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Table 3 Characteristics of included studies

From: Community-based psychosocial substance use disorder interventions in low-and-middle-income countries: a narrative literature review

References Setting Study design and objectives Target population/s and condition Intervention objectives
Almeida do Carmo et al. [87] Sao Paulo, Brazil Cross-sectional retrospective to evaluate the effects of a recovery housing and social reintegration program for people recovering from substance dependence 69 persons ages ≥ 18 in recovery from substance dependence, abstinent after discharge from detoxification (alcohol, crack cocaine, marijuana) Reintegration into society by helping users enter employment, achieve autonomy, remain abstinent and adhere to treatment
Assanangkornchai et al. [86] Four district hospitals and four healthcare centers in two provinces in Southern Thailand RCT to assess the effectiveness of the WHO ASSIST-BI [78] procedure compared with ASSIST-screening followed by simple advice (SA) in primary care in low-population areas 236 persons ages ≥ 16 identified as problem or risky substance users (alcohol, amphetamine-type substances, cannabis, cocaine, hallucinogens, inhalants, opioids, sedatives and other substances) Improve identification of substance misuse and provide support for users to understand their risky SU and develop abstinence strategies
Humeniuk et al. [71] Australia: walk-in sexually transmitted disease clinic. Brazil: 30 primary health care (PHC) units, two health centers and one out-patient setting
India: community health centers in Shadipur. United States: community clinic
RCT to evaluate the effectiveness of a BI [brief intervention] for illicit drugs [cannabis, cocaine, amphetamine-type stimulants (ATS) and opioids] in PHC clients; determine whether a BI targeted at one substance would increase use of another substance, evaluate whether the general severity of substance involvement affects the response to a BI 731 persons who scored between 4 and 26 on the ASSIST (moderate-risk range) for cannabis, cocaine, ATS or opioids Reduce risky substance use (SU) in PHC clients using the WHO ASSIST and its linked brief intervention
Kane et al. [70] Three high-density, low-resource areas in Lusaka, Zambia RCT protocol (trial completed). The primary aims of the trial are to evaluate the effectiveness of the adapted CETA intervention on (a) reducing and preventing women’s experience of intimate partner violence (IPV) and (b) reducing male partner’s hazardous alcohol use Hazardous alcohol use and intimate partner violence. Family ‘units’ consisting of three individuals: an adult woman, her male husband or partner (who must be a hazardous drinker according to AUDIT scores), ages ≥ 18, and one of her children (male or female, ages 817) CETA: an adaptable mental health intervention that targets cognitive and behavior change through a variety of intervention components. CETA was specifically adapted in this intervention to be delivered in group settings and to include a CBT-based substance use (SU) reduction element
Lancaster et al. [76], data also extracted from sister article Miller et al. [77] Kyiv, Ukraine (one community site), Thai Nguyen, Vietnam (two district health center sites), and Jakarta, Indonesia (one hospital site) Two-arm RCT designed to determine the feasibility, barriers and uptake of an integrated intervention combining health systems navigation and psychosocial counselling for the early engagement and adherence of antiretroviral therapy (ART) and medication-assisted treatment for substance use (MAT) for people who inject drugs (PWID) living with HIV People who inject drugs (PWID) more than 12 times per 3 months (n = 502), who were HIV-positive (viral load of 1000 copies) and their non-infected injection partners (n = 806) were recruited as network units. Ages 18–60
Conditions: intravenous substance use and HIV
 Harm reduction, improved retention and adherence to SU treatment and HIV care, psychosocial counselling, and referral for ART at any CD4 count
L’Engle et al. [75] Three health drop-in centers in Mombasa, Kenya RCT to assess whether a brief alcohol intervention leads to reduced alcohol use and sexually transmitted infection (STI)/HIV incidence and related sexual risk behaviors among moderate drinking female sex workers Population: Female sex workers of ages ≥ 18 with hazardous drinking (AUDIT score 7–19)
Conditions: Alcohol use disorder and STIs
 Brief intervention based on WHO Brief Intervention for Alcohol Use. The main objective was to facilitate change/reduction in drinking and risky sexual behaviors
Nadkarni et al. [82] Eight primary health centers in Goa, India To study and describe the development of the Counselling for Alcohol Problems (CAP) brief intervention
