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Community I-STAR Mozambique: Community Implementation of SBIRT using Technology for Alcohol use Reduction in Mozambique

Award Number: R01AA025947
ORGANIZATION: NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/20/2018
PERIOD OF PERFORMANCE END DATE: 08/31/2025

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Community I-STAR Mozambique: Community Implementation of SBIRT using Technology for Alcohol use Reduction in Mozambique - Hazardous drinking (HD) is a major public health burden worldwide with significant morbidity and mortality. The prevention and treatment gap associated with this global burden requires that efficacious interventions be scaled-up, leveraging existing platforms and participation of policy makers ready to apply and sustain evidence-informed policies over time. To reduce HD, the WHO recommends using Screening, Brief Intervention, Referral to Treatment (SBIRT) and the mental health Gap Action Programme guidelines (mhGAP). As low- and middle-income countries (LMIC) embrace SBIRT and mhGAP for community-based HD services (HDS), a main scale-up challenge is ensuring effectiveness, fidelity, and sustainability of services. Mobile health technology (mHealth), such as the mSBIRT app developed by members of our team, is a promising tool for widespread cost-effective delivery of evidence-based HDS by community health workers (CHWs) because of its potential to increase fidelity, effectiveness, and sustainability. The proposed project, Community I-STAR (Implementation of SBIRT using Technology for Alcohol use Reduction) Mozambique, will leverage the following existing Mozambique Ministry of Health (MoH) programs: (1) a task-shifting strategy training psychiatric technicians (PsyTs) to use the mhGAP; (2) the WHO-funded epilepsy community program delivered by CHWs; and (3) an mHealth program for malaria, pneumonia, and diarrhea (inSCALE - Innovations at Scale for Community Access and Lasting Effects). These currently operating programs set the stage for the use of mSBIRT by CHWs to deliver community HDS in Mozambique and generate policy for scale-up of government-funded community HDS harnessing existing human resources. Community I-STAR Mozambique comprises three phases: 1) mSBIRT adaptation, 2) a cluster-randomized trial, and 3) scale-up of the most cost-effective intervention. After a formative phase to adapt mSBIRT to Mozambique’s context/culture, we will conduct a 2- year, cluster-randomized, hybrid effectiveness-implementation type 2 trial in 12 districts: 6 districts randomized to receive mSBIRT and 6 to an SBIRT Conventional Training and Supervision strategy (SBIRT-CTS), with both arms delivered by CHWs. The arm showing higher cost-effectiveness in the 2-year trial will be scaled up to the other 6 districts for 12 “cross-over” months. Throughout the trial and the “cross-over” scale-up, qualitative and process data will complement quantitative assessments to examine implementation, sustainability, and scale-up. Our approach redefines work roles without requiring new human resources, and it comports with the MoH’s commitment to implementing HDS. We will use evidence-based practices (SBIRT) to a) build capacity for complete task-shifting of sustainable community-HDS practices; and b) use implementation tools to examine implementation and effectiveness of two SBIRT delivery strategies followed by evaluation of scale-up of the most cost-effective strategy. Community I-STAR Mozambique will scale-up a cost-effective, sustainable program and inform policy applicable to Mozambique and other LMICs.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = -$252,005 )
2026	2022	RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC.	1051 RIVERSIDE DR	NEW YORK	NY	10032	NEW YORK	USA	Alcohol Research Programs	000	5	1/14/2026	NON-COMPETING CONTINUATION	-$252,005
														Subtotal = -$252,005

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2022	RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC.	1051 RIVERSIDE DR	NEW YORK	NY	10032	NEW YORK	USA	Alcohol Research Programs	000	5	4/25/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $121,312 )
2023	2023	RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC.	1051 RIVERSIDE DR	NEW YORK	NY	10032	NEW YORK	USA	Alcohol Research Programs	002	5	9/14/2023	SUPPLEMENT FOR EXPANSION	$0
2023	2023	RESEARCH FOUNDATION FOR MENTAL HYGIENE INC	1051 RIVERSIDE DR	NEW YORK	NY	10032	NEW YORK	USA	Alcohol Research Programs	000	5	5/10/2023	SUPPLEMENT FOR EXPANSION	$121,312
2023	2022	RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC.	1051 RIVERSIDE DR	NEW YORK	NY	10032	NEW YORK	USA	Alcohol Research Programs	001	5	9/14/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $121,312

Issue Date FY: 2022 ( Subtotal = $641,803 )
2022	2022	RESEARCH FOUNDATION FOR MENTAL HYGIENE INC	1051 RIVERSIDE DR	NEW YORK	NY	10032	NEW YORK	USA	Alcohol Research Programs	000	5	8/19/2022	NON-COMPETING CONTINUATION	$641,803
														Subtotal = $641,803

Issue Date FY: 2021 ( Subtotal = $644,782 )
2021	2021	RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC.	1051 RIVERSIDE DR	NEW YORK	NY	10032	NEW YORK	USA	Alcohol Research Programs	000	4	9/10/2021	NON-COMPETING CONTINUATION	$644,782
														Subtotal = $644,782

Issue Date FY: 2020 ( Subtotal = $642,678 )
2020	2020	RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC.	1051 RIVERSIDE DR	NEW YORK	NY	10032	NEW YORK	USA	Alcohol Research Programs	000	3	8/19/2020	NON-COMPETING CONTINUATION	$642,678
														Subtotal = $642,678

Issue Date FY: 2019 ( Subtotal = $645,256 )
2019	2019	RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC.	1051 RIVERSIDE DR	NEW YORK	NY	10032	NEW YORK	USA	Alcohol Research Programs	000	2	8/28/2019	NON-COMPETING CONTINUATION	$645,256
														Subtotal = $645,256

Issue Date FY: 2018 ( Subtotal = $704,483 )
2018	2018	RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC.	1051 RIVERSIDE DR	NEW YORK	NY	10032	NEW YORK	USA	Alcohol Research Programs	000	1	9/17/2018	NEW	$704,483
														Subtotal = $704,483

Grand Total All Awards = $3,148,309

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Community I-STAR Mozambique: Community Implementation of SBIRT using Technology for Alcohol use Reduction in Mozambique

Award Number: R01AA025947

ORGANIZATION: NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/20/2018

PERIOD OF PERFORMANCE END DATE: 08/31/2025

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