Getting to Zero: Understanding HIV Viral Suppression and Transmission in the United States.
R01DA055527. NIH/NIDA. 04-15-2022 to 02-28-2027.

The goal of this R01 is to test the effectiveness of implementing an innovative clinic-level intervention across eight HIV Medical Home models in multiple geographic settings. This intervention features an evidence-based mobile health (mHealth) app (CHESS) and peer-driven support. Our aim is to close information gaps, build intrinsic motivation, and develop behavioral skills needed for sustained adherence to treatment to increase the proportion of patients with viral suppression and reduce missed clinic appointments. We will also conduct an implementation cost analysis and cost-effectiveness analysis to inform future sustainment of the intervention model.

Promoting the implementation of clinical guidelines for opioid prescribing in primary care using systems consultation.
R01DA047279. NIH/NIDA. 09-30-2018 to 09-29-2023.

The goal of this R01 is to determine how to implement safer opioid prescribing practices as efficiently and effectively as possible in primary care clinics. We will test the implementation strategy we developed in our R34 clinical trial planning grant, systems consultation, in a sequential, multiple assignment randomized trial (SMART).  Systems consultation consists of the following strategies: academic detailing to target the health system, facilitation to target the clinic, and physician peer coaching to target prescribers. This study will test an adaptive systems consultation in a multi-level, hybrid type 3 SMART to determine which sequence and combination of systems consultation strategies work most effectively in different clinics.

Integrating mHealth for alcohol use disorder into clinical practice.
R01AA024150. NIH/NIAAA. 08-01-2018 to 04-30-2023.

The goal of this R01 is to implement an mHealth system to treat alcohol use disorder in a primary care setting. We aim to address questions that to our knowledge have not been studied before in the treatment of alcohol use disorder in primary care: What is the efficacy of an mHealth system used by patients with clinician oversight and monitoring versus usual care for alcohol use disorder in primary care? What is the efficacy of an mHealth system integrated into clinical care compared to patients using it independently?


Conceptualizing the problem of implementation: a systems engineering perspective applied in substance abuse treatment.
K01DA039336. NIH/NIDA. 05-01-2017 to 04-30-2020.

The major goals of this K01 are to learn and apply the technique of multi-attribute utility theory to assess the perceived value of an evidence-based practice for addiction treatment from the perspective of key healthcare stakeholders, and use it as a basis to identify and mitigate potential causes of failure.

Physician coaching to reduce opioid-related harms.
R34DA036720. NIDA. 07-01-2014 to 06-30-2017.

This project pilot tested a strategy for improving the safety of opioid prescribing for chronic pain patients in primary care. The strategy, ultimately called systems consultation, was modified during the pilot test and proved successful. The long-range goal was to develop an approach for moving evidence-based practices into wide use in healthcare generally.