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Opioid Use DisorderACTIONNCT05286879

Addressing Risk Through Community Treatment for Infectious Disease and Opioid Use Disorder Now (ACTION) Among Justice-involved Populations

A study testing Patient Navigator and Mobile Health Unit in people with Opioid Use Disorder and Infectious Disease, run by Yale University at 3 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is a 5-year Hybrid Type 1 Effectiveness-Implementation Randomized Control Trial (RCT) that compares two models of linking and retaining individuals recently released from justice involvement to the continuum of community-based HIV prevention and treatment, HCV treatment, STI treatment, and opioid use disorder… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Patient Navigator and Mobile Health Unit
Could I receive a placebo?
No, everyone receives an active treatment
How many people
601 participants
Where
3 sitesUnited States
Study dates
31 Mar 2022to 12 Dec 2025
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Living in one of our research areas
  • Age 18 or older
  • Able to provide written informed consent in English or Spanish
  • Involvement with the criminal justice system within the last 6 months
  • Living with HIV or being at risk of acquiring HIV and willing to learn about PrEP
  • Willing to be tested for HIV (unless already confirmed via medical record)
  • Having a history of opioid and/or stimulant use within 12 months prior to being in a controlled setting and/or in the last 6 months within the community
  • Having a history of condomless sexual intercourse, STI diagnosis, and/or IDU within 6 months prior to being in a controlled setting and/or in the last 6 months within the community

Who cannot join

  • Severe medical or psychiatric disability making participation unsafe
  • Unable to provide consent
  • Not remaining in the local area after release from custody
  • Being released to inpatient care
  • Potential risk to research staff

Trial locations and contacts

3 sites in 1 country.

United States3 sites
  • UT Southwestern

    Dallas, Texas, 75390

  • Texas Christian University

    Fort Worth, Texas, 76129

  • Yale School of Medicine

    New Haven, Connecticut, 06510

Other trials in United States

About this study

This is a 5-year Hybrid Type 1 Effectiveness-Implementation Randomized Control Trial (RCT) that compares two models of linking and retaining individuals recently released from justice involvement to the continuum of community-based HIV prevention and treatment, HCV treatment, STI treatment, and opioid use disorder (OUD) prevention and treatment, medication for opioid use disorder (MOUD) service cascades of care.

Read the detailed description

This 5-year Hybrid Type 1 Effectiveness-Implementation RCT trial compares two models of linking and retaining individuals recently released from justice involvement to the continuum of community-based HIV and OUD prevention and treatment (MOUD) service cascades of care. A significant innovation of this RCT is that it will be delivered within 4 communities where coalition infrastructures have been established as part of the Justice Community Opioid Innovation Network (JCOIN) studies, a National Institute on Drug Abuse (NIDA)-funded Cooperative Agreement initiative to mitigate the impact criminal justice (CJ)-involved individuals with OUD are having on local communities, and the investigators will be able to build on that existing infrastructure. Specifically, up to 960 CJ-involved individuals will be recruited across 2 CT (New London/Middlesex Counties and Windham/Tolland/New Haven/Hartford Counties) \& 2 Texas (Dallas and Tarrant Counties) high risk communities. HIV status will be assessed via rapid testing at initial point of contact. Participants will be randomized to receive at post-release either: a) a Patient Navigator (PN) system for care, wherein navigators will assist linking study participants to appropriate community service providers (e.g., OUD/SUD treatment including MOUD, and HCV testing and treatment; those not living with HIV will be provided access to pre-exposure prophylaxis (PrEP) services, and those living with HIV will receive assistance with gaining initial or continued access to antiretroviral therapy (ART) services, or b) services delivered via a Mobile Health Unit (MHU) within the participants community where participants will receive PrEP/ART, MOUD, and harm reduction services on the MHU or assistance from a community health worker (CHW) in linking to appropriate community-based OUD and other medical and behavioral health providers. The interventions will last for 6 months post-release from custody. The focus of this study is the randomized controlled trial.

