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Johnson K, Gilbert L, Hunt T, Wu E, Metsch L, Goddard-Eckrich D, Richards S, Tibbetts R, Rowe JC, Wainberg ML, El-Bassel N. The effectiveness of a group-based computerized HIV/STI prevention intervention for black women who use drugs in the criminal justice system: study protocol for E-WORTH (Empowering African-American Women on the Road to Health), a Hybrid Type 1 randomized controlled trial. Trials 2018; 19:486. [PMID: 30201039 PMCID: PMC6131955 DOI: 10.1186/s13063-018-2792-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 07/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper describes the study protocol of a hybrid type I randomized controlled trial that evaluates the effectiveness and cost-effectiveness of implementing Empowering African-American Women on the Road to Health (E-WORTH), an Afrocentric, group-based, computerized human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention intervention for controlled substance-using black women in community corrections settings in New York City. METHODS/DESIGN We provide an overview of E-WORTH's hybrid type I design, which is guided by the Consolidated Framework for Implementation Research (CFIR). E-WORTH combines HIV/STI and intimate partner violence (IPV) prevention components and tests the comparative effectiveness of E-WORTH and streamlined HIV testing versus streamlined HIV testing alone in decreasing biologically confirmed HIV and STI incidence, sexual risk, and IPV, as well as in improving access to HIV and STI prevention services and care. DISCUSSION This paper provides an overview of E-WORTH's intervention protocol and serves as a framework for using hybrid type I designs, guided by the CFIR conceptual framework, to evaluate HIV/STI and IPV prevention interventions in community corrections settings. We discuss how E-WORTH's hybrid type I design advances implementation science through its effectiveness and cost-effectiveness aims as well as through a mixed-methods study that evaluates multilevel theory-driven factors (structural, organizational, staffing, and client) guided by the CFIR that influences the implementation of E-WORTH in a criminal justice setting. This study also addresses the novel challenges and opportunities of implementing an intervention that targets specific racial subgroup(s) in a community corrections setting that services all populations, implementing a group-based intervention with technological components in such settings, and employing community-based participatory research strategies to guide recruitment and retention efforts. TRIAL REGISTRATION ClinicalTrials.gov, NCT02391233 . Registered on 17 March 2015.
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Affiliation(s)
- Karen Johnson
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
- Columbia University School of Social Work, Social Intervention Group, 1255 Amsterdam Avenue, New York, NY 10027 USA
| | - Louisa Gilbert
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
| | - Timothy Hunt
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
| | - Elwin Wu
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
| | - Lisa Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032 USA
| | - Dawn Goddard-Eckrich
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
- Social Intervention Group, Columbia University Teacher’s College, 1255 Amsterdam Avenue, New York, NY 10027 USA
| | - Stanley Richards
- The Fortune Society, 625 West 140th Street, New York, NY 10031 USA
| | - Rick Tibbetts
- New York City Department of Probation, 210 Joralemon Street, Brooklyn, NY 11201 USA
| | - Jessica C. Rowe
- Center for Teaching and Learning, Columbia University, Lewisohn Hall, 2970 Broadway #603, New York, NY 10027 USA
| | - Milton L. Wainberg
- Columbia University / New York State Psychiatric Institute, 1051 Riverside Drive, #24, New York, NY 10032 USA
| | - Nabila El-Bassel
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
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Davis A, Goddard-Eckrich D, Dasgupta A, El-Bassel N. Risk factors associated with sexually transmitted infections among women under community supervision in New York City. Int J STD AIDS 2018; 29:766-775. [PMID: 29471763 DOI: 10.1177/0956462418755223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The number of women under community supervision in the United States has increased, and this population has a high risk for sexually transmitted infections (STIs). We examined STI prevalence and multiple risk factors among drug-involved women under community supervision in New York City. Data were from a randomized controlled trial testing the efficacy of a behavioral HIV/STI intervention (Women on the Road to Health [WORTH]) among drug-involved women in the community corrections system in New York City from 2009 to 2012. To be eligible for inclusion, women had to be under community supervision within the past 90 days, have used illicit drugs at least once in the past six months, and have unprotected sex at least once in the past 90 days. Participants completed a survey containing items on STI risk factors and were tested for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Multivariable regression was used to examine associations between risk factors and STI diagnosis. Of 333 women tested, 89 (26.7%) tested positive for an STI. Ten (3.0%) were positive for C. trachomatis, 4 (1.2%) for N. gonorrhoeae, and 77 (23.1%) for T. vaginalis. Women with any STI were more likely to be black (AOR: 2.02; 95% CI: 1.08-3.77), homeless in the past 90 days (AOR: 2.07; 95% CI: 1.01-4.26), arrested in the past 90 days (AOR: 1.97; 95% CI: 1.14-3.39), and have a greater number of sexual partners in the past 90 days (AOR: 1.24; 95% CI: 1.08-1.42). Drug-using women under community supervision have a high burden of STIs driven by multiple risk factors. Implementing STI screening, prevention, and treatment programs in community supervision settings could facilitate a reduction in STIs among this population.
