Evaluation of Peer Specialists on VA PACTs

NCT02732600 | Completed Results

• 1 other identifier: QUX 16-001
• Study Type: interventional
• Target: 5,616
• Locations: 1 country
• Sites: 25

Brief Summary

In August 2014, the White House issued an Executive Action mandating that 25 VA medical centers place Peer Specialists (Veterans recovered from mental illness who are trained to support other Veterans with mental illness) on Primary Care Teams. Research shows that the success of adding new staff to existing teams can be improved by outside aid and facilitation. This quality improvement project will evaluate whether providing expanded support to half of the Primary Care Teams will lead to better outcomes when compared with teams that do not get extra support.

Conditions

Mental Illness; Physical Illness

Keywords

Veterans; Veterans Health; Patient Compliance; Primary Health Care; Health Care Providers; Health Promotion

Outcome Measures

Primary Outcomes (1)

• Patient Activation Measure Change

  The Patient Activation Measure (PAM) is a 13-item survey that measures an individual's perceived ability to manage his or her illness and health behaviors and act as an effective patient. It has been shown to be reliable, valid, sensitive to change and correlates with measures of improved self-management. Scores for this outcome range from Zero to One Hundred with higher scores indicating higher levels of patient activation (better outcome).

  Baseline, 6 months, 1 year

Secondary Outcomes (8)

• Team Development Measure

  Baseline, 6 months, 1 year

• Peer Fidelity Measure

  6 months, 1 year

• The Satisfaction Index-Mental Health

  Baseline, 6 months, 1 year

• Number of Unique Veterans Seen (Adjusted for Employment Period and Hours Worked Per Week)

  one year, across two years

• Average Number of Visits Per Veteran Per Peer Specialist-Adjusted (Across Both Years)

  across both years

Study Arms (2)

Standard Implementation

NO INTERVENTION

Standard Implementation sites will receive written guidance and limited consultation by the investigators' team.

Facilitated Implementation

EXPERIMENTAL

Facilitated Implementation sites will receive one year of support based on the i-PARIHS implementation model which includes training, implementation planning, ongoing external facilitation, feedback and consultation.

Other: Facilitated Implementation

Interventions

Facilitated Implementation OTHER

Facilitated Implementation sites will receive one year of support based on the i-PARIHS implementation model which includes training, implementation planning, ongoing external facilitation, feedback and consultation

Facilitated Implementation

Eligibility Criteria

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

You may qualify if:

• Included sites must be VA PACT Primary Care Health teams with existing Peer Specialists who are able to include an existing Peer Specialist on their team for a minimum of 10 hours per week for one year

You may not qualify if:

• Non VA PACT teams, VA sites without an existing Peer Specialists, and VA PACT primary care teams that cannot commit a Peer Specialist to Primary Care for a minimum of 10 hours per week are excluded

Sponsors & Collaborators

• VA Office of Research and Development: lead
• US Department of Veterans Affairs: collaborator

Study Sites (25)

