoption, Implementation, and Maintenance.

If effective, the intervention has the potential to reduce HIV incidence by harnessing existing social support in the lives of people living with HIV, strengthening the public health impact of Treatment as Prevention. Thus, the research holds significant promise for addressing racial and geographic health disparities and will result in a sustainable, scalable program and implementation strategy that can be disseminated in HIV clinics nationwide.

Conditions

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HIV Seropositivity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Following study registration (at which a unique Study Identification (ID) will be assigned), Index participants will be randomized to either the intervention group (n=300) or Treatment as Usual (n=300). Intervention arm Indexes will identify a Support Confidant (SC) (creating Index-SC dyads). Study staff will discuss pros and cons of treatment as usual (equipoise induction) to balance the desirability of the two intervention conditions.

After the 12-month follow-up survey, we will re-randomize the 300 Index-Support Confidant dyads in the intervention condition with equal probability to continue receiving standard mini-boosters (n=150 Index-Support Confidant dyads) or a return to treatment as usual (n=150 Index-Support Confidant dyads). The randomization schedule will be prepared in advance, and treatment assignment will be obtained using the randomization module in REDCap.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Due to the nature of the intervention, it is not possible to blind participants, interventionists, and investigators. However, we take the following steps to minimize bias, assess contamination, and enhance rigor: (1) collecting baseline data prior to randomization; (2) Treatment as Usual (TAU) providers are blinded to allocation; and (3) assessing contamination at follow-up surveys by identifying overlap between the networks of those in each study arm.

Study Groups

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Social Network Support Intervention Condition

The intervention condition will be delivered by trained Intervention Case Managers to n=300 Index participants and their Support Confidant.

The intervention consists of (1) selection and invitation of a Support Confidant, (2) a face-to-face intervention between the Intervention Case Manager and the Index and Support Confidant, and (3) quarterly interactive mini-booster sessions delivered to the Index and Support Confidant via text or telephone, based on participant preference.

At 12 months, Index participants in the experimental condition will be re-randomized to either continue receiving quarterly interactive mini-booster sessions or to stop receiving mini-boosters and return to treatment as usual.

Group Type EXPERIMENTAL

Social Network Support Intervention

Intervention Type BEHAVIORAL

The Social Network Support Intervention is an evidence-based, flexible, and tailored intervention that leverages existing social network members to promote retention in care and viral suppression among people living with HIV. The intervention consists of (1) selection and invitation of a Support Confidant, (2) a face-to-face intervention between the Intervention Case Manager and the Index and Support Confidant, and (3) quarterly interactive mini-booster sessions delivered to the Index and Support Confidant via text or telephone, based on participant preference.

Treatment as Usual Condition

Treatment as Usual is comprehensive and follows Department of Health and Human Services guidelines and local protocols on the provision of HIV primary care, which include scheduling one HIV primary care visit and lab tests (including viral load) once every six months, i.e., two HIV primary care visits per year. In addition, all sites provide standard case management and mental health and psychosocial support services to all patients.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Social Network Support Intervention

The Social Network Support Intervention is an evidence-based, flexible, and tailored intervention that leverages existing social network members to promote retention in care and viral suppression among people living with HIV. The intervention consists of (1) selection and invitation of a Support Confidant, (2) a face-to-face intervention between the Intervention Case Manager and the Index and Support Confidant, and (3) quarterly interactive mini-booster sessions delivered to the Index and Support Confidant via text or telephone, based on participant preference.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Aged 18-49 years old, inclusive
* Speak English
* Own a cell phone not shared with anyone else
* Have missed at least one HIV care scheduled visit or have not been virally suppressed in the past 24 months.
* Resides in Chicagoland, Illinois or Alabama



* Index agrees to engage the Support Confidant
* Age 18 years or older
* Speaks English
* Owns a cell phone not shared with others
* Is not a romantic/sexual partner of the Index participant

Exclusion Criteria

* Romantic/Sexual partners of Index participant
* Relationship strain or abuse present in Index-Support Confidant relationship
Minimum Eligible Age

18 Years

Maximum Eligible Age

49 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Tulane University

OTHER

Sponsor Role collaborator

University of Alabama at Birmingham

OTHER

Sponsor Role collaborator

Birmingham AIDS Outreach

UNKNOWN

Sponsor Role collaborator

Chicago Center for HIV Elimination

UNKNOWN

Sponsor Role collaborator

Howard Brown Health

UNKNOWN

Sponsor Role collaborator

Thrive Alabama

UNKNOWN

Sponsor Role collaborator

University of Chicago

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Alida Bouris, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Chicago

David S Batey, PhD

Role: PRINCIPAL_INVESTIGATOR

Tulane University

Locations

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University of Alabama at Birmingham 1917 Clinic

Birmingham, Alabama, United States

Site Status NOT_YET_RECRUITING

Birmingham AIDS Outreach

Birmingham, Alabama, United States

Site Status RECRUITING

Thrive Alabama

Huntsville, Alabama, United States

Site Status RECRUITING

Howard Brown Health

Chicago, Illinois, United States

Site Status RECRUITING

Chicago Center for HIV Elimination

Chicago, Illinois, United States

Site Status RECRUITING

Crown Family School of Social Work, Policy, and Practice at the University of Chicago

Chicago, Illinois, United States

Site Status NOT_YET_RECRUITING

Tulane University

New Orleans, Louisiana, United States

Site Status NOT_YET_RECRUITING

Countries

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United States

Central Contacts

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Alida Bouris, PhD

Role: CONTACT

773-834-4304

David S Batey, PhD

Role: CONTACT

504-862-3485

Facility Contacts

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Kathy Gaddis

Role: primary

Emma S Kay, PhD

Role: primary

Erin Bortel

Role: primary

Juan Rivera

Role: primary

Rebecca Eavou

Role: primary

Alida Bouris, PhD

Role: primary

773-834-4304

David S Batey, PhD

Role: primary

References

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Provided Documents

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Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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IRB22-0110

Identifier Type: -

Identifier Source: org_study_id

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