Bethany Bray, PhD

Sponsor: National Institute on Drug Abuse (U01 DA036926)
Principal Investigator: Michele Kipke
Role: Co-Investigator
Project Dates: August 15, 2015 – July 31, 2025

Men who have sex with men (MSM) have been disproportionally affected by the HIV epidemic, with MSM having the highest annual rates of HIV incidence each year. Among MSM, the highest HIV incidence is among 13-14 and 25-34 year olds. The situation is particularly difficult for African American/Black and Hispanic/Latino young men who have sex with men (YMSM). Funded by the National Institute on Drug Abuse, the Healthy Young Men’s (HYM) Cohort Study conducts longitudinal research to help prevent new HIV infections, reduce transmission, and reduce HIV/AIDS-related disparities by focusing on successful engagement in care. The HYM Cohort Study includes 448 African American/Black, Hispanic/Latino, and Black/Latino YMSM in the Los Angeles area. Participants were 16-24 years old at recruitment and data collection is ongoing. Data are collected every six months, including self-report, drug screening, STIs/HIV testing, and biospecimens (plasma, buffy coat, rectal swabs). We are using this cohort to understand the transitions and trajectories of STIs/HIV, substance use, mental health, and engagement in care, with a focus on how these processes are informed by intersectionality: the multidimensional, interconnected experiences of stigma stemming from multiple, intersecting identities (sexual, gender, racial/ethnic, other markers).

Sponsor: National Institute on Drug Abuse (U01 DA036926)
Principal Investigator: Michele Kipke
Role: Co-Investigator
Project Dates: August 15, 2015 – July 31, 2025

Transgender men and women, especially those who have sex with cisgender men, represent a population at exceedingly high risk for HIV and other STIs. The CDC estimates that 1 in 7 (14%) of transwomen have HIV, with the percentage being much higher for African American/Black (44%) and Latina (26%) transwomen; the CDC also estimates that 3% of transmen have HIV. In addition to transgender youth, there is also concern about gender minority youth and their risk for STIs/HIV. Transgender and gender minority youth (TGMY) refers to a diverse group of youth who have varied gender identities that differ from their sex assigned at birth. TGMY are an important population for targeted interventions not only because they are at high risk of HIV infection, but because of challenges and barriers they face accessing needed HIV prevention, testing, treatment, and other healthcare services. Funded by the National Institute on Drug Abuse, the Transgender and Gender Minority Youth’s (TRUTH) Cohort Study conducts longitudinal research to understand disparities in health outcomes and health care access among TGMY in the Los Angeles area. The TRUTH Cohort Study includes 110 TGMY, ages 16-24 years. Data are collected every six months, including self-report, drug screening, STIs/HIV testing, and biospecimens (plasma, buffy coat, rectal swabs). We are using this cohort to understand the transitions and trajectories of STIs/HIV, substance use, mental health, and engagement in care, with a focus on how these processes are informed by intersectionality: the multidimensional, interconnected experiences of stigma stemming from multiple, intersecting identities (sexual, gender, racial/ethnic, other markers).

Sponsor: National Institute on Drug Abuse (P50 DA039838)
Principal Investigator: Bethany Bray
Project Dates: August 1, 2015 – July 31, 2021