Study objectives:

Aim 1 (Intervention Effectiveness) Primary: To compare the effectiveness of PN vs. MHU service delivery on participant length of time to initiating post-release PrEP (prevention)/ART (treatment) medication within 6 months following release from justice involvement. Secondary outcomes will examine the continuum of PrEP and HIV care outcomes, including (but not limited to) the following additional HIV-related measures: viral suppression for people living with HIV (PLH), PrEP adherence, HIV risk behaviors; HCV Measures: HCV testing \& linkage to treatment. Importantly, the investigators will also assess OUD and Substance Use Disorders (SUD)-related measures: OUD/SUD diagnoses, MOUD prescription receipt \& retention, opioid \& stimulant use, and overdose incidents. Other outcomes of interest include sexually transmitted infection (STI) incidence; and primary medical care appointments.

Aim 2 (Implementation): To evaluate Patient Navigation (PN ) and Mobile Health Unit (MHU) feasibility, acceptability, and costs. Primary implementation outcomes include feasibility (health care utilization impact among released individuals, contributions of interagency workgroup members on outcomes); acceptability (participant satisfaction, perceived usefulness); sustainment (continued utilization), and costs required to implement and sustain the approaches as well as to scale-up in additional communities. Additional outcomes will examine the broader impact on community health care including other health services accessed, expanded OUD services, and common barriers (e.g., stigma) to service access across the community provider spectrum. The investigators will also assess cost offsets and effectiveness of the service delivery models on the cascade outcomes. A Persons Who Inject Drugs (PWID) sub-study will focus on gaining insight into participant and social context (inner and outer) factors associated with the effectiveness outcomes.

Note: The study sample size was revised from 864 to 538 participants following identification of an error in the original power analysis, which incorrectly used HIV-positive initiation rates to estimate the overall effect size. A revised power analysis was conducted, and the updated sample size was reviewed and approved by the Data and Safety Monitoring Board (DSMB) during its August 2023 review.

Being tested
Patient Navigator, Mobile Health Unit
Keywords
Justice involvement, HIV Prevention, Hepatitis C Prevention
Medical subject headings
Opioid-Related Disorders, Communicable Diseases, Risk Reduction Behavior, Substance-Related Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Patient NavigatorBehavioural

    Linkage to services for OUD/SUD treatment including MOUD, Hepatitis C virus (HCV) testing and treatment; those not living with HIV infection will be provided access to PrEP services, and those living with HIV will receive assistance with gaining initial or continued access to ART services during the 6-month post-release intervention period

  • Mobile Health UnitBehavioural

    Participants will receive HIV PrEP/ HIV ART, MOUD, harm reduction services on the MHU and or assistance from a community health worker in linking to appropriate community-based OUD and other medical and behavioral health providers across the 6 month post-release intervention period

Study groups in NCT05286879
Study groupRoleWhat they receive
Patient NavigatorOtherNavigators will assist linking study participants to appropriate community service providers
Receives: Behavioral: Patient Navigator
Mobile Health UnitOtherStudy participants will be linked to a MHU within their community
Receives: Behavioral: Mobile Health Unit

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mean Time to Post-release Initiation of ART Medication

    Restricted mean survival was used to reflect the number of days a person was without medication. Measured by self-reported initiation within 6-months. ART initiation will be measured as the date of self-reported initiation within the 6-month intervention period.

    Measured: From the day of release/randomization to initiation of ART up to 6 months

  2. Mean Time to Post-release Initiation of PrEP Medication

    Restricted mean survival was used to reflect the number of days a person was without medication. Measured by self-reported initiation within 6-months. PrEP initiation will be measured as the date of self-reported initiation within the 6-month intervention period.

    Measured: From the day of release/randomization to initiation of PrEP up to 6 months

Secondary outcomes (14)
  1. Number of Participants That Initiate PrEP

    The proportion of participants who initiate PrEP, of those who are not living with HIV, will be assessed via self-report and through confirmation with community provider

    Measured: From the day of release/randomization to initiation of PrEP up to 6 months

  2. Proportion of Participants Prescribed PrEP at End of Intervention.

    Proportion of participants prescribed PrEP at end of intervention via self-report and through confirmation with community provider

    Measured: 6 months

  3. Number of Participants Adherent to PrEP by Self-report

    For participants who initiate PrEP, adherence will be assessed by self-reported PrEP adherence via Visual Analog Scale (VAS), 0-100, higher scores mean better adherence. 80% or greater on the VAS scale was considered adherent.

