NCT01710943

Brief Summary

The proposed study involves developing and evaluating an interactive, web-based CBT intervention for OEF/OIF Veterans with hazardous or problematic substance use and PTSD symptoms (PTSD or subsyndromal PTSD). The intervention will address the special culture and experiences of the investigators targeted population (OEF/OIF Veterans). The web-based CBT intervention includes 24 modules, to be used across 24 sessions targeting OEF/OIF Veterans with hazardous or problematic substance use and PTSD symptoms. The investigators ask participants to complete 2 sessions per week (one module per session) for 12 weeks. The first 18 modules to be completed across 18 sessions (9 weeks) are considered core modules relevant to all Veterans in the target population. These modules are designed to reduce posttraumatic stress symptoms as well as reduce and prevent the escalation of problematic substance use. The remaining 6 module topics are considered "optional" and are used based on the interest and clinical need of various sub-groups of VA patients. The study includes initial input as well as feedback on a beta version from experts who have worked with OEF/OIF veterans with PTSD and substance abuse problems as well as input/feedback from the target population (the Veterans themselves). In addition to presenting content grounded in evidence-based CBT interventions, the program also employs state of the art technologies to deliver module content grounded in evidence-based learning principles, including Computer-Assisted Instruction, Computer Simulation and other interactive exercises.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
216

participants targeted

Target at P75+ for phase_1

Timeline
Completed

Started Sep 2010

Typical duration for phase_1

Geographic Reach
1 country

2 active sites

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

September 1, 2010

Completed
1.7 years until next milestone

First Submitted

Initial submission to the registry

April 26, 2012

Completed
6 months until next milestone

First Posted

Study publicly available on registry

October 19, 2012

Completed
1.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2014

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2014

Completed
Last Updated

October 19, 2012

Status Verified

October 1, 2012

Enrollment Period

3.8 years

First QC Date

April 26, 2012

Last Update Submit

October 17, 2012

Conditions

Keywords

Web-based CBTPTSDAlcohol MisuseSubstance MisuseIntegrated Primary CareOEF/OIF Veterans

Outcome Measures

Primary Outcomes (10)

  • PTSD Symptomatology

    Comparing baseline score of the PCL-M to 12 weeks score

    12 weeks

  • PTSD Symptomatology

    Comparing baseline score of the PCL-M to score 1 month post-intervention discharge

    1 month post-intervention

  • PTSD Symptomatology

    Comparing baseline score of the PCL-M to score 3 months post-intervention

    3 months post-intervention

  • Alcohol and Drug Use

    Comparing baseline score of the Timeline Follow-back (TLFB)to 12 weeks score

    12 weeks

  • Alcohol and Drug Use

    Comparing baseline TLFB score to score 1 month post-intervention

    1 month post-intervention

  • Alcohol and Drug Use

    Comparing baseline TLFB score to score 3 month post-intervention

    3 month post-intervention

  • Quality of Life

    Comparing baseline EuroQOl and WHOQOL-Bref scores to scores at 12 weeks

    12 weeks

  • Quality of Life

    Comparing baseline EuroQOl and WHOQOL-Bref scores to scores at 1 month post-intervention

    1 month post-intervention

  • Quality of Life

    Comparing baseline EuroQOl and WHOQOL-Bref scores to scores at 3 months post-intervention

    3 month post-intervention

  • Cost-Effectiveness

    Cost-effectiveness of web-based intervention compared to standard care, as measured by the Brief DATCAP, EuroQol EQ5D, and Non-Study Medical and Other Services (NSMS) scales

    12 weeks

Secondary Outcomes (13)

  • Resiliency and Positive Affect

    12 weeks

  • Resiliency and Positive Affect

    1 month post-intervention

  • Resiliency and Positive Affect

    3 months post-intervention

  • Insomnia

    12 weeks

  • Insomnia

    1 month post-intervention

  • +8 more secondary outcomes

Study Arms (2)

Web-based Cognitive Behavioral Treatment

EXPERIMENTAL

Participants who are randomly assigned to the treatment condition will receive the same standard care as those in the control condition and they will also receive access to the web-based CBT intervention. Participants in this condition will be asked to complete 24 CBT sessions, 2 sessions/topics per week for 12 weeks. Participants will be asked to complete the 18 "core modules" of the program during the first 9 weeks of the trial and then to re-visit important modules and complete optional modules of their choice during the final 3 weeks of the trial.

