Clinical Trials Directory

Trials / Completed

CompletedNCT05282173

Community Health Worker Training to Reduce Depression and Substance Use Stigma in TB/HIV Care in South Africa

Training CHWs to Support Re-Engagement in TB/HIV Care in the Context of Depression and Substance Use

Status
Completed
Phase
N/A
Study type
Interventional
Enrollment
82 (actual)
Sponsor
University of Maryland, College Park · Academic / Other
Sex
All
Age
18 Years
Healthy volunteers
Accepted

Summary

Poor engagement in care contributes to HIV- and TB-related morbidity and mortality in South Africa (SA). Community health workers (CHWs) are frontline lay health workers who work to re-engage patients who are lost to follow-up (LTFU) in HIV/TB care. Patients with depression and substance use (SU) have a greater likelihood of being LTFU in HIV/TB care, and there is evidence that CHWs may exhibit stigma towards these patients. When CHWs have negative attitudes towards these patients, on average they spend less time with these patients, are less likely to implement evidence-based practices, and deliver less patient-centered care. Therefore, this purpose of this study is to examine the implementation and preliminary effectiveness of a brief training ("Siyakhana"). The purpose of this training is to provide CHWs with psychoeducation, skills, and support around working with HIV/TB patients with depression/SU. The investigators will assess the training's implementation and changes in CHWs' stigma towards HIV/TB patients with depression/SU.

Detailed description

South Africa (SA) has the highest number of people living with HIV in the world and a high tuberculosis (TB) burden. Poor engagement in care contributes to HIV- and TB-related morbidity and mortality. In this context, community health workers (CHWs) are frontline lay health workers who play a central role in re-engaging patients who are lost to follow-up (LTFU) in HIV/TB care. Even with existing CHW programs focused on re-engaging patients who are LTFU, people with depression, hazardous alcohol use, or other substance use (SU) are particularly susceptible to poor engagement in HIV/TB care and have a greater likelihood of being LTFU. At the moment, CHWs receive minimal, if any, training on depression and SU, and there is some evidence that CHWs may exhibit stigma towards these patients. When CHWs have negative attitudes towards these patients, on average they spend less time with these patients, are less likely to implement evidence-based practices, and deliver less patient-centered care. Therefore, the purpose of this study is to examine the implementation and preliminary effectiveness of a brief training ("Siyakhana") focused on providing CHWs with psychoeducation, skills, and support around working with patients with depression/SU. In a Type 2, hybrid effectiveness-implementation trial, and using a stepped wedge design, the investigators will primarily assess the training's implementation (feasibility, acceptability, and fidelity) and changes in CHWs' stigma towards HIV/TB patients with depression/SU.

Conditions

Interventions

TypeNameDescription
BEHAVIORALSiyakhana CHW TrainingPlease see arm description.

Timeline

Start date
2022-06-08
Primary completion
2023-08-01
Completion
2023-08-01
First posted
2022-03-16
Last updated
2025-03-06
Results posted
2025-03-06

Locations

1 site across 1 country: South Africa

Source: ClinicalTrials.gov record NCT05282173. Inclusion in this directory is not an endorsement.