Staying Connected: Trauma Center to Tribal Community Linkage for Physically Injured American Indian Patients

NCT00938067 | Completed

• 2 other identifiers: 35970-CP60 MD0005-07
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to provide American Indian trauma patients, treated at the Harborview Level 1 urban trauma center, compassionate and culturally sensitive care and to link them to care in their distant tribal communities. The specific aims include 1) interview Native healers to gather information on culture-specific aspects of recovery from traumatic injury and on linking care to tribal communities, 2) conduct a randomized controlled trial to evaluate the implementation and effectiveness of the intervention. The investigators hypothesize that intervention patients will demonstrate greater improvement than controls in post-traumatic stress disorder (PTSD) symptoms, depression, functioning, diagnoses, and fewer new injuries during the 6 months after the index injury.

Conditions

Injuries

Keywords

Injuries, Trauma

Outcome Measures

Primary Outcomes (1)

• Post Traumatic Stress Disorder Symptoms assessed by a PCL score

  Six months

Secondary Outcomes (1)

• Depression, Composite International Diagnostic Interview and alcohol abuse/dependence

  Six months

Study Arms (1)

Staying Connected: Care Management

EXPERIMENTAL

The intervention combines case management, psychopharmacological and culturally appropriate and individually tailored trauma support activities with evidence-based treatments.A key feature is the provision of a continuous healing relationship by a care management treatment team.The care manager, informed by the Native healer interviews, will provide a culturally appropriate and ongoing helping relationship to each intervention patient in the weeks and months post-injury and will remain in close contact with the trauma survivor subject for 6 months.Together, the care manager and trauma survivor subject will work on a plan to readjust to daily activities. The care management team will also coordinate psychopharmacological interventions for PTSD and related co-morbidities with primary care and or other community providers.

Behavioral: Staying Connected

Interventions

Staying Connected BEHAVIORAL

The overarching goal of the Staying Connected intervention is to establish a compassionate and culturally sensitive treatment trajectory that diminishes posttraumatic suffering by reducing symptomatic distress, improving functional recovery, and reducing the risk of injury recurrence. This trajectory begins with surgical treatment and extends through outpatient care and community rehabilitation. The collaborative care intervention fundamentally restructures the delivery of mental health care within trauma care systems by bringing together providers currently working independently to form an interdisciplinary mental health team. Team members work together and in a liaison capacity with other trauma center providers and community practitioners in order to bridge care across service delivery sectors.

Staying Connected: Care Management

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Harborview trauma patient 18 years or older
• self identify as American Indian or Alaska Native
• speak English

You may not qualify if:

• non-American Indian or Alaska Native status reported
• monolingual non-English speaking status
• age \< 18 years
• old head, spinal cord or other injuries that prevent participation in the interview
• any self-inflicted injury, active psychosis, mania, and victims of intimate partner violence who require immediate intervention
• currently incarcerated patients or a recent history of severe violence which will likely yield criminal charges

Sponsors & Collaborators

• University of Washington: lead

Study Sites (1)

Harborview Medical Center

Seattle, Washington, 98104, United States

Location

MeSH Terms

Conditions

Wounds and Injuries; Accidental Injuries

Study Officials

• Doug Zatzick, MD

  University of Washington

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: July 9, 2009
• First Posted: July 13, 2009
• Study Start: June 1, 2009
• Primary Completion: June 1, 2010
• Study Completion: December 1, 2011
• Last Updated: June 20, 2012

Record last verified: 2012-06

Locations

US (1)