Targeted Strategies to Accelerate Evidence-Based Psychotherapy (EBP) Implementation in Military Settings

NCT03663452 | Completed

• 1 other identifier: ROS0029
• Study Type: interventional
• Target: 8
• Locations: 1 country
• Sites: 8

Brief Summary

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.

Conditions

Posttraumatic Stress Disorder

Outcome Measures

Primary Outcomes (1)

• PE use

  The proportion of PTSD patients who receive PE, as measured by coded electronic medical record data

  Baseline to 20 months

Secondary Outcomes (1)

• Change in patients' PTSD severity

  Baseline to 20 months

Other Outcomes (1)

• TACTICS usability and satisfaction

  Immediately after the 5-month TACTICS intervention

Study Arms (2)

Prolonged exposure training

ACTIVE COMPARATOR

Behavioral: Prolonged exposure training

TACTICS

EXPERIMENTAL

Behavioral: Targeted Assessment and Context-Tailored Implementation of Change Strategies (TACTICS)

Interventions

Targeted Assessment and Context-Tailored Implementation of Change Strategies (TACTICS) BEHAVIORAL

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.

TACTICS

Prolonged exposure training BEHAVIORAL

Providers will receive a 2-day workshop training in the delivery of prolonged exposure, followed by weekly phone clinical consultation.

Prolonged exposure training

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Provides behavioral health care to PTSD patients

You may not qualify if:

• Plans to relocate within next 5 months

Sponsors & Collaborators

• Palo Alto Veterans Institute for Research: lead
• United States Department of Defense: collaborator

Study Sites (8)

Bassett Army Community Hospital / Ft. Wainwright

Fairbanks, Alaska, 99703, United States

Location

Mental Health Clinic / Travis Air Force Base

Fairfield, California, 94535, United States

Location

Naval Hospital Jacksonville / Naval Air Station Jacksonville

Jacksonville, Florida, 32214, United States

Location

Blanchfield Army Community Hospital (BACH) / Fort Campbell

Fort Campbell North, Kentucky, 42223, United States

Location

81st Medical Group / Keesler Air Force Base

Biloxi, Mississippi, 39530, United States

Location

49th Medical Group / Holloman Air Force Base

Alamogordo, New Mexico, 88330, United States

Location

William Beaumont Army Medical Center (WBAMC) / Fort Bliss

El Paso, Texas, 79920, United States

Location

Brooke Army Medical Center (BAMC) / Fort Sam Houston

San Antonio, Texas, 78234, United States

Location

Related Publications (1)

• Rosen CS, Davis CA, Riggs D, Cook J, Peterson AL, Young-McCaughan S, Comtois KA, Haddock CK, Borah EV, Dondanville KA, Finley EP, Jahnke SA, Poston WSC, Wiltsey-Stirman S, Neitzer A, Broussard CR, Brzuchalski MA, Clayton MSP, Conforte LAM, Flores A, Hein J, Keith CF, Jinkerson CJ, Letendre M, Nofziger D, Pollick K, Santiago CK, Waggoner LCJ, Woodworth C, McLean CP; TACTICS Research Group. Targeted Assessment and Context-Tailored Implementation of Change Strategies (TACTICS) to increase evidence based psychotherapy in military behavioral health clinics: Design of a cluster-randomized stepped-wedge implementation study. Contemp Clin Trials. 2020 Jun;93:106008. doi: 10.1016/j.cct.2020.106008. Epub 2020 Apr 21.

  PMID: 32330670 DERIVED

MeSH Terms

Conditions

Stress Disorders, Post-Traumatic

Condition Hierarchy (Ancestors)

Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Mental Disorders

Study Officials

• Carmen McLean, PhD

  carmen.mclean4@va.gov

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Co-Principal Investigator

Model Details: 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.

Study Record Dates

• First Submitted: September 4, 2018
• First Posted: September 10, 2018
• Study Start: January 10, 2019
• Primary Completion: February 1, 2023
• Study Completion: September 1, 2023
• Last Updated: August 21, 2025

Record last verified: 2025-08

Locations

US (8)