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Am J Public Health. 2018 Jun;108(6):791-798. doi: 10.2105/AJPH.2018.304350. Epub 2018 Apr 19.

Efficacy of Communication Training of Community Health Workers on Service Delivery to People Who Inject Drugs in Vietnam: A Clustered Randomized Trial.

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Li Li, Li-Jung Liang, Chunqing Lin, Chiao-Wen Lan, and Sung-Jae Lee are with the Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles. Nguyen Tran Hien, Nguyen Anh Tuan, Le Anh Tuan, Duong Cong Thanh, and Nguyen Thi Thanh Ha are with the HIV/AIDS Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.



To evaluate the efficacy of an intervention targeted to commune health workers (CHWs) who deliver services to people who inject drugs (PWID) in Vietnam.


From 2014 to 2016, we conducted a cluster randomized controlled trial of 300 CHWs and 900 PWID in 60 communes in 2 provinces of Vietnam. Intervention CHWs participated in training sessions to enhance their communication skills. Trained CHWs were asked to deliver individual sessions to PWID. We assessed the outcomes at baseline and at 3-, 6-, 9-, and 12-month follow-ups.


Intervention CHWs showed greater improvement in provider-client interactions than did control CHWs at all follow-ups (range of difference = 3.33-5.18; P < .001). Intervention CHWs showed greater reduction in negative attitudes toward PWID at the 12-month follow-up (mean ±SD = 1.75 ±0.50; P < .001). PWID in the intervention group exhibited greater improvement in drug avoidance than did those in the control group from the 6-month follow-up on (range of difference = 1.21-1.65; P < .001). We observed no intervention effect on heroin use as measured by urinalysis.


This intervention targeting CHWs could lead to desired outcomes for both CHWs and PWID. NCT0213092.1.

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