Evidence map›Paper›PMID 39462341›Full record

Trial reportBMC medical research methodology2024

Tracking modifications to implementation strategies: a case study from SNaP - a hybrid type III randomized controlled trial to scale up integrated systems navigation and psychosocial counseling for PWID with HIV in Vietnam.

Minh X Nguyen, Sophia M Bartels, Christopher F Akiba, Teerada Sripaipan, Ha Tt Nong, Linh Th Dang, Ha V Tran, Van Th Hoang, Giang M Le, Vivian F Go and 2 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC medical research methodology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03952520 (Scaling up HIV Prevention Trials Network), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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.

NCT03952520 nacompletednot on this map

Scaling up HIV Prevention Trials Network (HPTN) 074: a Cluster Randomized Implementation Trial of an Evidence-based Intervention for Antiretroviral Therapy for PWID in Vietnam

TypeinterventionalSponsorUniversity of North Carolina, Chapel HillRan2020 to 2024Enrolled1,000ConditionsHIV Infections, Drug UseArmsStandard Approach (SA), Tailored Approach (TA)
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Tailored interventions to address determinants of practice.The Cochrane database of systematic reviews · 2026
    Pooled it
  2. Article
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

12 authors.

Minh X NguyenDepartment of Epidemiology, Institute of Preventive Medicine and Public Health, Hanoi Medical University, No 1 Ton That Tung, Dong Da, Hanoi, Vietnam. binhminh@live.unc.edu.
Sophia M BartelsDepartment of Health Behavior, University of North Carolina, Chapel Hill, NC, USA.
Christopher F AkibaRTI International, Research Triangle Park, NC, USA.
Teerada SripaipanDepartment of Health Behavior, University of North Carolina, Chapel Hill, NC, USA.
Ha Tt NongThe University of North Carolina-Vietnam Office, Hanoi, Vietnam.
Linh Th DangThe University of North Carolina-Vietnam Office, Hanoi, Vietnam.
Ha V TranThe University of North Carolina-Vietnam Office, Hanoi, Vietnam.
Van Th HoangDepartment of Global Health, Hanoi Medical University, Hanoi, Vietnam.
Giang M LeDepartment of Epidemiology, Institute of Preventive Medicine and Public Health, Hanoi Medical University, No 1 Ton That Tung, Dong Da, Hanoi, Vietnam.
Vivian F GoDepartment of Health Behavior, University of North Carolina, Chapel Hill, NC, USA.
William C MillerDepartment of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.
Byron J PowellCenter for Mental Health Services, Brown School, Washington University in St. Louis, St. Louis, MO, USA.

Funding

Scaling up HPTN 074: a Cluster Randomized Implementation Trial of an Evidence-based Intervention for Antiretroviral Therapy for PWID in VietnamR01DA047876 · NIDA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI GO, VIVIAN F., MILLER, WILLIAM C · 2018 to 2022
$4.8M
IMPLEMENTATION RESEARCH INSTITUTE FOR MENTAL HEALTH SERVICES IRI-MHSR25MH080916 · NIMH · WASHINGTON UNIVERSITY · PI Byron James Powell · 2009 to 2026
$3.7M
NIDA NIH HHS R01 DA047876NIDA NIH HHS R01DA047876NIH HHS R25MH080916NIMH NIH HHS R25 MH080916
6 · The paper itself

Abstract

introductionEvaluation of implementation strategies is core to implementation trials, but implementation strategies often deviate from the original plan to adjust to the real-world conditions. The optimal approach to track modifications to implementation strategies is unclear, especially in low-resource settings. Using data from an implementation trial for people who inject drugs (PWID) with HIV in Vietnam, we describe the tracking of implementation strategy modifications and present findings of this process.

methodsSNaP (Systems Navigation and Psychosocial Counseling) is a hybrid type-III effectiveness-implementation randomized controlled trial aiming to scale up the evidence-based intervention, integrated systems navigation and psychosocial counseling, for PWID with HIV in Vietnam. Forty-two HIV testing sites were randomized 1:1 to a standard or tailored arm. While the standard arm (SA) received a uniform package of strategies, implementation strategies for the tailored arm (TA) were tailored to address specific needs of each site. The central research team also met monthly with the TA to document how their tailored strategies were implemented over time. Five components were involved in the tracking process: describing the planned strategies; tracking strategy use; monitoring barriers and solutions; describing modifications; and identifying and describing any additional strategies.

resultsOur approach allowed us to closely track the modifications to implementation strategies in the tailored arms every month. TA sites originally identified 27 implementation strategies prior to implementation. During implementation, five strategies were dropped by four sites and two new strategies were added to twelve sites. Modifications of five strategies occurred at four sites to accommodate their changing needs and resources. Difficulties related to the COVID-19 pandemic, low number of participants recruited, high workload at the clinic, lack of resources for HIV testing and high staff turnover were among barriers of implementing the strategies. A few challenges to tracking modifications were noted, including the considerable amount of time and efforts needed as well as the lack of motivation from site staff to track and keep written documentations of modifications.

conclusionsWe demonstrated the feasibility of a systematic approach to tracking implementation strategies for a large-scale implementation trial in a low-resource setting. This process could be further enhanced and replicated in similar settings to balance the rigor and feasibility of implementation strategy tracking. Our findings can serve as additional guidelines for future researchers planning to report and track modifications to implementation strategies in large, complex trials.

trial registrationclinicaltrials.gov ID: NCT03952520 (first posted 2019-05-16).

Indexed as

CounselingHIV InfectionsPatient NavigationAdultCOVID-19FemaleHumansMaleSubstance Abuse, IntravenousVietnamHIV/AIDSImplementation scienceImplementation strategiesImplementation trialLow-resource settingsTracking modifications

Identifiers

PMID39462341
PMCPMC11520046

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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 OpenQuestion graph.