Improving Identification of Mental Health/Substance Use Disorders in HIV Primary Care: Pilot Clinical Response

Study Overview
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Brief Summary
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This research is a feasibility pilot of an intervention to respond to positive screening tests for mental health(MH) and substance use (SU) captured through the Patient Reported Outcomes questionnaires (PROs). The PROs are currently performed in the clinic, however, the results are neither reviewed with patients nor transmitted to providers. This pilot assesses the feasibility of moving the PROs into the clinical realm by having patients review the PRO results, identifying an issue to discuss at the patient's next HIV primary care visit, and determining whether this process increases discussion of MH and SU disorders in the subsequent clinical visit and/or increases referrals to MH and/or SU treatment.

Official Title
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Improving Identification of Mental Health/Substance Use Disorders in HIV Primary Care: Pilot Clinical Response

Conditions
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HIV Infections

Intervention / Treatment
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* Behavioral: Patient Designated Positive Screen Shared with Provider


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: must be enrolled in the Johns Hopkins Clinical Cohort at the Johns Hopkins Moore Clinic must be living with HIV Exclusion Criteria: -

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention - Positive Screen Shared<br>In the intervention, participants will be given the opportunity to determine which positive screen, if any, that the participant would like to discuss with the participant's provider at the next HIV primary care appointment. The participant will be notified that all positive screens will be shared with the provider prior to the participant's next HIV primary care visit, and that any positive screen the patient has chosen to discuss with the provider will be specified. The provider will receive the PROs result (score, interpretation, and recommendation) prior to the next HIV primary care visit. | Behavioral: Patient Designated Positive Screen Shared with Provider<br>* Patient Designated Positive Screen Shared with Provider -- In the intervention, participants will be given the opportunity to determine which positive screen, if any, that the participant would like to discuss with the participant's provider at the next HIV primary care appointment. The participant will be notified that all positive screens will be shared with the provider prior to their next HIV primary care visit, and that any positive screen the patient has chosen to discuss with the provider will be specified. The provider will receive the PROs result (score, interpretation, and recommendation) prior to their next HIV primary care visit<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mental Health or Substance Use Issue Raised in Visit | Number of participants for whom review and coding of audio recording captured a mental health or substance use issue during their visit | Visit following intervention which will occur on the same day or up to 1 week after the intervention | 
| Audio Recording Data - Mental Health/Substance Use Action Taken | Number of participants for whom review of transcript of clinic visit characterized discussion of mental health issues and referral for services | Visit following intervention which will occur on the same day or up to 1 week after the intervention |