    Measured: 6 months

  4. Change in HIV Status

    Change in HIV status for participants testing negative using rapid point of care (POC) via Orasure tests at baseline that have a follow-up reactive HIV point of care test

    Measured: Baseline and 12 months

  5. Number of Participants Adherent to ART by Self-report

    For PLH, adherence to ART treatment will be assessed by self-reported ART adherence via Visual Analog Scale (VAS) 0-100, higher scores mean better adherence. 80% or greater on the VAS scale was considered adherent.

    Measured: 6 months

  6. HIV Viral Suppression

    For PLH, HIV viral suppression, for those with HIV at time of randomization: the percent who maintain or achieve HIV viral load < 200 copies/mL at 6 months

    Measured: 6 months

  7. Number of Participants With Changes in Sexual Risk Behaviors

    Changes in injection and sexual risk behaviors, a summary item from Dr. Springer's HIV Risk Behavior tool created for NIDA Seek, Test, Treat, and Retain (STTR) will be used to assess sharing of injection equipment and other drug and sexual risk behaviors

    Measured: from baseline up to 6 months

  8. Number of Participants With Changes in HIV Injection Risk Behaviors

    Changes in injection and sexual risk behaviors, a summary item from Dr. Springer's HIV Risk Behavior tool created for NIDA Seek, Test, Treat, and Retain (STTR) will be used to assess sharing of injection equipment and other drug and sexual risk behaviors

    Measured: from baseline up to 6 months

  9. Number of Participants That Used Opioids by Opioid Type

    Type of opioids used (not as prescribed) will be assessed by the Texas Christian University Drug Screen 5.

    Measured: 6 months

  10. Opioid Abstinence

    The mean days of opioid use by self-report via the timeline followback (TLFB).

    Measured: 6 months

  11. Number of Participants With Substance Use Treatment Participation

    Substance use treatment participation will be collected via self-report. Treatments include detoxification, residential treatment, and medication treatments.

    Measured: 6 months

  12. Number of Participants That Used Substances by Type of Substance

    Types of other substances used (e.g. stimulant, benzodiazepine, marijuana, synthetic cannabinoids, and alcohol) not as prescribed will be assessed self-reported via Texas Christian University Drug Screen 5

    Measured: 6 months

  13. Substance Use Related Overdoses at 6 Months

    Occurrence of non-fatal and fatal substance use related overdoses, through self-report, confirmation with medical providers, and mortality index data

    Measured: 6 months

  14. Substance Use Related Overdoses at 12 Months

    Occurrence of non-fatal and fatal substance use related overdoses, through self-report, confirmation with medical providers, and mortality index data

    Measured: From Month 6 to Month 12

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Mar 2022
  2. Study start31 Mar 2022
  3. Primary completion31 Jul 2025
  4. Study completion12 Dec 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
601 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05286879
Sponsor's protocol ID
2000029346
Other IDs
1U01DA053039-01
Acronym
ACTION
Status last verified
Aug 2026
First submitted
25 Feb 2022
Last updated
21 Sep 2026
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes

Publications

  • Villaire S, Sease T, Pankow J, Bennett A, Pulitzer Z, Hansen L, Frank C, Di Paola A, Lehman W, Sanchez M, McQuaid A, Schultheis A, Stein B, Springer SA, Nijhawan AE, Knight K. A qualitative examination of barriers and facilitators to HIV prevention and treatment for people involved with the criminal justice system. Health Justice. 2025 Jun 6;13(1):37. doi: 10.1186/s40352-025-00344-6.

    PubMed 40478391
  • Springer SA, Nijhawan AE, Knight K, Kuo I, Di Paola A, Schlossberg E, Frank CA, Sanchez M, Pankow J, Proffitt RP, Lehman W, Pulitzer Z, Thompson K, Violette S, Harding KK; ACTION Cooperative Group. Study protocol of a randomized controlled trial comparing two linkage models for HIV prevention and treatment in justice-involved persons. BMC Infect Dis. 2022 Apr 15;22(1):380. doi: 10.1186/s12879-022-07354-x.

    PubMed 35428213

Questions about this trial

What is this clinical trial studying?

A study testing Patient Navigator and Mobile Health Unit in people with Opioid Use Disorder and Infectious Disease, run by Yale University at 3 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 21 Sep 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mean Time to Post-release Initiation of ART Medication (time frame: From the day of release/randomization to initiation of ART up to 6 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05286879, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Sep 2026.

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