Motivational Interviewing to Increase Uptake of Drug Checking and Safe Drug Use Behaviors to Reduce Overdose

NCT ID: NCT06855836

Last Updated: 2025-12-12

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

588 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-03

Study Completion Date

2029-05-31

Brief Summary

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A hybrid type 1 study will be conducted to evaluate efficacy and preliminary implementation considerations for a novel intervention to promote uptake of drug checking services (DCS) and safer drug use behaviors among people who use drugs (PWUD) to reduce incidence of overdose (OD) and HIV and Hepatitis C virus (HCV) infections in San Diego County.

Along with \~50 other syringe services programs (SSPs) in the US, the Harm Reduction Coalition San Diego (HRCSD), a local SSP, recently launched CheckSD (San Diego), a DCS using test strips (TS) and Fourier Transform Infrared Spectrometry (FTIR) that allows people to submit drug samples with non-nominal identifiers and obtain personalized results. While most existing DCS using FTIR offer some counseling, no theory-based interventions to increase DCS uptake and promote post-DCS adoption of safer drug use behaviors have been rigorously evaluated

Detailed Description

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588 PWUD who have not yet used CheckSD will be recruited into a two-arm randomized controlled trial (RCT) (N=294 per group). Recruitment sources will be the community and La Frontera study. Both arms will have access to CheckSD's standard of care (SOC) already available at SSP sites (i.e., FTIR, and overdose education and naloxone distribution (OEND)). PWUD randomized to receive MI-CHANCE will receive it from HRCSD's peer counselors who will be trained in motivational interviewing (MI) to encourage CheckSD uptake and safer drug use behaviors. Those in the attention-control SOC arm will receive Flu and Hepatitis A education. All will undergo semi-annual follow-up for 30 months.

Primary Objective: To test the efficacy of MI-CHANCE on reducing rates of combined fatal and non-fatal OD over 30 months and examine social cognitive theory (SCT)-informed mediators and moderators of intervention effects (i.e., knowledge, outcome expectancies, self-efficacy)

Conditions

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Overdose

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

All recruited study participants will receive the Overdose Education and Naloxone Distribution (OEND) materials. The control group will receive additional Flu and Hepatitis A education as Group 1, and the experimental group will receive the MI-CHANCE intervention as Group 2
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Standard of Care Control (SOC; Group 1) -TS + FTIR + Flu and Hepatitis A education.

Participants will receive naloxone, overdose prevention pamphlets and be shown videos (English or Spanish) on how naloxone works. Participants will be offered the services of drug sample testing by CheckSD's technician after their study session. The training videos will be on Flu and Hepatitis A education. Overall, the session for Group 1 as the attention control participants will last 30 minutes.

Group Type PLACEBO_COMPARATOR

TS + FTIR + Flu and Hepatitis A Education

Intervention Type BEHAVIORAL

Naloxone and educational materials (i.e. pamphlets) on overdose prevention, videos (English or Spanish) on naloxone, flu and Hepatitis A education.

MI-CHANCE Intervention (Group 2) - TS+FTIR+MI.

Participants will receive naloxone, overdose prevention pamphlets and MI in a 30-minute counseling session. Trained peer-support specialists will engage participants in discussion on the drug supply, ask to rate how certain they are about their drugs' content, how they perceive their OD risk, and shown a brief video about FTIR. Using "decisional balance", participants will identify pros and cons of regularly using DCS prior to drug use and modifying drug use behaviors based on their own potential safer alternatives. Once the balance shifts towards positive change, they will be offered to get their own drug tested by CheckSD's technician and provided with results highlighting drug potency and purity. If they decline, a dummy sample containing fentanyl will be used. Participants will develop an action plan with harm reduction principles to problem-solve specific challenges, identify their goals to use DCS and prevent OD.

