scholarly journals Barriers and facilitators to recruitment and enrollment of HIV-infected individuals with opioid use disorder in a clinical trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kim A. Hoffman ◽  
Robin Baker ◽  
Lynn E. Kunkel ◽  
Elizabeth Needham Waddell ◽  
Paula J. Lum ◽  
...  
Keyword(s):  
Eligible Patient ◽  
Barriers And Facilitators ◽  
Recruitment Strategies ◽  
Structural Factors ◽  
Opioid Use ◽  
Hiv Viral Load ◽  
Treatment As Usual ◽  
Study Recruitment ◽  
Study Protocols ◽  
Peer Outreach

Abstract Background The CTN-0067 CHOICES trial tests implementation of extended-release naltrexone (XR-NTX) versus treatment-as-usual (TAU) for opioid use disorders (OUD) in HIV clinics to improve HIV viral suppression. The study team investigated recruitment strategies to elucidate the barriers and facilitators to recruitment and enrollment in the study. Main text Methods: Semi-structured, in-depth, digitally recorded interviews were completed with study recruitment-related staff and medical providers (n = 26) from six participating HIV clinics in the fall of 2018. Interviews probed 1) factors that might prevent prospective participants from engaging in study recruitment and enrollment procedures and 2) strategies used by study staff that encourage eligible patient participation. Interviews were transcribed and thematically analyzed using a content analysis approach. Results: All respondents reported that barriers to recruitment and enrollment included challenging patient social and structural factors (e.g., homelessness or living environments with high substance use, criminal justice involvement), difficulty locating patients with unsuppressed HIV viral load and OUD within the HIV clinic, time-consuming study enrollment processes, and stigma around HIV and OUD which inhibited treatment seeking. Some respondents observed that distrust of research and researchers impeded recruitment activities in the community. A specific medication-related barrier was patient fear of opioid abstinence required prior to XR-NTX induction. Facilitators of recruitment included use of trusted peer outreach/recruitment workers in the community, hospitalizations that offered windows of opportunities for screening and XR-NTX induction, providing participant transportation, and partnerships with harm reduction organizations for referrals. Conclusions Though study personnel encountered barriers to recruitment in the CHOICES study, persons with untreated HIV and OUD can be enrolled in multisite clinical trials by using enhanced recruitment strategies that extend outside of the HIV clinic. Employing peer outreach workers and collaborating with syringe service programs may be especially helpful in facilitating recruitment and merit inclusion in similar study protocols.

Neurofeedback for Opioid Dependent Patients in an Outpatient Setting: A Pilot Feasibility Study

2021 ◽  
Author(s):  
Helena A. Rempala ◽  
Justin A. Barterian
Keyword(s):  
Large Scale ◽  
The United States ◽  
Outpatient Setting ◽  
Opioid Use Disorder ◽  
High Rate ◽  
Treatment Center ◽  
Opioid Use ◽  
Treatment As Usual ◽  
Factors Affecting ◽  
Study Approach

Abstract Background: Neurofeedback (NF) has been described as “probably efficacious” when used in conjunction with other interventions for substance use disorders, including the most recent studies in population of individuals with opioid use disorder. Despite these promising outcomes, the seriousness of the opioid epidemic, and the high rate of relapse even with the most effective medication-assisted maintenance treatments NF continues to be an under-researched treatment modality. This article explores factors that affected the feasibility of adding Alpha/Theta Neurofeedback to treatment as usual for opioid dependence in an outpatient urban treatment center. The study strived to replicate previous research completed in Iran that found benefits of NF for opioid dependence.Methods: Out of approximately two dozen patients eligible for Alpha/Theta NF, about 60% (n=15) agreed to participate; however, only 2 participants completed treatment. The rates of enrollment in response to active treatment were monitored. Results: The 4 factors affecting feasibility were: 1) the time commitment required of participants, 2) ineffectiveness of standard incentives to promote participation, 3) delayed effects of training, and 4) the length and number of treatments required.Conclusion: The findings indicate a large scale study examining the use of NF for the treatment of opioid use disorder in the United States will likely be difficult to accomplish without modification to the traditional randomized control study approach and suggests challenges to the implementation of this treatment in an outpatient setting.