The Dissemination, Software, and Technology (DST) Core serves the Center for Complex Data to Knowledge in Drug Abuse and HIV Behavioral Science (CD2K Center) in three critical domains: dissemination of the methodological innovations developed in the CD2K Center; development and dissemination of user-friendly, free software; and technological support for the many activities of the CD2K Center that depend on multimedia platforms involving computers, the Internet, and other computing resources. The Specific Aims are as follows. (1) To implement a vigorous dissemination strategy that ensures drug abuse and HIV scientists worldwide can readily apply the innovative methods developed in the CD2K Center. We implement a comprehensive dissemination plan that serves several clearly defined audiences. Dissemination vehicles include technical, drug abuse/HIV, and tutorial journal articles; a rich, dynamic website, including a “teacher’s corner” to help instructors include our innovative methods in their curricula; workshops, pre-conference events/meetings, and stand-alone scientific meetings; podcasts; a monthly electronic newsletter; an annual report; virtual discussion forums during which scientists worldwide can receive input from CD2K Center investigators; and a major initiative to prepare online introductory lectures and learning paths on the methods we develop. (2) To collaborate with CD2K Center research and pilot project investigators to create, document, and maintain user-friendly and reliable software that implements the methods developed by these projects. This software, distributed free of charge via our website, includes SAS procedures/macros, Stata plug-ins, R packages/functions, web-based applications, and stand-alone Windows programs. (3) To provide a broad array of technological and technology-related support to the CD2K Center in several areas: development and maintenance of the Center website, engineered with a state-of-the-art, database-driven content management system so that it remains both an accessible point of first contact for researchers seeking information about our methodological techniques and a valuable ongoing resource for more advanced users; implementation of the CD2K Center data safety and monitoring plan and proper storage and handling of all data, including ensuring that all CD2K Center investigators, trainees, and staff comply with all procedures for ensuring confidentiality and security of each data set.; installation and maintenance of computer hardware and software used by CD2K Center investigators, trainees, and staff, provision of support in a variety of technical areas, and service as liaisons between the CD2K Center and technical support units.

Sponsor: National Institute on Drug Abuse (P50 DA039838)
Principal Investigator: Stephanie Lanza
Role: Co-Investigator
Project Dates: August 1, 2015 – July 31, 2021

To accelerate the fight against drug abuse and HIV, it is critical to gain a deeper understanding of heterogeneity in intervention effects. The overarching goal of this project is to develop a powerful new framework that integrates ideas from latent class analysis and time-varying effect models to enable researchers to discover (a) clinically useful, multidimensional moderators and (b) moderators that play a dynamic (i.e., age- and time-varying) role in the effects of interventions on univariate and multidimensional outcomes. We are using data from the Global Appraisal of Needs (GAIN) assessment system, a longitudinal study of alcohol and drug addiction service utilization, and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III), a nationally representative study on alcohol and drug use and disorders, related risk factors, and associated physical and mental disabilities, to address new questions motivated by innovative, quantitative methods. For example, we are considering questions like “What configurations of risk factors correspond to greater effects of an intervention program?” and “How does gender function as a moderator of the effect of outpatient drug abuse services, deferentially across ages 16 to 50?” Ultimately, our work on innovative, quantitative methods will enable researchers to gain critical knowledge that will inform the development of more effective, targeted drug abuse and HIV interventions.

Sponsor: National Institute on Drug Abuse (R13 DA020334)
Principal Investigator: Bethany Bray
Project Dates: August 1, 2005 – May 31, 2021

Due to recent technological advances, state-of-the art data collection and analysis methods are evolving faster than ever before. This makes it difficult for drug abuse and HIV prevention researchers to keep up with the latest research methods. The annual Summer Institutes on Innovative Methods are designed to provide drug abuse and HIV researchers with the knowledge and skills needed to apply the most salient innovations in the collection and analysis of intensive longitudinal data (ILD). This focus on ILD is in response to (a) technological advances that enable the collection of real-time, real-world data related to health behavior (e.g., smart phones, wearable sensors), and (b) the growing priority area at the National Institutes of Health on mHealth (mobile health). ILD enable a deeper, more nuanced study of dynamic processes related to behavior and have the potential to inform the real-time delivery of behavioral interventions. These conferences help prevention scientists gain conceptual and practical understanding of state-of-the-art ILD methods they can apply in their research. All of these conferences are presented by leading experts in ILD methods and feature hands-on data analysis and/or sample data collection by participants. Topics include the collection of ILD, power analysis for planning new ILD studies, two modern analytic methods for ILD that can help researchers gain critical knowledge from their complex data, and a new randomized trial design to collect intensive, causal information. These conferences are helping scientists gain the skills needed to build the next generation of adaptive behavioral interventions. These conferences are now hosted via partnership between The Methodology Center at Penn State and the Center for Dissemination and Implementation Science at the University of Illinois at Chicago.