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Affiliation(s)
- Alissa Davis
- 1 HIV Center, Division of Gender, Sexuality, & Health, New York State Psychiatric Institute and Columbia University Medical Center, New York, NY, USA.,2 Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
| | - Dawn Goddard-Eckrich
- 2 Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
| | - Anindita Dasgupta
- 2 Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
| | - Nabila El-Bassel
- 2 Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
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Gilbert L, Goddard-Eckrich D, Hunt T, Ma X, Chang M, Rowe J, McCrimmon T, Johnson K, Goodwin S, Almonte M, Shaw SA. Efficacy of a Computerized Intervention on HIV and Intimate Partner Violence Among Substance-Using Women in Community Corrections: A Randomized Controlled Trial. Am J Public Health 2016; 106:1278-86. [PMID: 27077342 DOI: 10.2105/ajph.2016.303119] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To test the efficacy of a computerized, group-based HIV and intimate partner violence (IPV) intervention on reducing IPV victimization among substance-using women mandated to community corrections. METHODS Between November 2009 and January 2012, we randomly allocated 306 women from community corrections in New York City to 3 study arms of a computerized HIV and IPV prevention trial: (1) 4 group sessions intervention with computerized self-paced IPV prevention modules (Computerized Women on the Road to Health [WORTH]), (2) traditional HIV and IPV prevention intervention group covering the same HIV and IPV content as Computerized WORTH without computers (Traditional WORTH), and (3) a Wellness Promotion control group. Primary outcomes were physical, injurious, and sexual IPV victimization in the previous 6 months at 12-month follow-up. RESULTS Computerized WORTH participants reported significantly lower risk of physical IPV victimization, severe injurious IPV victimization, and severe sexual IPV victimization at 12-month follow-up when compared with control participants. No significant differences were seen between Traditional WORTH and control participants for any IPV outcomes. CONCLUSIONS The efficacy of Computerized WORTH across multiple IPV outcomes highlights the promise of integrating computerized, self-paced IPV prevention modules in HIV prevention groups.
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Affiliation(s)
- Louisa Gilbert
- Louisa Gilbert, Dawn Goddard-Eckrich, Timothy Hunt, Xin Ma, Mingway Chang, Tara McCrimmon, Karen Johnson, and Stacey A. Shaw are with Social Intervention Group, Columbia University, New York, NY. Jessica Rowe is with Columbia Center for New Media Teaching and Learning, New York, NY. Sharun Goodwin is with The New York City Department of Probation, New York, NY. Maria Almonte is with Bronx Community Solutions, Center for Court Innovation, Bronx, NY
| | - Dawn Goddard-Eckrich
- Louisa Gilbert, Dawn Goddard-Eckrich, Timothy Hunt, Xin Ma, Mingway Chang, Tara McCrimmon, Karen Johnson, and Stacey A. Shaw are with Social Intervention Group, Columbia University, New York, NY. Jessica Rowe is with Columbia Center for New Media Teaching and Learning, New York, NY. Sharun Goodwin is with The New York City Department of Probation, New York, NY. Maria Almonte is with Bronx Community Solutions, Center for Court Innovation, Bronx, NY
| | - Timothy Hunt
- Louisa Gilbert, Dawn Goddard-Eckrich, Timothy Hunt, Xin Ma, Mingway Chang, Tara McCrimmon, Karen Johnson, and Stacey A. Shaw are with Social Intervention Group, Columbia University, New York, NY. Jessica Rowe is with Columbia Center for New Media Teaching and Learning, New York, NY. Sharun Goodwin is with The New York City Department of Probation, New York, NY. Maria Almonte is with Bronx Community Solutions, Center for Court Innovation, Bronx, NY
| | - Xin Ma
- Louisa Gilbert, Dawn Goddard-Eckrich, Timothy Hunt, Xin Ma, Mingway Chang, Tara McCrimmon, Karen Johnson, and Stacey A. Shaw are with Social Intervention Group, Columbia University, New York, NY. Jessica Rowe is with Columbia Center for New Media Teaching and Learning, New York, NY. Sharun Goodwin is with The New York City Department of Probation, New York, NY. Maria Almonte is with Bronx Community Solutions, Center for Court Innovation, Bronx, NY
| | - Mingway Chang
- Louisa Gilbert, Dawn Goddard-Eckrich, Timothy Hunt, Xin Ma, Mingway Chang, Tara McCrimmon, Karen Johnson, and Stacey A. Shaw are with Social Intervention Group, Columbia University, New York, NY. Jessica Rowe is with Columbia Center for New Media Teaching and Learning, New York, NY. Sharun Goodwin is with The New York City Department of Probation, New York, NY. Maria Almonte is with Bronx Community Solutions, Center for Court Innovation, Bronx, NY
| | - Jessica Rowe
- Louisa Gilbert, Dawn Goddard-Eckrich, Timothy Hunt, Xin Ma, Mingway Chang, Tara McCrimmon, Karen Johnson, and Stacey A. Shaw are with Social Intervention Group, Columbia University, New York, NY. Jessica Rowe is with Columbia Center for New Media Teaching and Learning, New York, NY. Sharun Goodwin is with The New York City Department of Probation, New York, NY. Maria Almonte is with Bronx Community Solutions, Center for Court Innovation, Bronx, NY
| | - Tara McCrimmon