Southern Arizona VA Health Care System, Tucson, AZ

Tucson, Arizona, 85723, United States

Location

VA Palo Alto Health Care System, Palo Alto, CA

Palo Alto, California, 94304-1290, United States

Location

San Francisco VA Medical Center, San Francisco, CA

San Francisco, California, 94121, United States

Location

VA Connecticut Healthcare System West Haven Campus, West Haven, CT

West Haven, Connecticut, 06516, United States

Location

North Florida/South Georgia Veterans Health System, Gainesville, FL

Gainesville, Florida, 32608, United States

Location

West Palm Beach VA Medical Center, West Palm Beach, FL

West Palm Beach, Florida, 33410, United States

Location

Atlanta VA Medical and Rehab Center, Decatur, GA

Decatur, Georgia, 30033, United States

Location

Jesse Brown VA Medical Center, Chicago, IL

Chicago, Illinois, 60612, United States

Location

Edward Hines Jr. VA Hospital, Hines, IL

Hines, Illinois, 60141-5000, United States

Location

VA Northern Indiana Health Care System Marion Campus, Marion, IN

Marion, Indiana, 46953, United States

Location

Lexington VA Medical Center, Lexington, KY

Lexington, Kentucky, 40502, United States

Location

Maine VA Medical Center, Augusta, ME

Togus, Maine, 04330, United States

Location

Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD

Baltimore, Maryland, 21201, United States

Location

Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA

Bedford, Massachusetts, 01730, United States

Location

John D. Dingell VA Medical Center, Detroit, MI

Detroit, Michigan, 48201, United States

Location

St. Louis VA Medical Center John Cochran Division, St. Louis, MO

St Louis, Missouri, 63106, United States

Location

Syracuse VA Medical Center, Syracuse, NY

Syracuse, New York, 13210, United States

Location

Salisbury W.G. (Bill) Hefner VA Medical Center, Salisbury, NC

Salisbury, North Carolina, 28144, United States

Location

Chillicothe VA Medical Center, Chillicothe, OH

Chillicothe, Ohio, 45601, United States

Location

Cincinnati VA Medical Center, Cincinnati, OH

Cincinnati, Ohio, 45220, United States

Location

Chalmers P. Wylie Ambulatory Care Center, Columbus, OH

Columbus, Ohio, 43203-1278, United States

Location

Philadelphia VA Medical Center, Philadelphia, PA

Philadelphia, Pennsylvania, 19104, United States

Location

VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA

Pittsburgh, Pennsylvania, 15240, United States

Location

Wm. Jennings Bryan Dorn VA Medical Center, Columbia, SC

Columbia, South Carolina, 29209, United States

Location

White River Junction VA Medical Center, White River Junction, VT

White River Junction, Vermont, 05009-0001, United States

Location

Related Publications (3)

• Peeples AD, Muralidharan A, McCarthy S, Goldberg R, Kuykendall L, Vineyard N, Chinman M. Barriers and Enablers to Implementing Peer Specialists in Veterans Health Administration Primary Care: a Qualitative Study. J Gen Intern Med. 2023 Feb;38(3):707-714. doi: 10.1007/s11606-022-07782-0. Epub 2022 Sep 20.

  PMID: 36127539 DERIVED

• Chinman M, Goldberg R, Daniels K, Muralidharan A, Smith J, McCarthy S, Medoff D, Peeples A, Kuykendall L, Vineyard N, Li L. Implementation of peer specialist services in VA primary care: a cluster randomized trial on the impact of external facilitation. Implement Sci. 2021 Jun 7;16(1):60. doi: 10.1186/s13012-021-01130-2.

  PMID: 34099004 DERIVED

• Chinman M, Daniels K, Smith J, McCarthy S, Medoff D, Peeples A, Goldberg R. Provision of peer specialist services in VA patient aligned care teams: protocol for testing a cluster randomized implementation trial. Implement Sci. 2017 May 2;12(1):57. doi: 10.1186/s13012-017-0587-7.

  PMID: 28464935 DERIVED

MeSH Terms

Conditions

Mental Disorders; Patient Compliance

Condition Hierarchy (Ancestors)

Patient Acceptance of Health Care; Treatment Adherence and Compliance; Health Behavior; Behavior

Limitations and Caveats

While the uploaded Study Protocol is in publication form, this represents the only written study protocol. Because the study was classified as non-research, there is no IRB protocol.

Results Point of Contact

• Title: Richard Goldberg
• Organization: VISN 5 Mental Illness Research, Education, and Clinical Center

Richard.Goldberg@va.gov

410-637-1851

Study Officials

• Matthew J. Chinman, PhD

  VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA

  PRINCIPAL INVESTIGATOR

• Richard W Goldberg, PhD

  Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: FED
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 4, 2016
• First Posted: April 8, 2016
• Study Start: January 1, 2016
• Primary Completion: March 31, 2019
• Study Completion: October 31, 2019
• Last Updated: July 27, 2023
• Results First Posted: June 12, 2020

Record last verified: 2023-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (25)