Sponsor: National Institute on Drug Abuse (R33 DA045850) (R21 DA045850)
Principal Investigators: Dennis Watson and Alan McGuire
Role: Co-Investigator
Project Dates: September 1, 2017 – August 31, 2021

This project seeks to develop Planned Outreach, Intervention, Naloxone, and Treatment (POINT) as an effective emergency department-based intervention for connecting opioid overdose survivors to medication assisted treatment. This project holds significant public health potential through its use of peer recovery coaching to address barriers that prevent opioid users from accessing evidence-based treatment. Our chosen approach for this study will also facilitate timely translation of research to practice, which is necessary given the significant toll the opioid epidemic is taking on this country.

POINT was developed by Dr. Krista Brucker, Department of Emergency Medicine, Indiana University School of Medicine

Sponsor: National Institute on Drug Abuse (R21DA051628)
Principal Investigators: Melissa D Blank and Aaron P Metzger
Role: Co-Investigator
Project Dates: August 1, 2020 – July 31, 2022

As the large majority of tobacco users initiate in adolescence or young adulthood, it is important to characterize patterns of use across this period of development.

For both age groups, a rise in the use of alternative tobacco products (e.g., electronic cigarettes, hookah/waterpipes), as well as the use of two or more tobacco products concurrently (e.g., polytobacco use) has been noted. Yet little work has examined how these patterns of single or polytobacco use change from early adolescence into emerging adulthood, and even less work has examined comprehensively the multitude of factors that might predict this change. The proposed project seeks to fill these gaps by using a combination of variable- and person-centered analytic techniques to examine longitudinal patterns of change and associated antecedents from a socio-ecological framework. Using a nationally-representative dataset, the Population Assessment of Tobacco and Health (PATH), this project will a) examine trajectories and related predictors of single tobacco product use from early adolescence (age 12) to emerging adulthood (age 22) using variable-centered latent growth models, b) examine transitions into and out of polytobacco use classes, as well as predictors of these classes, from early adolescence (age 12) to emerging adulthood (age 22) using person-centered latent transition analysis, and c) examine interactions among individual (e.g., motives for use; sensation seeking), interpersonal (e.g., parent modeling and rules), and contextual (e.g., geographic location) factors in predicting trajectories of single tobacco product use and transitions in polytobacco use. These analyses will not only provide crucial information about the emergence and relative stability of different use patterns over time, but also differences between patterns that are protective versus risky based on a consideration of multifaceted and interacting antecedents.

Consequently, our proposal addresses the Food and Drug Administration’s research priority to “identify and explain between- persons differences and within-person changes in tobacco use patterns, including…polyuse of tobacco products (i.e., use of multiple products within the same time-period and switching between multiple products)”. In the longterm, this project can inform evidenced-based public health efforts aimed at preventing or ceasing tobacco use in the earliest stages of use.

Geri Donenberg, PhD

Sponsor: National Institute on Minority Health and Health Disparities (R43 MD014113)
Principal Investigators: Geri Donenberg, David Smith, Edward Feil
Project Dates: September 24, 2019 – February 29, 2020

