Working...
ClinicalTrials.gov
ClinicalTrials.gov Menu

REACH VET Program Evaluation (REACH VET)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
ClinicalTrials.gov Identifier: NCT03280225
Recruitment Status : Active, not recruiting
First Posted : September 12, 2017
Last Update Posted : March 1, 2019
Sponsor:
Information provided by (Responsible Party):
VA Office of Research and Development

Brief Summary:
The VA's Office of Mental Health and Suicide Prevention is implementing an new program to increase suicide prevention outreach for Veterans at highest risk for suicide. Using a statistical model, REACH VET, short for Recovery Engagement and Coordination for Health - Veterans Enhanced Treatment, uses information from Veterans' health records to identify those who are at a higher risk for suicide, hospitalization, illness, or other negative outcomes. Once a Veteran is identified, his or her VA mental health or primary care provider reaches out to check on the Veteran's well-being and review their treatment plan to determine if enhanced care is needed. The goal of the proposed study is to evaluate the implementation of this program in collaboration with the Partnered Evidence-based Policy Resource Center (PEPReC). The objectives of this evaluation are to evaluate how well this program is put into place using a strategy called virtual external facilitation, and to collect data about the cost of the program and the strategy.

Condition or disease Intervention/treatment
Suicide Other: External facilitation

Detailed Description:

The VA's Office of Mental Health and Suicide Prevention is implementing an innovative new program to increase suicide prevention outreach and target Veterans at highest risk for suicide. Using a new predictive model, REACH VET, short for Recovery Engagement and Coordination for Health - Veterans Enhanced Treatment, analyzes existing data from Veterans' health records to identify those who are at a statistically elevated risk for suicide, hospitalization, illness, or other adverse outcomes. Once a Veteran is identified, his or her VA mental health or primary care provider reaches out to check on the Veteran's well-being and review their condition(s) and treatment plans to determine if enhanced care is needed.

The goal of the proposed study is to evaluate the implementation of REACH VET in collaboration with the Partnered Evidence-based Policy Resource Center (PEPReC).

The objectives of this evaluation are to:

  1. evaluate the implementation of REACH VET using virtual external facilitation, and
  2. collect preliminary data about the cost and cost offsets.

The proposed evaluation will examine the impact of a virtual external facilitation strategy on the implementation of REACH VET in 28 medical facilities across 7 Veteran Integrated Service Networks (VISNs) in a stepped wedge design. Primary implementation outcomes include reach, adoption, and implementation fidelity. Qualitative interviews will be conducted with implementation facilitators, Suicide Prevention Coordinator(s), clinical leadership, and providers to identify barriers and facilitators to implementation of REACH VET and the experience of facilitation. Secondary data will be collected on the cost of the intervention and the cost of implementation strategy.


Layout table for study information
Study Type : Observational
Estimated Enrollment : 400 participants
Observational Model: Other
Time Perspective: Prospective
Official Title: Risk Stratified Enhancements to Clinical Care: Targeting Care for Patients Identified Through Predictive Modeling as Being at High Risk for Suicide, With the Office of Mental Health Operations
Actual Study Start Date : September 18, 2017
Estimated Primary Completion Date : September 30, 2019
Estimated Study Completion Date : December 31, 2020

Resource links provided by the National Library of Medicine


Group/Cohort Intervention/treatment
VISNs requesting implementation support
VA has divided the country into regions of care and these are called Veteran Integrated Service Networks (VISNs). This group consists of VISNs with facilities that need additional implementation support to fully implement REACH VET and that agree to participate.
Other: External facilitation
Facilitation is an evidence-based implementation strategy to support sites that have difficulty implementing innovative programs. Facilitation is a multi-faceted "process of interactive problem solving and support that occurs in the context of a recognized need for improvement and a supportive interpersonal relationship (Powell et al., 2015)." Facilitation has been used nationally across VA to implement a number of different clinical interventions. The current project will examine this minimally intensive version of implementation facilitation, virtual external facilitation.
Other Name: Virtual external facilitation, facilitation, implementation facilitation




Primary Outcome Measures :
  1. Reach [ Time Frame: 6 months ]
    Reach is the proportion of patients identified at each facility who receive the REACH VET intervention.

  2. Adoption [ Time Frame: 6 months ]
    Adoption is the proportion of mental health and primary care providers in each facility that participate.

  3. Implementation fidelity [ Time Frame: 6 months ]
    Implementation fidelity is whether facilities implemented all components of the intervention as directed.


Secondary Outcome Measures :
  1. Cost of implementation [ Time Frame: weekly through study completion, an average of 2 years ]
    Cost of implementation will be estimated by documenting the amount of effort and time needed to offer virtual external facilitation.

  2. Cost of intervention [ Time Frame: up to 6 months ]
    Cost of the intervention will be estimated by documenting the amount of effort and time needed to implement REACH VET activities.

  3. Organizational Readiness for Change survey [ Time Frame: 1 month ]
    The Organizational Readiness for Change survey is a quantitative survey that assesses an organization's culture and readiness for change.

  4. Barriers, facilitators, experience of facilitation process [ Time Frame: 6 months ]
    Barriers and facilitators to implementing REACH VET and the experience of the facilitation process will be assessed via qualitative interviews.


Biospecimen Retention:   None Retained
No biospecimens will be collected.


Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Layout table for eligibility information
Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
The study population will include facilities receiving virtual external facilitation for REACH VET and those VA employees at those facilities involved in the implementation or REACH VET.
Criteria

Inclusion Criteria:

  • VA employee at a facility receiving virtual external facilitation
  • Involved in REACH VET implementation

Exclusion Criteria:

  • Not a VA employee
  • Not employed at a facility receiving virtual external facilitation
  • Not involved in REACH VET implementation

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03280225


Locations
Layout table for location information
United States, Arkansas
Central Arkansas Veterans Healthcare System Eugene J. Towbin Healthcare Center, Little Rock, AR
North Little Rock, Arkansas, United States, 72114-1706
United States, Colorado
VA Eastern Colorado Health Care System, Denver, CO
Denver, Colorado, United States, 80220
Sponsors and Collaborators
VA Office of Research and Development
Investigators
Layout table for investigator information
Principal Investigator: Sara J. Landes, PhD Central Arkansas Veterans Healthcare System Eugene J. Towbin Healthcare Center, Little Rock, AR

Publications of Results:
Reger MA, Luxton DD, Tucker R, Comtois KA, Keen AD, Landes SJ, Matarazzo BB, Thompson C. Implementation Methods for the Caring Contacts Suicide Prevention Intervention. Professional Psychology, Research and Practice. 2017 Oct 1; 48(5):369-377.

Layout table for additonal information
Responsible Party: VA Office of Research and Development
ClinicalTrials.gov Identifier: NCT03280225     History of Changes
Other Study ID Numbers: SDR 16-195
First Posted: September 12, 2017    Key Record Dates
Last Update Posted: March 1, 2019
Last Verified: February 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Layout table for additional information
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No

Keywords provided by VA Office of Research and Development:
Suicide
Prevention
Implementation
Facilitation

Additional relevant MeSH terms:
Layout table for MeSH terms
Suicide
Self-Injurious Behavior
Behavioral Symptoms