Peer Intervention to Improve Access Among Rural Women Veterans With Psychological Distress and Unmet Social Needs

NCT05477706 | Unknown

• 2 other identifiers: H-503341652536
• Study Type: interventional
• Target: 72
• Locations: 1 country
• Sites: 2

Brief Summary

This research project will refine and evaluate delivery of a peer-delivered evidence-based intervention to improve perceived access and actual engagement with mental health treatment and social resource service use among rural women Veterans, especially Veterans of color, with psychological distress and unmet social needs.

Conditions

Psychological Distress; Depression; PTSD; Anxiety

Keywords

Peer-delivered Intervention; Psychological Distress; Unmet social needs; Rural Women Veterans; PTSD; Depression; Suicide risk; Telehealth; Anxiety

Outcome Measures

Primary Outcomes (2)

• Change in actual engagement with social resource services and mental health treatment

  VHA Administrative data will be used to assess face-to-face and digital visits (encounters) along with self-reported number of visits on the Epidemiological Catchment Area Survey (ECA).

  Baseline, 6 Months (post-intervention), and 9 Months (3 Months post-intervention)

• Change in perceived access to social resource services and mental health treatment

  The Assessment of Perceived Access to Care (APAC) measure will be used to assess perceived access to social resource services and mental health treatment at each time-point with a scale of 1-5 so that higher total scores equals better access.

  Baseline, 6 Months (post-intervention), and 9 Months (3 Months post-intervention)

Secondary Outcomes (10)

• Veteran satisfaction

  6 Months (post-intervention) and 9 Months (3 Months post-intervention)

• Change in depression symptoms

  Baseline, 6 Months (post-intervention), and 9 Months (3 Months post-intervention)

• Change in social needs

  Baseline, 6 Months (post-intervention), and 9 Months (3 Months post-intervention)

• Change in greater perceived progress on needs

  Baseline, 6 Months (post-intervention), and 9 Months (3 Months post-intervention)

• Change in functioning

  Baseline, 6 Months (post-intervention), and 9 Months (3 Months post-intervention)

Other Outcomes (3)

• Therapeutic alliance

  Baseline, 6 Months (post-intervention), and 9 Months (3 Months post-intervention)

• Perceived Confidence

  Baseline, 6 Months (post-intervention), and 9 Months (3 Months post-intervention)

• Autonomy Support

  Baseline, 6 Months (post-intervention), and 9 Months (3 Months post-intervention)

Study Arms (2)

Personalized Support for Progress (PSP)

EXPERIMENTAL

PSP includes an initial 60-minute video or phone appointment and then follow-up tailored to the Veteran's preferences. The Peer Specialist guides the Veteran through a card-sorting task to prioritize concerns and then create a personalized care plan. The Peer then provides up to six months of outreach and support to implement the care plan. At the end of the six months, the Veteran and peer review the plan, determine next steps and consider other supports and resources to sustain progress made.

Other: Personalized Support for Progress (PSP)

Tailored Referral (TR)

ACTIVE COMPARATOR

The Tailored Referral (TR) comparator will be comprised of written or emailed information describing resources and contact information for VHA and local social and mental health resources. Examples include information about the appropriate office/person to reach within the local VA or area, help scheduling an appointment, or information for a same-day Primary Care - Mental Health Integration (PCMHI) assessment.

Other: Tailored Referral (TR)

Interventions

Personalized Support for Progress (PSP) OTHER

Personalized Support for Progress (PSP) is a Peer Specialist delivered intervention in which a peer supports Veterans in prioritizing their needs and attaining access to the Veterans' preferred services.

Personalized Support for Progress (PSP)

Tailored Referral (TR) OTHER

TR consists of detailed resource information and referral, consistent with standard practice.

Tailored Referral (TR)

Eligibility Criteria

• Age: 18 Years+
• Gender Eligibility Details: Self-identification as woman or gender fluid
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Veteran status (non-Veterans will not be enrolled in this trial)
• Identifies as a woman or as gender fluid
• Resides in a rural or highly rural area
• Psychological distress in the past 6 months as evidenced by a diagnosis in the electronic health record or elevated score on the PHQ-9, GAD-7 and/or PCL
• At least one social need in the past 6 months on the PRAPARE
• Ability to communicate in English including reading, writing, hearing, and speaking well enough to complete research and intervention tasks.
• Any provider (physician, social worker, therapist, etc. with experience working with rural women Veterans) employed by the VHA
• Any peer specialist employed by the VHA who identifies as a woman or as gender fluid

You may not qualify if:

• Any Veteran with high suicide or homicide risk and/or evaluated by the PI or another clinician to be clinically unstable
• Veterans with impairment that would not allow them to engage in study activities including active psychosis, cognitive deficits, severe substance use requiring detoxification (documented in electronic health record or reported by a primary care clinician team member)
• Aim 2 (Randomized controlled trial of PSP compared to TR)
• Veteran status (non-Veterans will not be enrolled in this trial)
• Identifies as a woman or as gender fluid
• Resides in a rural or highly rural area
• Veteran must reside in Southeastern Texas, Arkansas or Louisiana
• Psychological distress in the past 6 months as evidenced by a diagnosis in the electronic health record or elevated score on the PHQ-9, GAD-7 and/or PCL
• At least one social need in the past 6 months on the PRAPARE
• Ability to communicate in English including reading, writing, hearing, and speaking well enough to complete research and intervention tasks.
• Any Veteran with high suicide or homicide risk and/or evaluated by the PI or another clinician to be clinically unstable
• Veterans with impairment that would not allow them to engage in study activities including active psychosis, cognitive deficits, severe substance use requiring detoxification (documented in EMR or reported by a PACT member)
• Veterans who have current VA or non-VA peer support engagement (an appointment within the last month and/or additional follow-up scheduled)

Sponsors & Collaborators

• Syracuse VA Medical Center: lead
• US Department of Veterans Affairs: collaborator

Study Sites (2)

Syracuse VA Medical Center

Syracuse, New York, 13210, United States

Location

Michael E. DeBakey VA Medical Center

Houston, Texas, 77030, United States

Location

Related Publications (53)

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MeSH Terms

Conditions

Depression; Stress Disorders, Post-Traumatic; Anxiety Disorders

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior; Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Mental Disorders

Study Officials

• Ellen Poleshuck, PhD

  Syracuse VA Medical Center

  PRINCIPAL INVESTIGATOR

• Derrecka Boykin, PhD

  Michael E. DeBakey Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: FED
• Responsible Party: SPONSOR

Model Details: randomized clinical trial

Study Record Dates

• First Submitted: July 6, 2022
• First Posted: July 28, 2022
• Study Start: October 1, 2021
• Primary Completion: January 1, 2024
• Study Completion: October 1, 2024
• Last Updated: July 28, 2022

Record last verified: 2022-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, CSR, ANALYTIC CODE
• Time Frame: The data will be available once the database is finalized and will remain available in the future.
• Access Criteria: Access to the data can be obtained by emailing the PIs and describing the reason the data is needed.

Locations

US (2)