- Louisa Gilbert, Dawn Goddard-Eckrich, Timothy Hunt, Xin Ma, Mingway Chang, Tara McCrimmon, Karen Johnson, and Stacey A. Shaw are with Social Intervention Group, Columbia University, New York, NY. Jessica Rowe is with Columbia Center for New Media Teaching and Learning, New York, NY. Sharun Goodwin is with The New York City Department of Probation, New York, NY. Maria Almonte is with Bronx Community Solutions, Center for Court Innovation, Bronx, NY
| | - Karen Johnson
- Louisa Gilbert, Dawn Goddard-Eckrich, Timothy Hunt, Xin Ma, Mingway Chang, Tara McCrimmon, Karen Johnson, and Stacey A. Shaw are with Social Intervention Group, Columbia University, New York, NY. Jessica Rowe is with Columbia Center for New Media Teaching and Learning, New York, NY. Sharun Goodwin is with The New York City Department of Probation, New York, NY. Maria Almonte is with Bronx Community Solutions, Center for Court Innovation, Bronx, NY
| | - Sharun Goodwin
- Louisa Gilbert, Dawn Goddard-Eckrich, Timothy Hunt, Xin Ma, Mingway Chang, Tara McCrimmon, Karen Johnson, and Stacey A. Shaw are with Social Intervention Group, Columbia University, New York, NY. Jessica Rowe is with Columbia Center for New Media Teaching and Learning, New York, NY. Sharun Goodwin is with The New York City Department of Probation, New York, NY. Maria Almonte is with Bronx Community Solutions, Center for Court Innovation, Bronx, NY
| | - Maria Almonte
- Louisa Gilbert, Dawn Goddard-Eckrich, Timothy Hunt, Xin Ma, Mingway Chang, Tara McCrimmon, Karen Johnson, and Stacey A. Shaw are with Social Intervention Group, Columbia University, New York, NY. Jessica Rowe is with Columbia Center for New Media Teaching and Learning, New York, NY. Sharun Goodwin is with The New York City Department of Probation, New York, NY. Maria Almonte is with Bronx Community Solutions, Center for Court Innovation, Bronx, NY
| | - Stacey A Shaw
- Louisa Gilbert, Dawn Goddard-Eckrich, Timothy Hunt, Xin Ma, Mingway Chang, Tara McCrimmon, Karen Johnson, and Stacey A. Shaw are with Social Intervention Group, Columbia University, New York, NY. Jessica Rowe is with Columbia Center for New Media Teaching and Learning, New York, NY. Sharun Goodwin is with The New York City Department of Probation, New York, NY. Maria Almonte is with Bronx Community Solutions, Center for Court Innovation, Bronx, NY
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Witte SS, Wu E, El-Bassel N, Hunt T, Gilbert L, Medina KP, Chang M, Kelsey R, Rowe J, Remien R. Implementation of a couple-based HIV prevention program: a cluster randomized trial comparing manual versus Web-based approaches. Implement Sci 2014; 9:116. [PMID: 25208569 PMCID: PMC4172848 DOI: 10.1186/s13012-014-0116-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 08/23/2014] [Indexed: 12/03/2022] Open
Abstract
Background Despite great need, the number of HIV prevention implementation studies remains limited. The challenge for researchers, in this time of limited HIV services agency resources, is to conceptualize and test how to disseminate efficacious, practical, and sustainable prevention programs more rapidly, and to understand how to do so in the absence of additional agency resources. We tested whether training and technical assistance (TA) in a couple-based HIV prevention program using a Web-based modality would yield greater program adoption of the program compared to training and TA in the same program in a manual-based modality among facilitators who delivered the interventions at 80 agencies in New York State. Methods This study used a cluster randomized controlled design. Participants were HIV services agencies (N = 80) and up to 6 staff members at each agency (N = 253). Agencies were recruited, matched on key variables, and randomly assigned to two conditions. Staff members participated in a four-day, face-to-face training session, followed by TA calls at two and four months, and follow-up assessments at 6, 12, and 18 months post- training and TA. The primary outcomes examined number of couples with whom staff implemented the program, mean number of sessions implemented, whether staff implemented at least one session or whether staff implemented a complete intervention (all six sessions) of the program. Outcomes were measured at both the agency and participant level. Results Over 18 months following training and TA, at least one participant from 13 (33%) Web-based assigned agencies and 19 (48%) traditional agencies reported program use. Longitudinal multilevel analysis found no differences between groups on any outcomes at the agency or participant level with one exception: Web-based agencies implemented the program with 35% fewer couples compared with staff at manual-based agencies (IRR 0.35, CI, 0.13-0.94). Conclusion Greater implementation of a Web-based program may require more resources and staff exposure, especially when paired with a couple-based modality. Manual-based and traditional programs may hold some advantage or ease for implementation, particularly at a time of low economic resources. Trial registration ClinicalTrials.gov identifier: NCT01863537
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Affiliation(s)
- Susan S Witte
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Ave, New York 10027, NY, USA.
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