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

> **NIH NIH R01** · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · 2022 · $641,803

## Abstract

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. Comm...

## Key facts

- **NIH application ID:** 10487488
- **Project number:** 5R01AA025947-05
- **Recipient organization:** NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
- **Principal Investigator:** MILTON L WAINBERG
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $641,803
- **Award type:** 5
- **Project period:** 2018-09-20 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10487488

## Citation

> US National Institutes of Health, RePORTER application 10487488, Community I-STAR Mozambique: Community Implementation of SBIRT using Technology for Alcohol use Reduction in Mozambique (5R01AA025947-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10487488. Licensed CC0.

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