Youth under age 18 involved in the criminal justice system are disproportionately minorities and affected by substance abuse, mental illness, and HIV/STI. Most young offenders are released on community supervision without the STI, mental health, or substance use screening, diagnosis, and treatment afforded detained youth, despite similar rates of risk behavior. Their long-term trajectory is poor, the costs to society are high, and lasting effects on community well-being and individual employment prospects are profound. Altering this trajectory is a public health priority. Preventing HIV Among Teens (PHAT) Life is an evidence-based program that meets the need in juvenile justice to address youths’ co-morbid health problems. The next––and perhaps most critical––step in ensuring that this decade-long line of research produces actual, real-world improvements in the lives of probation youth is to develop a PHAT Life training strategy that is effective, cost-effective, and sustainable within juvenile justice settings. This private/public collaboration between Oregon Research Behavioral Intervention Strategies and the University of Illinois at Chicago will leverage existing resources and competencies to create a commercially viable technology-based training tool for PHAT Life with great potential for sustainability and cost-effectiveness. Building on PHAT Life’s past research, in this SBIR Phase I research we will (a) develop and evaluate a prototype interactive web browser and mobile app multimedia training tool to enable para-professionals (e.g., health educators, probation staff, youth care staff) to deliver PHAT Life to youth on probation, and (b) identify additional training materials needed to address facilitator gaps (e.g., HIV/STI knowledge, managing group dynamics). The proposed technology-based training tool should be highly sustainable, because it (a) relies on “indigenous” personnel to deliver the intervention, (b) is likely to prove cost-effective since we will utilize a technology that can deliver training at scale, and (c) will improve fidelity both by leveraging technology to provide consistent training experiences to para-professionals and by including a computer-mediated video recorded observation of group sessions that will be reviewed and graded by an expert trainer to increase the likelihood of intervention implementation fidelity.

Sponsor: National Institute of Child Health and Human Development (UG3 HD096875)
Principal Investigators: Geri Donenberg and Linda-Gail Bekker
Project Dates: September 1, 2018 – August 31, 2020

This project will adapt and evaluate the effectiveness and cost-effectiveness of IMARA, a family-based HIV prevention package for South African adolescent girls and young women and female caregivers. Reducing new HIV and STI infections among South African adolescent girls and young women (AGYW) is global public health priority. South Africa has world’s largest HIV epidemic, and South African adolescent girls and young women acquire HIV at twice the rate of and seroconvert on average 5 – 7 years earlier than male peers. 15-19 year-old females account for over two thirds of new HIV infections in sub-Saharan Africa, but only 15% know their HIV status. HIV mortality is rising among adolescents while decreasing for every other age group. As new infections continue to outpace access to and availability of PrEP and ART, primary prevention remains the most viable strategy to stem new transmissions. South African efforts to prevent HIV transmission in youth focus mostly on individual-level behavior change, but adolescent girls and young women’s persistent HIV disparities are explained by broad social and structural inequities that shape and constrain HIV-risk behaviors. Comprehensive HIV prevention packages that are integrated, synergistic, and tailored to the local epidemiology and cultural context are likely to achieve and sustain maximum reductions in HIV-risk. Female caregivers are an untapped resource in the HIV prevention toolbox and offer a novel opportunity to strengthen AGYW prevention efforts, particularly for uptake of new biomedical technologies like PrEP and HIV testing and counseling. Adolescent girls and young women may also be change agents for female caregivers who want to be positive role models for AGYW and thus, change their own behavior to practice HIV prevention. Establishing the cost- effectiveness of comprehensive HIV prevention packages will inform sustainment over time. This proposal answers a compelling need to reduce incident HIV and STI infections among South African women and AGYW to achieve an AIDS-free generation.

The IMARA program was developed with support (R01 MD006198) from the National Institute of Minority Health and Health Disparities.

IMARA logo
Sponsor: Substance Abuse and Mental Health Services Administration (H79 SP021757)
Principal Investigator: Geri Donenberg
Project Dates: September 30, 2016 – September 29, 2021

