Evidence map›Paper›PMID 41918133›Full record

ArticleAddiction science & clinical practice2026

Practice facilitation to implement stepped care for unhealthy alcohol use in HIV clinics: study protocol for a type III hybrid effectiveness-implementation study.

Geetanjali Chander, D Scott Batey, Elizabeth J Austin, Madeleine J Bentley, Edward R Cachay, Heidi M Crane, Claire Farel, Julia Fleming, David J Grelotti, Heidi E Hutton and 7 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Addiction science & clinical practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05241990 (A Hybrid Type III Implementation Trial Testing Practice Facilitation as a Strategy to Improve Alcohol Treatment Adoption and Implementation in HIV Care), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05241990 narecruitingnot on this map

A Hybrid Type III Implementation Trial Testing Practice Facilitation as a Strategy to Improve Alcohol Treatment Adoption and Implementation in HIV Care

TypeinterventionalSponsorJohns Hopkins UniversityRan2023 to 2027Enrolled300ConditionsHiv, Alcohol Use, UnspecifiedArmsPractice Facilitation, Alcohol Stepped Care
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Geetanjali ChanderDepartment of Medicine, School of Medicine, University of Washington, 325 9th Avenue, Seattle, WA, USA. gchander@uw.edu.
D Scott BateySchool of Social Work, Tulane University, New Orleans, LA, USA.
Elizabeth J AustinDepartment of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA.
Madeleine J BentleyDepartment of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA.
Edward R CachayDepartment of Medicine, University of California San Diego School of Medicine, San Diego, CA, USA.
Heidi M CraneDepartment of Medicine, School of Medicine, University of Washington, 325 9th Avenue, Seattle, WA, USA.
Claire FarelDepartment of Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
Julia FlemingFenway Community Health Center, Boston, MA, USA.
David J GrelottiDepartment of Psychiatry, San Diego School of Medicine, University of California, San Diego, CA, USA.
Heidi E HuttonDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Bulat IdrisovDepartment of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA.
JoAnna MathenaDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Mary E McCaulDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Sonia NapravnikDepartment of Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
Conall O'ClerighFenway Community Health Center, Boston, MA, USA.
Bryan LauDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Emily C WilliamsDepartment of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA.

Funding

NIH/NIAAA ARCH P01AA029544
6 · The paper itself

Abstract

backgroundDespite availability of evidence-based alcohol reduction interventions (EBIs), unhealthy alcohol use (UAU) remains a barrier to HIV medication adherence, viral suppression, and retention in HIV care. While translation of alcohol EBIs into HIV clinical practice is important for comprehensive HIV care, their implementation in HIV settings is impeded by resource constraints, workflow challenges, and negative perceptions of alcohol-related care.

methodsGuided by the Consolidated Framework for Implementation Research and Reach, Effectiveness, Adoption, Implementation and Maintenance frameworks, we will conduct a Hybrid Type 3 effectiveness-implementation study testing whether external practice facilitation increases reach, adoption, implementation, and maintenance of stepped care for UAU in three Center for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) HIV clinics in the United States. We will secondarily test whether practice facilitation is associated with clinical outcomes. We will first conduct a mixed methods formative evaluation to tailor delivery of practice facilitation (including the tools, technical assistance, and content expertise offered) based on each site’s context and needs (Aim 1). We will then deliver practice facilitation across the three sites sequentially to implement a stepped-care model of alcohol treatment to patients with UAU. Stepped care, where non-responders to alcohol EBIs are offered a more intensive therapy, will specifically include person- or computer-delivered brief alcohol intervention, on-line cognitive behavioral therapy, and linkages to alcohol pharmacotherapy. Clinical outcomes will include: (1) clinic-level implementation outcomes of stepped care EBIs for alcohol use including reach, adoption, maintenance, using mixed methods (Aim 2a) and (2) patient-level outcomes using interrupted time series analysis with synthetic controls (Aim 2b). Finally, we will use summative evaluation to describe barriers and facilitators to implementation of the interventions at each site to describe maintenance and inform widespread sustainable implementation (Aim 3). DISCUSSION: This trial tests an implementation strategy to improve the delivery of stepped care, an evidence-based treatment approach for UAU in HIV clinics. Practice facilitation has shown promise for implementing evidence-based care for UAU in primary care but use of practice facilitation for this purpose in HIV clinics is novel. Results from this implementation study may support broader implementation of alcohol evidence-based practices in HIV care.

trial registrationThe trial is registered with Clinicaltrials.gov, identifier NCT05241990 Date of submission 2/16/2022.

Indexed as

AlcoholismHIV InfectionsAdherence InterventionsHumansUnited StatesAlcoholAlcohol use disorder treatmentHIVPractice facilitationScreening

Identifiers

PMID41918133
PMCPMC13045120

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.