scholarly journals Health and Access to Healthcare in Homeless People: Protocol for a Mixed-methods Study

2021 ◽  
Author(s):  
Miguel A. Bedmar Pérez ◽  
Miquel Bennasar-Veny ◽  
Berta Artigas Lelong ◽  
Francisca Salvà Mut ◽  
Joan Pou Bordoy ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Health Status ◽  
Homeless People ◽  
Premature Death ◽  
Access To Healthcare ◽  
Mixed Methods Study ◽  
Poor Health ◽  
Barriers And Facilitators ◽  
Second Phase ◽  
Structural Factors

Abstract BackgroundHomelessness is a more complex problem than the simple lack of a place to live. Homeless people (HP) often suffer from poor health and premature death due to their limited access healthcare, and are also deprived of basic human and social rights. The study protocol described here aims to evaluate the complex relationship between homelessness and health, and identify the barriers and facilitators that impact access to healthcare by HP.MethodsThis is a mixed-methods study that uses an explanatory sequential design. The first phase will consist of a cross-sectional study of 300 HP. Specific health questionnaires will be used to obtain information on health status, challenges during the COVID-19 pandemic, self-reported use of healthcare, diagnoses and pharmacologic treatments, substance abuse (DAST-10), diet quality (IASE), depression (PHQ-9), and human basic needs and social support (SSQ-6). The second phase will be a qualitative study of HP using the “life story” technique with purposive sampling. We will determine the effects of different personal, family, and structural factors on the life and health status of participants. The interviews will be structured and defined using Nussbaum's capability approach. DiscussionIt is well-known that HP experience poor health and premature death, but more information is needed about the influence of the different specific social determinants of these outcomes and about the barriers and facilitators that affect the access of HP to healthcare. The results of this mixed methods study will help to develop global health strategies that improve the health and access to healthcare in HP.

scholarly journals Patient Barriers and Facilitators to Medications for Opioid Use Disorder in Primary Care

2019 ◽  
Vol 54 (14) ◽  
pp. 2409-2419 ◽  
Author(s):  
Babak Tofighi ◽  
Arthur Robin Williams ◽  
Chemi Chemi ◽  
Selena Suhail-Sindhu ◽  
Vicky Dickson ◽  
...  
Keyword(s):  
Primary Care ◽  
Opioid Use Disorder ◽  
Barriers And Facilitators ◽  
Opioid Use ◽  
Patient Barriers

scholarly journals Using Twitter to recruit participants for health research: An example from a caregiving study

2018 ◽  
Vol 25 (4) ◽  
pp. 1485-1497 ◽  
Author(s):  
Marina Bastawrous Wasilewski ◽  
Jennifer N Stinson ◽  
Fiona Webster ◽  
Jill Irene Cameron
Keyword(s):  
Health Research ◽  
Secondary Analysis ◽  
Future Research ◽  
Recruitment Strategies ◽  
Study Recruitment ◽  
Twitter Account ◽  
Do So

Twitter has the potential to optimize research conduct, but more research is needed around the nature of study-related tweets and strategies for optimizing reach. In the context of our caregiving study, we aimed to describe the nature and extent of study-related tweets, the extent to which they were shared by others, and their potential reach. To do so, we conducted a secondary analysis of our Twitter recruitment. We aggregated and categorized study-related tweets and analyzed the reach of the 10 most retweeted tweets. Results indicated that of 71 caregivers, 27 were recruited via Twitter. General recruitment tweets were most-shared by users. Tweet reach ranged from 5273 to 62,144 users. Twitter caregivers were demographically comparable to non-Twitter caregivers but had higher Internet proficiency and fewer children. Overall, using a personal Twitter account can expand the reach of study recruitment. Future research should compare different recruitment strategies and explore characteristics that may challenge the heterogeneity of Twitter samples.