Methods: Three steps are described—(i) identifying potential treatment strategies; (ii) developing a theoretical framework for the treatment; and (iii) evaluating the acceptability and feasibility of the treatment (through a pilot RCT comparing CAP with enhanced usual care (EUC))
Males ages ≥ 18 who had a clinical diagnosis of AUD from a mental health professional or who scored 12+ on the Alcohol Use Disorders Identification Test (AUDIT) Reduce harmful drinking behaviors through CAP delivery in primary care services by trained non-professionals
Nadkarni et al. [73] Ten primary health centers in Goa, India Single-blind individually randomized trial comparing counselling for alcohol problems (CAP) plus enhanced usual care (EUC) versus EUC only Alcohol dependent males (AUDIT score of 20 or above) 18–64 years old Investigate the feasibility and cost-effectiveness of: identifying and recruiting men with probable AD [alcohol dependence] in primary care; delivering a brief treatment for AD by lay counsellors in primary care
CAP intervention was used to treat alcohol dependence in primary care
Noknoy et al. [72] Eight primary care units (PCU) in rural Northeast (n = 7) and central (n =1) Thailand RCT to determine the effectiveness of Motivational Enhancement Therapy (MET) for hazardous drinkers in PCU settings Hazardous drinkers ages ≥ 18 (AUDIT score of 8 or more) Reduce alcohol consumption among hazardous drinkers in Thailand and harmful drinking behaviors
Pan et al. [88] Four community-based Methadone Maintenance Treatment (MMT) clinics in Shanghai, China RCT to determine [1] whether CBT is effective in improving treatment retention and reducing drug use for opiate-dependent Chinese patients in MMT and [2] whether CBT is effective in decreasing addiction severity and psychological stress for MMT patients. Control group were patients receiving MMT alone Opiate dependent patients according to psychiatrist diagnosis with DSM-IV. Ages 18–65 Cognitive behavioral therapy alongside methadone maintenance treatment to improve treatment adherence and decrease severity of SUD
Papas et al. [83], data also extracted from Papas et al. [43] HIV outpatient clinic in Eldoret, Kenya RCT of a culturally adapted Cognitive-Behavioral Therapy (CBT) to reduce alcohol use among HIV-infected outpatients Persons ages ≥ 18, enrolled as HIV outpatients (receiving or eligible to receive antiretroviral) who satisfy the hazardous or binge drinking criteria (score3 on the AUDIT-C, or6 drinks per occasion at least monthly Culturally adapted CBT to achieve abstinence from alcohol and/or encourage approximations to abstinence
Parry et al. [50] Durban, South Africa. A number of locations (i.e. streets in residential and industrial areas, and hotspots where drug users are known to frequent, such as shelters and community-based organizations) Pre-post intervention study, formal evaluation to test whether a community-level intervention aimed at alcohol and other drugs (AOD) users has an impact on risky AOD use and sexual risk behavior Self-reported alcohol and/or drug users ages ≥ 16 Brief, peer-delivered, risk reduction outreach intervention to reduce AOD use and HIV risky behaviors
Peltzer et al. [84] Forty primary health care facilities in 3 districts in South Africa RCT to assess the effectiveness of screening and brief intervention (SBI) for alcohol use disorders among TB patients in public primary care clinics. Intervention group received SBI and control group received treatment as usual in addition to an alcohol education leaflet Harmful drinkers (AUDIT scores 7 and above for women and 8 and above for me) ages ≥ 18, currently in treatment for tuberculosis (primary care) Screening and brief intervention to reduce alcohol misuse delivered by a clinic lay-counsellor
For early identification of alcohol problems in public primary care the AUDIT and for the brief intervention the WHO brief intervention package for hazardous and harmful drinking was used
Rotheram-Borus et al. [74] 24 low-income urban neighborhoods bordering Cape Town, South Africa RCT to investigate the effects of a community-based home visiting maternal health intervention by trained non-professional health workers (mentor mothers) Low income pregnant women
Self-reported drinking during pregnancy
Improve maternal health through a home visiting intervention focused on general maternal and child health, HIV/tuberculosis, alcohol use, and nutrition
Xiaolu et al. [89] 18 local hospitals in Beichuan county, China Cluster randomized study… to determine the prevalence of problem alcohol use among the patients from village hospitals and investigate whether a structured BI for those with identified alcohol problems was effective in reducing their alcohol consumption. Nine intervention hospitals and 9 control hospitals Persons ages ≥ 18 scoring 7 or above on the AUDIT. Persons who have experienced a catastrophic event (i.e. earthquake) ‘Brief
Intervention for Substance Use: manual for use in primary care’ recommended by WHO in 2003
  1. Italicized text are direct quotations extracted from the included studies