JMIR Publications

ABSTRACT

Background:

A chronic condition, drug addiction requires long-term multi-pronged healthcare and treatment services. Community-based approaches can offer the advantages of managing integrated care along the care continuum and improving clinical outcomes. However, scant rigorous research focuses on sustainable, community-based care and service delivery.

Objective:

This protocol describes a study aiming to develop and test an intervention that features the alliance of community health workers and family members to provide integrated support and individualized services and treatment for people who use drugs (PWUD) in community settings.

Methods:

Based on the NIDA’s Seek-Test-Treat-Retain (STTR) framework, an intervention that provides training to community health workers (CHW) will be developed and piloted before an intervention trial. Trained community health workers will conduct home visits and provide support for PWUD and their families. The intervention trial will be conducted in three regions in Vietnam, with 60 communities (named communes). These communes will be randomized to either an intervention or control condition. Intervention outcomes will be evaluated at baseline, 3, 6, 9, and 12 months. The primary outcome measure is PWUD’s STTR fulfillment, consisting of multiple individual fulfillment indicators across five domains: Seek, Test, Treat, Retain, and Health. The secondary outcomes of interest are the CHW’s service provision and family members’ support. The primary analysis will follow an intention-to-treat approach. Generalized mixed-effects regression models will be used to compare changes in the outcome measures from baseline between intervention and control.

Results:

This study is ongoing. We will distribute reports based on the baseline data in late 2023. The intervention outcome results will be available within six months of the final data collection date, i.e., intervention outcome findings are expected to be available in late 2025.

Conclusions:

This study will inform the establishment of community health workers and family members alliance, a locally available infrastructure, to support addiction services and care for PWUD. The methodology, findings, and lessons learned are expected to shed light on the addiction service continuum's implementation and demonstrate a community-based addiction service delivery model that can be transferable to other countries. Clinical Trial: ClinicalTrials.gov NCT05315492; https://clinicaltrials.gov/ct2/show/NCT05315492