The purpose of this project is to increase the capacity of the Community Outreach Intervention Projects (COIP) to serve 13-24 year-old African-American (AA) women residing in Chicago’s West, South, and Southeast sides. Through collaboration with partner agencies and input from community members, the activities of this project will build a solid foundation for delivering and sustaining high quality and accessible state-of-the-science HIV prevention and substance abuse services within COIP. IMARA (Informed, Motivated, Aware, and Responsible about AIDS) is a culturally relevant, multi-level, integrated, family-based, HIV and mental health prevention program that simultaneously targets African American women and their daughters. This proposal will increase the availability and accessibility of IMARA and other education and awareness programs, HIV testing and counseling, and evidence-based practices for behavioral and substance use risk reduction, thereby increasing the number of young AA women who are screened, tested, linked to care, and offered brief substance use and sexual risk reduction programs. Increased testing will indicate AA women at high-risk for these health conditions, identify newly discovered positives, and offer on-site HIV primary care. Co-location of behavioral and medical services will create a seamless continuum of primary prevention to active treatment, leading to earlier diagnosis and improved health-related outcomes. The expansion of resources proposed in this application will increase COIP’s capacity to serve 13-24 year old AA women. COIP’s close collaboration with the HIV Community Care Network (HCCN), the Hepatitis C Community Alliance to Test and Treat (HepCCATT), and New Age Services Corporation (NASC) will facilitate referrals for treatment of HIV, viral hepatitis, and serious substance abuse, respectively.

The IMARA program was developed with support (R01 MD006198) from the National Institute of Minority Health and Health Disparities.

Sponsor: International Maternal Pediatric And Adolescent Clinical Trials network (IMPAACT)
Co-chairs: Geri Donenberg, PhD and Dorothy Dow, MD

IMPAACT 2016 is a multi-site, two-arm, randomized, controlled study preceded by a feasibility and acceptability pilot to examine if an Indigenous Leader Outreach Model (ILOM) of trauma-informed cognitive behavioral therapy (TI-CBT) intervention demonstrates improved mental health outcomes and ART adherence for youth living with HIV. The study will proceed in two stages over approximately three and one-half years. In Stage, 1 the feasibility and acceptability of the ILOM of TI-CBT program, consisting of 6 two-hour sessions, will be evaluated for 15-19 year-olds living with HIV and their caregivers using the ADAPT-ITT Model. In Stage 2, the efficacy of an ILOM of TI-CBT intervention using a 2-arm randomized controlled trial design will be evaluated for 15-19 year-olds living with HIV and their caregivers. This study will prioritize implementation in countries with high volumes of 15 – 19 year-olds living with HIV, and sites with minimal mental health care infrastructure in order to achieve the biggest impact and deliver the program in areas of greatest need.

Overall support for the International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT) was provided by the National Institute of Allergy and Infectious Diseases (NIAID) with co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Institute of Mental Health (NIMH), all components of the National Institutes of Health (NIH), under Award Numbers UM1AI068632 (IMPAACT LOC), UM1AI068616 (IMPAACT SDMC) and UM1AI106716 (IMPAACT LC), and by NICHD contract number HHSN275201800001I.

Sponsor: National Institute on Minority Health and Health Disparities (R01 MD010433)
Principal Investigator: Geri Donenberg
Project Dates: September 23, 2015 – July 30, 2020

PHAT Life: Preventing HIV/AIDS Among Teens is an intervention designed to help youth on juvenile probation make healthy choices regarding sexual health and substance use. The intervention content provides youth with health knowledge and emotional management skills which help them make healthy decisions. The program is comprised of 8 sessions that are delivered over a 2-week period to small groups of youth.

We deliver the program in partnership with the Cook County Juvenile Probation Department at probation programming throughout the Chicagoland area.

