Targeted Strategies to Accelerate Evidence-Based Psychotherapy (EBP) Implementation in Military Settings
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|ClinicalTrials.gov Identifier: NCT03663452|
Recruitment Status : Not yet recruiting
First Posted : September 10, 2018
Last Update Posted : May 13, 2019
Palo Alto Veterans Institute for Research
United States Department of Defense
Information provided by (Responsible Party):
Carmen McLean, Palo Alto Veterans Institute for Research
This study will evaluate a program designed to increase military treatment facilities' use of Prolonged Exposure (PE), an evidence-based psychotherapy for PTSD. The results will determine whether this program increases PE use and improves patient outcomes compared to conventional provider training in PE, and feedback from clinic leaders and staff will be used to gauge program usability, identify successful components, and refine program for expansion.
|Condition or disease||Intervention/treatment||Phase|
|Posttraumatic Stress Disorder||Behavioral: Targeted Assessment and Context-Tailored Implementation of Change Strategies (TACTICS) Behavioral: Prolonged exposure training||Not Applicable|
Show Detailed Description
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||90 participants|
|Intervention Model:||Sequential Assignment|
|Intervention Model Description:||This project will use a cluster-randomized stepped wedge design in eight MHS behavioral health outpatient clinics. All sites first receive PE training, and are randomly allocated to receive the TACTICS intervention either 5, 10, or 15 months later.|
|Masking:||Single (Outcomes Assessor)|
|Primary Purpose:||Health Services Research|
|Official Title:||Targeted Strategies to Accelerate Evidence-Based Psychotherapy (EBP) Implementation in Military Settings|
|Estimated Study Start Date :||June 2019|
|Estimated Primary Completion Date :||April 2020|
|Estimated Study Completion Date :||April 2020|
|Active Comparator: Prolonged exposure training||
Behavioral: Prolonged exposure training
Providers will receive a 2-day workshop training in the delivery of prolonged exposure, followed by weekly phone clinical consultation.
Behavioral: Targeted Assessment and Context-Tailored Implementation of Change Strategies (TACTICS)
TACTICS begins with a mixed methods assessment (using data from medical records, staff surveys, and staff interviews) to identify barriers and facilitators of PE use in each clinic. From a menu of implementation strategies that can be matched to local conditions, an implementation plan is developed in collaboration with clinic personnel and deployed to address specific barriers and leverage strengths at each clinic site over a 5-month period.
Primary Outcome Measures :
- PE use [ Time Frame: Baseline to 20 months ]The proportion of PTSD patients who receive PE, as measured by coded electronic medical record data
Secondary Outcome Measures :
- Change in patients' PTSD severity [ Time Frame: Baseline to 20 months ]Patients' PTSD symptoms, as measured by change on a PTSD symptom measure routinely collected at behavioral health appointments.
Other Outcome Measures:
- TACTICS usability and satisfaction [ Time Frame: Immediately after the 5-month TACTICS intervention ]Usability of and overall satisfaction with TACTICS among senior leaders, clinic leaders, and providers, as assessed through post-TACTICS qualitative interviews.
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