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COBALT: Comorbid Affective Disorders, AIDS/HIV, and Long Term Health

Award Number: R01MH100470
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 12/06/2017
PERIOD OF PERFORMANCE END DATE: 08/31/2019

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COBALT: Comorbid Affective Disorders, AIDS/HIV, and Long Term Health - DESCRIPTION (provided by applicant): Long term objective. The objective of the COBALT (Comorbid Affective Disorders, AIDS/HIV, and Long Term Health) study is to address an important gap in research evidence for cost-effective, scalable interventions for HIV positive adults on antiretroviral treatment (ART) with depression in low resource settings. Specific aims. COBALT has 4 aims: (1). To improve HIV outcomes and ART adherence through improved identification and management of depression, alcohol misuse and chronic diseases of lifestyle. (2). To improve comorbid depression outcomes in patients receiving ART through improved detection and management using a stepped care model. (3) To reduce the risk profile among ART patients for: (i) alcohol misuse disorders; and ii) cardiovascular disease and its risk factors through improved detection and management of these conditions. (4) To improve integrated treatment/care of long-term conditions at the primary health care level among patients receiving ART and to evaluate the health synergies and health systems implications, including cost-effectiveness of better integrated care. Research design and methods. We plan to conduct a cluster randomised controlled trial at the level of health clinics in the North West Province in South Africa. Compared with the 'usual treatment' control clinics, the experimental clinics will be enhanced using two interventions which we have previously successfully piloted, evaluated and implemented. (1) a guideline-based training programme for nurses that integrates the management of non-communicable and mental health conditions with infectious diseases, and whose predecessor has been adopted by the national government and implemented at scale reaching 18,000 health workers in 1,700 clinics throughout the country. (2) A group psychosocial intervention delivered by lay counselors, which has been successfully piloted in the KwaZulu-Natal Province. Task- shifting is central to these interventions, and necessary if we are to test an intervention capable of being scaled-up within settings so limited by the availabiliy of skilled human resources. We therefore propose the COBALT trial to evaluate the real-world effectiveness and cost-effectiveness of a facility-based intervention combining for people with HIV/AIDS: (i) case-detection and management of depression and chronic diseases of lifestyle, notably hypertension, diabetes, cardiovascular disease and alcohol misuse by nurses, with (ii) group psychosocial intervention for depression delivered by lay counselors, to improve both mental health and HIV outcomes in depressed adults receiving ART.


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: 2022 ( Subtotal = -$87,867 )
2022	2018	KING'S COLLEGE LONDON	THE STRAND	LONDON				GBR	Mental Health Research Grants	000	5	10/1/2021	SUPPLEMENT FOR EXPANSION	-$30,482
2022	2018	KING'S COLLEGE LONDON	THE STRAND	LONDON				GBR	Mental Health Research Grants	001	5	10/1/2021	SUPPLEMENT FOR EXPANSION	-$57,385
														Subtotal = -$87,867

Issue Date FY: 2020 ( Subtotal = -$219,267 )
2020	2018	KING'S COLLEGE LONDON	THE STRAND	LONDON		WC2R 2LS		GBR	Mental Health Research Grants	001	5	2/27/2020	SUPPLEMENT FOR EXPANSION	-$93,821
2020	2017	KING'S COLLEGE LONDON	THE STRAND	LONDON		WC2R 2LS		GBR	Mental Health Research Grants	000	5	2/27/2020	NON-COMPETING CONTINUATION	-$125,446
														Subtotal = -$219,267

Issue Date FY: 2018 ( Subtotal = $93,821 )
2018	2018	KING'S COLLEGE LONDON	THE STRAND	LONDON		WC2R 2LS		GBR	Mental Health Research Grants	001	5	8/8/2018	SUPPLEMENT FOR EXPANSION	$0
2018	2018	KING'S COLLEGE LONDON	THE STRAND	LONDON		WC2R 2LS		GBR	Mental Health Research Grants	000	5	5/28/2018	SUPPLEMENT FOR EXPANSION	$93,821
														Subtotal = $93,821

Issue Date FY: 2017 ( Subtotal = $316,056 )
2017	2017	KING'S COLLEGE LONDON	THE STRAND	LONDON		WC2R 2LS		GBR	Mental Health Research Grants	000	5	9/1/2017	NON-COMPETING CONTINUATION	$316,056
														Subtotal = $316,056

Issue Date FY: 2016 ( Subtotal = $421,595 )
2016	2016	KING`S COLLEGE LONDON	BOX P004 DE CRESPIGNY PARK	LONDON				GBR	Mental Health Research Grants	001	4	8/27/2016	NON-COMPETING CONTINUATION	$314,272
2016	2016	KING`S COLLEGE LONDON	BOX P004 DE CRESPIGNY PARK	LONDON				GBR	Mental Health Research Grants	000	3	5/25/2016	SUPPLEMENT FOR EXPANSION	$107,323
														Subtotal = $421,595

Issue Date FY: 2015 ( Subtotal = $397,592 )
2015	2015	KING`S COLLEGE LONDON	BOX P004 DE CRESPIGNY PARK	LONDON				GBR	Mental Health Research Grants	000	3	8/27/2015	NON-COMPETING CONTINUATION	$397,592
														Subtotal = $397,592

Issue Date FY: 2014 ( Subtotal = $345,585 )
2014	2014	KING`S COLLEGE LONDON	BOX P004 DE CRESPIGNY PARK	LONDON				GBR	Mental Health Research Grants	000	2	8/7/2014	NON-COMPETING CONTINUATION	$345,585
														Subtotal = $345,585

Issue Date FY: 2013 ( Subtotal = $405,108 )
2013	2013	KING`S COLLEGE LONDON	BOX P004 DE CRESPIGNY PARK	LONDON				GBR	Mental Health Research Grants	000	1	8/30/2013	NEW	$405,108
														Subtotal = $405,108

Grand Total All Awards = $1,672,623

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COBALT: Comorbid Affective Disorders, AIDS/HIV, and Long Term Health

Award Number: R01MH100470

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 12/06/2017

PERIOD OF PERFORMANCE END DATE: 08/31/2019

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