Behavioral: Web-based Cognitive Behavioral Treatment

Treatment as Usual

NO INTERVENTION

TAU consists of the usual Veterans Integrated Service Network 2 (VISN) primary care services. As we have described, all of the participants will be recruited from patients presenting for treatment typically for physical complaints in primary care clinics in VA's VISN 2 (Upstate NY). VISN 2 officially practices a co-located, collaborative care model of integrated (behavioral health and physical health) in its primary care clinics. This integrated model has been implemented widely in both VA and non-VA primary care clinics in the United States .

Interventions

Participants in this condition will be asked to complete 24 CBT sessions, 2 sessions/topics per week for 12 weeks. We expect that each session will be approximately 30 minutes in duration. Participants will be asked to complete the 18 "core modules" of the program during the first 9 weeks of the trial and then to re-visit important modules and complete optional modules of their choice during the final 3 weeks of the trial. They can choose to do this using a designated computer in a private room at their local VA or can complete these sessions in the privacy of their own home with their personally-owned computers. Participants can choose to complete each session on any day/time of their choosing in a given week.

Also known as: Web-based CBT
Web-based Cognitive Behavioral Treatment

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • At least 18 years of age
  • An OEF or OIF veteran (verified via CPRS)
  • Screen positive on the Audit-C (\>=3 for women or \>= 4 for men) OR screen positive on the PC-PTSD (\>=3).
  • Currently receiving primary medical care at a VA Medical Center (verified via CPRS)

You may not qualify if:

  • Insufficient ability to understand or provide informed consent
  • Lack sufficient ability to use English to participate in the consent process,
  • Current plan or intent to harm themselves as measured with the suicide assessment in Appendix D after the consent process.
  • Phase 2: Feedback Sessions
  • At least 18 years of age
  • An OEF or OIF veteran (verified via CPRS)
  • Hazardous or harmful substance use as measured by one of the following:
  • AUDIT-C score of \>=3 (for women) or \>= 4 (for men) OR
  • DAST score of \>=2 OR
  • Have exited a controlled environment (e.g., detoxification unit, hospital, or correctional facility) within 30 days of screening AND within 30 days prior to entering the controlled environment report:
  • i. heavy drinking (\>3 drinks for women or \> 4 drinks for men on one or more days), or ii.use of any illegal drugs, iii.or misuse of prescription drugs (use in excess of the directions or any non-medical use)
  • Screen positive on the PC-PTSD (\>=2).
  • Currently receiving primary medical care at a VA Medical Center (verified via CPRS)
  • Insufficient ability to understand or provide informed consent
  • Lack sufficient ability to use English to participate in the consent process, the computerized intervention or the assessments.
  • +19 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Buffalo VA Medical Center

Buffalo, New York, 14215, United States

RECRUITING

Syracuse VA Medical Center

Syracuse, New York, 13210, United States

RECRUITING

MeSH Terms

Conditions

Stress Disorders, Post-Traumatic

Condition Hierarchy (Ancestors)

Stress Disorders, TraumaticTrauma and Stressor Related DisordersMental Disorders

Study Officials

  • Andrew Rosenblum, Ph.D.

    National Development and Research Institutes, Inc.

    PRINCIPAL INVESTIGATOR
  • Stephen Maisto, Ph.D.

    Syracuse University

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Kyle Possemato, Ph.D.

CONTACT

Michelle Acosta, Ph.D.

CONTACT

Study Design

Study Type
interventional
Phase
phase 1
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Director, Institute for Treatment and Services Research

Study Record Dates

First Submitted

April 26, 2012

First Posted

October 19, 2012

Study Start

September 1, 2010

Primary Completion

June 1, 2014

Study Completion

June 1, 2014

Last Updated

October 19, 2012

Record last verified: 2012-10

Locations