Understanding Barriers and Facilitators to the Uptake of Best Practices for the Treatment of Co-Occurring Chronic Pain and Opioid Use Disorder

2019 ◽  
Vol 16 (2) ◽  
pp. 239-249 ◽  
Author(s):  
Allyson L. Varley ◽  
Sara Lappan ◽  
Juliet Jackson ◽  
Burel R. Goodin ◽  
Andrea L. Cherrington ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Best Practices ◽  
Opioid Use Disorder ◽  
Barriers And Facilitators ◽  
Opioid Use

scholarly journals Why do patients take part in research? An overview of systematic reviews of psychosocial barriers and facilitators

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Rebecca Sheridan ◽  
Jacqueline Martin-Kerry ◽  
Joanna Hudson ◽  
Adwoa Parker ◽  
Peter Bower ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Controlled Trial ◽  
Theoretical Domains Framework ◽  
Research Participation ◽  
Psychological Theory ◽  
Barriers And Facilitators ◽  
Recruitment Strategies ◽  
Psychosocial Determinants ◽  
Wide Range ◽  
Overview Of Systematic Reviews

Abstract Background Understanding why people take part in health research is critical to improve research efficiency and generalisability. The aim of this overview of systematic reviews was to identify psychosocial determinants of research participation and map them to psychological theory and empirical recruitment research, to identify effective strategies to increase research participation. Methods Qualitative and quantitative systematic reviews were systematically identified. No date or language limits were applied. Two reviewers independently selected reviews. Methodological quality was rated using AMSTAR, and poor-quality reviews (scoring 0–3) were excluded. Barriers and facilitators were coded to psychological theory (Theoretical Domains Framework) and empirical recruitment research (recruitment interventions that had been subjected to randomised controlled trial evaluation). Results We included 26 systematic reviews (429 unique primary studies), covering a wide range of patient populations and health settings. We identified five groups of facilitators, of which three were dominant (potential for personal benefit, altruism, trust) and appear to be relevant across research setting and design. We identified nine groups of barriers, which were more dependent on the particular study (context, population, design). Two determinants (participant information, social influences) were found to be both barriers and facilitators. Barriers and facilitators could be coded to the Motivation and Opportunity components of the Theoretical Domains Framework; only one was coded to a Capability component. There was some overlap between psychosocial determinants and empirical recruitment research, but some barriers and facilitators had not been tested at all. Conclusions Identifying effective recruitment strategies could increase the efficiency and generalisability of primary research. We identified a number of barriers and facilitators that could be addressed by researchers. There is a need for more research to identify effective recruitment strategies that draw on the psychosocial facilitators and barriers identified in this overview.

Barriers and Facilitators to Antiretroviral Therapy in Northern Tanzania in the Era of Test and Treat

2021 ◽  
Author(s):  
Omobola Mudasiru ◽  
Rebecca Hemono ◽  
Agatha Mnyippembe ◽  
Kassim Hassan ◽  
Prosper Njau ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Access To Care ◽  
Universal Access ◽  
Barriers And Facilitators ◽  
People Living With Hiv ◽  
Structural Factors ◽  
Care Providers ◽  
Test And Treat ◽  
Universal Test And Treat ◽  
Health Messaging

Abstract Background Tanzania adopted WHO’s universal test and treat policy in 2016, recommending antiretroviral therapy (ART) for all people living with HIV (PLHIV). However, many individuals continue to confront challenges initiating or continuing ART. The study aims to understand how barriers and facilitators to ART have evolved since Test and Treat policy in Tanzania.Between March and June 2018, 25 semi-structured in-depth interviews were conducted among PLHIV who were out of care, including PLHIV who never initiated ART and PLHIV who were formerly in care and discontinued ART. Participants were 18-years-old or older, identified from clinic databases at three health facilities and through home-based care providers. Data were coded and interpreted using content analysis and the socio-ecological framework.Results Low HIV literacy, poor quality of health messaging and comprehension, stigma, structural factors, and poverty were identified as main barriers to care. HIV literacy appeared higher among those formerly in care and some misconceptions about ART differed whether or not participants had previously initiated treatment. Participants expressed desire for more information about their health and treatment, including more engagement with their healthcare providers. Conclusions Our results are consistent with the barriers and facilitators to care reported prior to the implementation of the Test and Treat policy. Despite universal access to care, limited progress has been made in addressing the underlying challenges that PLHIV confront in initiating and continuing ART. Efforts such as increase in HIV literacy, improve health messaging, and strengthen healthcare provider-to-patient communication will facilitate access to care. The policy implication of these findings is that the landscape for barriers to ART has not changed drastically, efforts towards engagement to care need to be further refined and tailored to facilitate access to care.

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