Group Type EXPERIMENTAL

MI-CHANCE (TS + FTIR + MI)

Intervention Type BEHAVIORAL

MI-CHANCE was built following key principles of MI (partnership, acceptance, compassion and evocation) to empower PWUD, help them identify potential benefits of DCS and strategies to integrate these into their daily lives. The manual follows three key stages: 1) introducing DCS, 2) generating change talk, and 3) verbalizing commitment, using open questions, affirmations, reflections and summaries. Pros and cons for regularly using CheckSD and changing drug use behaviors accordingly were identified in the literature and through discussions with PWUD and HRCSD staff. Peer support specialists are urged to mirror participants' own language (e.g., oxy or M30s=oxycontin; carga= heroin; malilla=withdrawal, fetty=fentanyl). Challenges were categorized into 8 key areas: legal, financial, scheduling, transportation, ability to change drug use behaviors, communication with SSP staff, managing mood and substance use.

Interventions

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MI-CHANCE (TS + FTIR + MI)

MI-CHANCE was built following key principles of MI (partnership, acceptance, compassion and evocation) to empower PWUD, help them identify potential benefits of DCS and strategies to integrate these into their daily lives. The manual follows three key stages: 1) introducing DCS, 2) generating change talk, and 3) verbalizing commitment, using open questions, affirmations, reflections and summaries. Pros and cons for regularly using CheckSD and changing drug use behaviors accordingly were identified in the literature and through discussions with PWUD and HRCSD staff. Peer support specialists are urged to mirror participants' own language (e.g., oxy or M30s=oxycontin; carga= heroin; malilla=withdrawal, fetty=fentanyl). Challenges were categorized into 8 key areas: legal, financial, scheduling, transportation, ability to change drug use behaviors, communication with SSP staff, managing mood and substance use.

Intervention Type BEHAVIORAL

TS + FTIR + Flu and Hepatitis A Education

Naloxone and educational materials (i.e. pamphlets) on overdose prevention, videos (English or Spanish) on naloxone, flu and Hepatitis A education.

Intervention Type BEHAVIORAL

Other Intervention Names

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Motivational Interviewing

Eligibility Criteria

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Inclusion Criteria

A total of 588 PWUD participants will be recruited for the proposed study (MI-CHANCE). To be eligible to participate in this study, an individual must meet all of the following criteria:

1. Provision of signed and dated informed consent form
2. Stated willingness to comply with all study procedures and availability for the duration of the study
3. Be aged ≥18 years at time of recruitment
4. Must have used illicit opiates (e.g., heroin, fentanyl) and/or methamphetamine ≤1 week prior to recruitment date
5. Live in San Diego County with no plans to permanently move over the next 30 months
6. Have not previously used the CheckSD drug checking service
7. Enrolled into ongoing prospective cohort study La Frontera (the border) (existing or new participants)

Enrollment will be capped so that \<25% of the sample reports only using methamphetamine to ensure that the sample is comprised primarily of people who use opiates who are at greatest risk of OD. Recruitment will be done through targeted sampling at hotspots as well as homeless encampments, shelters and outreach through social media.

Exclusion Criteria

An individual who meets any of the following criteria will be excluded from participation in this study:

1. Not being able to provide a signed and dated informed consent form
2. Not willing to comply with all study procedures and availability for the duration of the study
3. Currently enrolled in another randomized controlled trial
4. Not having used illicit opiates (e.g., heroin, fentanyl), methamphetamine ≤1 week prior to recruitment date
5. Having used CheckSD (i.e. drug testing with TS+FTIR)
6. Participated in the MI-CHANCE pilot
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Harm Reduction Coalition of San Diego (HRCSD)

UNKNOWN

Sponsor Role collaborator

University of California, San Diego

OTHER

Sponsor Role lead

Responsible Party

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Steffanie Strathdee

Harold Simon Distinguished Professor, Co-director, Center for Innovative Phage Applications & Therapeutics (IPATH) Division of Infectious Diseases and Global Public Health Department of Medicine, UC San Diego Health Sciences

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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MI CHANCE - Park Blvd

San Diego, California, United States

Site Status

Countries

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United States

References

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Provided Documents

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Document Type: Informed Consent Form

View Document

Other Identifiers

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1R33DA061260-01

Identifier Type: NIH

Identifier Source: org_study_id

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