Behavioral Health Interdisciplinary Program - Collaborative Chronic Care Model (BHIP-CCM) Enhancement Project 2.0

NCT05997836 | Active Not Recruiting

• 1 other identifier: QUX 23-002
• Study Type: interventional
• Target: 81,424
• Locations: 1 country
• Sites: 17

Brief Summary

This quality improvement project aims to help outpatient mental health teams, known as Behavioral Health Interdisciplinary Program (BHIP) teams, adopt more collaborative care practices (consistent with the collaborative chronic care model or CCM). The investigators therefore aim to use two different implementation strategies -- centralized technical assistance and implementation facilitation -- to align BHIP teams' care practices more closely with the principles of the CCM.

Conditions

Mental Health

Keywords

collaborative care

Outcome Measures

Primary Outcomes (2)

• Role Clarity and Team Primacy subdomains of the Team Development Measure (TDM)

  The TDM is a measure of team functioning, and the two listed subdomains represent the co-primary outcome for the study. Note that, due to the stepped wedge design, only Wave 3 and Wave 4 sites will also have a pre-centralized technical assistance administration of the TDM. Also note that the primary time frame for this outcome, as listed above, will be post-implementation facilitation (8 months after the pre-implementation administration). Secondary analysis will also investigate one year post-implementation facilitation (20 months after the pre-implementation administration).

  Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration).

• Mental health hospitalization rate among Veterans treated within each BHIP team.

  Mental health hospitalizations represent a measure of clinical effectiveness (co-primary outcome for the study). Note that, due to the stepped wedge design, only Wave 3 and Wave 4 sites will also have a pre-centralized technical assistance calculation of the mental health hospitalization rate. Also note that the primary time frame for this outcome, as listed above, will be post-implementation facilitation (8 months after the pre-implementation administration). Secondary analysis will also investigate one year post-implementation facilitation (20 months after the pre-implementation administration).

  Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration).

Secondary Outcomes (3)

• Treatment cost

  Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration).

• All-cause mortality

  Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration).

• Treatment costs and hospitalization data compared to non-intervention sites

  Post-facilitation (8 months after start of implementation facilitation) and post-sustainment (12 months after post-facilitation)

Study Arms (4)

Wave 1

OTHER

Study design is a stepped wedge; Wave 1 begins by receiving Implementation Facilitation

Other: Implementation Facilitation

Wave 2

OTHER

Study design is a stepped wedge; Wave 2 begins by receiving Centralized Technical Assistance before crossing over to Implementation Facilitation

Other: Implementation Facilitation; Other: Centralized Technical Assistance

Wave 3

OTHER

Study design is a stepped wedge; Wave 3 begins by receiving Centralized Technical Assistance before crossing over to Implementation Facilitation

Other: Implementation Facilitation; Other: Centralized Technical Assistance

Wave 4

OTHER

Study design is a stepped wedge; Wave 4 begins by receiving Centralized Technical Assistance before crossing over to Implementation Facilitation

Other: Implementation Facilitation; Other: Centralized Technical Assistance

Interventions

Implementation Facilitation OTHER

Implementation Facilitation involves and External Facilitator (from outside of the participating medical center) and an Internal Facilitator (from inside the participating medical center) working together to help BHIP teams within the site adopt care practices that are more consistent with the CCM

Also known as: IF

Wave 1; Wave 2; Wave 3; Wave 4

Centralized Technical Assistance OTHER

Centralized Technical Assistance involves having external experts available for ad hoc consultation related to collaborative BHIP care practices.

Also known as: CTA

Wave 2; Wave 3; Wave 4

Eligibility Criteria

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

You may qualify if:

• Note that treatment assignment will be at the facility level, and given the stepped wedge design, sites in Waves 2-4 will cross over from Centralized Technical Assistance to Implementation Facilitation.
• Note that, for mental health hospitalizations, separate sites have been identified as comparators using a balancing algorithm.

You may not qualify if:

• Patients with a diagnosis of dementia in the electronic medical record.

Sponsors & Collaborators

• VA Office of Research and Development: lead
• US Department of Veterans Affairs Office of Mental Health and Suicide Prevention: collaborator

Study Sites (17)

Northern Arizona VA Health Care System, Prescott, AZ

Prescott, Arizona, 86313, United States

Location

Southern Arizona VA Health Care System, Tucson, AZ

Tucson, Arizona, 85723-0001, United States

Location

VA Palo Alto Health Care System, Palo Alto, CA

Palo Alto, California, 94304-1207, United States

Location

VA Greater Los Angeles Healthcare System, West Los Angeles, CA

West Los Angeles, California, 90073-1003, United States

Location

Orlando VA Medical Center, Orlando, FL

Orlando, Florida, 32827, United States

Location

Richard L. Roudebush VA Medical Center, Indianapolis, IN

Indianapolis, Indiana, 46202-2884, United States

Location

VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA

Boston, Massachusetts, 02130-4817, United States

Location

Fayetteville VA Medical Center, Fayetteville, NC

Fayetteville, North Carolina, 28301-3856, United States

Location

Jackson C. Montgomery VA Medical Center, Muskogee, OK

Muskogee, Oklahoma, 74401, United States

Location

Memphis VA Medical Center, Memphis, TN

Memphis, Tennessee, 38104-2127, United States

Location

West Texas VA Health Care System, Big Spring, TX

Big Spring, Texas, 79720, United States

Location

VA North Texas Health Care System Dallas VA Medical Center, Dallas, TX

Dallas, Texas, 75216-7167, United States

Location

Michael E. DeBakey VA Medical Center, Houston, TX

Houston, Texas, 77030-4211, United States

Location

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

White River Junction, Vermont, 05001-3833, United States

Location

Salem VA Medical Center, Salem, VA

Salem, Virginia, 24153-6404, United States

Location

Clarksburg Louis A. Johnson VA Medical Center, Clarksburg, WV

Clarksburg, West Virginia, 26301-4155, United States

Location

Huntington VA Medical Center, Huntington, WV

Huntington, West Virginia, 25704-9300, United States

Location

MeSH Terms

Conditions

Psychological Well-Being

Condition Hierarchy (Ancestors)

Personal Satisfaction; Behavior

Study Officials

• Christopher J. Miller, PhD

  VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA

  PRINCIPAL INVESTIGATOR

• Sara J. Landes, PhD MA BA

  Central Arkansas Veterans Healthcare System , Little Rock, AR

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: CROSSOVER
• Sponsor Type: FED
• Responsible Party: SPONSOR

Model Details: This study will use a stepped wedge design, with participating medical centers assigned to one of four different waves. Wave 1 will begin the trial receiving implementation facilitation. Waves 2-4 will begin the trial receiving centralized technical assistance, and will then cross over to implementation facilitation.

Study Record Dates

• First Submitted: August 1, 2023
• First Posted: August 18, 2023
• Study Start: July 14, 2023
• Primary Completion: October 30, 2024
• Study Completion: October 30, 2025
• Last Updated: November 6, 2024

Record last verified: 2024-11

Data Sharing

• IPD Sharing: Will not share

Locations

US (17)