Clinic-level Implementation of mHealth to Improve HIV Viral Suppression for Patients With Substance Use Disorders

NCT ID: NCT06109571

Last Updated: 2025-09-16

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

ENROLLING_BY_INVITATION

Clinical Phase

NA

Total Enrollment

806 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-12-04

Study Completion Date

2027-03-31

Brief Summary

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The current protocol aims to enroll up to 806 participants from 8 study sites in a clinic-supported intervention which will connect them to Vivent Health care team and a cohort of peer mentors for a year-long intervention period to support patient HIV care to maintain viral suppression and clinic appointments.

Detailed Description

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This protocol describes the implementation phase of a 5-year NIH-funded research project designed to evaluate the effectiveness of an innovative clinic-level intervention featuring an evidence-based, HIPAA-compliant mobile health (mHealth) application ("Connections," a smartphone app operated by the company CHESS Health) and peer-driven social support.

The goal of this project is to implement and evaluate an evidence-based mHealth system to improve HIV viral suppression and reduce missed clinic visits within a multi-site, comprehensive HIV care program. Connections is a mobile health app developed by CHESS Health to support patients with substance use disorders.

The investigators hypothesize that implementation of an adapted version of Connections within an established network of HIV clinical practices will reduce the occurrence of the primary outcome of virologic failure and the secondary outcome of missed clinic appointments.

The specific aims are:

1. To test the effectiveness of Connections using a stepped-wedge randomized trial.
2. To evaluate the implementation of Connections within the HIV Medical Home Model. Using the RE-AIM framework, we will analyze patient-level, provider-level, and clinic-level factors that influence the reach, implementation, adoption, and maintenance of Connections in HIV practices.
3. To systematically measure costs of implementation of Connections in relationship to its benefits related to preventing virologic failure and missed clinic appointments.

Conditions

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HIV Infections Substance Use Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Stepped-wedge, one-way crossover, cluster randomized trial
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Group 1: mHealth Implementation

First 2 sites begin enrollment. Research participants will be asked to complete weekly-check-in, 4 research surveys and engage in content available in the Connections app and with peer mentors over the course of a year.

Group Type EXPERIMENTAL

Connections App

Intervention Type DEVICE

The Connections app was developed for patients with substance use disorders or unhealthy substance use and adapted to include HIV support. For this study, it has been modified to provide additional resources to support patients engaged in HIV care. Connections' core features include agency-specific informational resources compiled in a resource center, patient self-monitoring through weekly check-in surveys, discussion rooms, and private messaging.

Group 2: mHealth Implementation

Next 2 sites begin enrollment 6 months after Group 1. Research participants will be asked to complete weekly-check-in, 4 research surveys and engage in content available in the Connections app and with peer mentors over the course of a year.

Group Type EXPERIMENTAL

Connections App

Intervention Type DEVICE

The Connections app was developed for patients with substance use disorders or unhealthy substance use and adapted to include HIV support. For this study, it has been modified to provide additional resources to support patients engaged in HIV care. Connections' core features include agency-specific informational resources compiled in a resource center, patient self-monitoring through weekly check-in surveys, discussion rooms, and private messaging.

Group 3: mHealth Implementation

Next 2 sites begin enrollment 6 months after Group 2. Research participants will be asked to complete weekly-check-in, 4 research surveys and engage in content available in the Connections app and with peer mentors over the course of a year.

Group Type EXPERIMENTAL

Connections App

Intervention Type DEVICE

The Connections app was developed for patients with substance use disorders or unhealthy substance use and adapted to include HIV support. For this study, it has been modified to provide additional resources to support patients engaged in HIV care. Connections' core features include agency-specific informational resources compiled in a resource center, patient self-monitoring through weekly check-in surveys, discussion rooms, and private messaging.

Group 4: mHealth Implementation

Next 2 sites begin enrollment 6 months after Group 3. Research participants will be asked to complete weekly-check-in, 4 research surveys and engage in content available in the Connections app and with peer mentors over the course of a year.

Group Type EXPERIMENTAL

Connections App

Intervention Type DEVICE

The Connections app was developed for patients with substance use disorders or unhealthy substance use and adapted to include HIV support. For this study, it has been modified to provide additional resources to support patients engaged in HIV care. Connections' core features include agency-specific informational resources compiled in a resource center, patient self-monitoring through weekly check-in surveys, discussion rooms, and private messaging.

Interventions

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Connections App

The Connections app was developed for patients with substance use disorders or unhealthy substance use and adapted to include HIV support. For this study, it has been modified to provide additional resources to support patients engaged in HIV care. Connections' core features include agency-specific informational resources compiled in a resource center, patient self-monitoring through weekly check-in surveys, discussion rooms, and private messaging.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Able to read, write and speak English
* Receives HIV Disease Care at Vivent Health
* At risk for poor engagement in HIV care, as evidenced by any one of the following:

* Prior missed clinic visits
* Poor adherence to medical treatment defined as 2 or more missed doses of medication in a month
* Unhealthy alcohol or other substance use, as evidenced by a diagnosis of substance use disorder on the patient's problem list, a prior referral to alcohol or substance abuse services, or answering "yes" to one or both of the following screening questions:

* Has drinking alcohol or using drugs (including marijuana) ever caused problems in your life, such as damaging relationships, causing you to not meet obligations at work, or getting in trouble with the law?
* Are you currently participating in any treatment or counseling because of problems caused by drug use? This can include groups like N. A., or one-on-one interaction with a doctor or therapist.

Exclusion Criteria

* Individuals who do not currently have a smartphone or are unwilling to obtain a smartphone will not be able to participate in this study.
* People who are unwilling to download and activate the Connections app.
* People with cognitive or other impairment that precludes the capacity to consent.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role collaborator

University of Wisconsin, Madison

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ryan Westergaard

Role: PRINCIPAL_INVESTIGATOR

UW School of Medicine and Public Health

Andrew Quanbeck

Role: PRINCIPAL_INVESTIGATOR

UW School of Medicine and Public Health

Locations

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Vivent Health Clinic

Denver, Colorado, United States

Site Status

Vivent Health Clinic

Kansas City, Missouri, United States

Site Status

Vivent Health Clinic

St Louis, Missouri, United States

Site Status

Vivent Health Clinic

Austin, Texas, United States

Site Status

Vivent Health Clinic

Green Bay, Wisconsin, United States

Site Status

Vivent Health Clinic

Kenosha, Wisconsin, United States

Site Status

Vivent Health Clinic

Madison, Wisconsin, United States

Site Status

Vivent Health Clinic

Milwaukee, Wisconsin, United States

Site Status

Countries

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United States

Other Identifiers

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1R01DA055527-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

Protocol Version 11/14/2024

Identifier Type: OTHER

Identifier Source: secondary_id

A534265

Identifier Type: OTHER

Identifier Source: secondary_id

SMPH/MEDICINE/INFECT DIS

Identifier Type: OTHER

Identifier Source: secondary_id

2023-0938

Identifier Type: -

Identifier Source: org_study_id

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