Juvenile offenders are disproportionately minorities and affected by HIV, sexually transmitted infections (STI), mental illness, and substance use. Evidence-based programs (EBP) are sorely needed in juvenile justice settings, yet few exist, and for those that do, implementation has been slow, challenging, and rarely sustained. Yet without intervention, young offenders continue to engage in risk behaviors while on probation, amplifying their own and worsening already serious health disparities. Altering this trajectory is public health priority. This study builds on a 10-year collaboration between the investigative team and Cook County Juvenile Probation and Court Services (the second largest juvenile probation system in the U.S.) to develop and deliver PHAT Life, a uniquely-tailored comprehensive risk reduction EBP for young offenders. Findings from PHAT Life’s recent efficacy trial reveal sustained reductions in sexual risk taking and substance use at 12-month follow up. The next step is to identify an implementation strategy that is both sustainable and cost-effective within juvenile probation. Few previous studies have compared peer- vs. adult- led behavior change programs and existing studies suffer from significant methodological deficiencies. This study will compare the effectiveness, cost-effectiveness, and sustainability of two implementation strategies, peer-led vs. probation staff-led PHAT Life, in juvenile probation’s Evening Reporting Centers. Peers will be young adults formerly involved in juvenile justice who serve on the Juvenile Advisory Council (Youth Representatives). Both Youth Representatives and probation staff will receive extensive training, supervision, and fidelity monitoring. We will compare the impact, costs, and cost-effectiveness of PHAT Life on 300 13-17 year-old male and female offenders’ risky sex, STI, substance use, and theoretical mediators when delivered by Youth Representatives vs. probation staff. Using qualitative methods, we will elicit the views of Youth Representatives, probation staff, and probation administrators regarding strategies to enhance PHAT Life’s sustainability within juvenile justice, and we will explore the impact delivering PHAT Life on Youth Representatives’ sexual risk, substance use, and other important outcomes. This proposal answers a compelling need for EBP in juvenile justice settings by addressing the interrelated issues of HIV/STI risk, substance use, and mental illness among probation youth, and their negative long-term trajectories. Comparing two implementation strategies–peers vs. probation staff–to determine the more effective and cost-effective approach will expedite uptake, delivery, and sustainability of much-needed EBP for teens who are at greatly elevated risk for HIV and other STIs.

Ashley Kendall, PhD

Sponsor: National Institute on Drug Abuse (K99 DA047890)
Principal Investigator: Ashley Friend-Kendall
Project Dates: March 1, 2019 – February 28, 2021

Juvenile offenders (JOs)—who are disproportionately African American—are at high risk for human immunodeficiency virus (HIV)/sexually transmitted infections (STI) due in part to elevations in three interrelated areas underpinned by poor emotion regulation: substance use, violent behavior, and sexual risk taking. Mindfulness-based interventions (MBIs) improve emotion regulation and may thereby reduce HIV/STI risk. However, the effects of MBIs on substance use, violence, and sexual risk taking among JOs are unknown. Importantly, the large majority of juveniles are released back into the community on probation following arrest, typically without evidence-based intervention services, positioning them for ongoing risk behavior. Given limited resources within the juvenile justice system, mobile interventions delivered by app are a promising method of reaching these youth. This point is underscored by the fact that African Americanyouth, who are overrepresented within the justice system, use smartphones at some of the highest rates in the country. In this study, we are adapting an existing MBI app through extensive focus group testing to specifically address HIV/STI risk behaviors among male and female JOs 13-17 years old on probation; conducting a pilot test of the adapted app; and then running a randomized controlled trial of its efficacy.

Monte Staton, PhD

Sponsor: Arnold Foundation
Principal Investigators: Dennis Watson and James Swartz
Role: Researcher
Project Dates: March 1, 2019 – February 28, 2022

Project STAMINA (Syringe Service Telehealth Access for Medication-Assisted Intervention through NAvigation) will assess implementation and test effectiveness of a model for linking people who use opioids to evidence-based medications for opioid use disorder (MOUD) through a syringe service program (SSP)-based telehealth MOUD-linkage intervention. Where similar models of treatment linkage depend on people who use opioids first accessing the formal healthcare system, typically through emergency medical services after an overdose has occurred, STAMINA will leverage the SSP setting to engage potential participants and link them to care before a potentially life-threatening event. Of the few similar SSP-based programs that exist, none explicitly utilize telehealth nor have they developed strong evidence of their effectiveness.

Sponsor: SAMHSA MAT-PDOA through IU Health West
Principal Investigators: Monte Staton
Project Dates: September 2019 to September 2021

Evaluation of implementation and patient outcomes of a new clinical program aiming to expand treatment services to persons with opioid use disorder, including Medication Assisted Treatment (MAT) and Intensive Outpatient Programming (IOP).