Mental Illness Clinical Trial
— Peers on PACTOfficial title:
Program Evaluation of Peer Specialists on VA PACTS: A Quality Improvement Project (QUE 15-289)
Verified date | July 2023 |
Source | VA Office of Research and Development |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
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.
Status | Completed |
Enrollment | 5616 |
Est. completion date | October 31, 2019 |
Est. primary completion date | March 31, 2019 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - 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 Exclusion Criteria: - 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 |
Country | Name | City | State |
---|---|---|---|
United States | Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD | Baltimore | Maryland |
United States | Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA | Bedford | Massachusetts |
United States | Jesse Brown VA Medical Center, Chicago, IL | Chicago | Illinois |
United States | Chillicothe VA Medical Center, Chillicothe, OH | Chillicothe | Ohio |
United States | Cincinnati VA Medical Center, Cincinnati, OH | Cincinnati | Ohio |
United States | Wm. Jennings Bryan Dorn VA Medical Center, Columbia, SC | Columbia | South Carolina |
United States | Chalmers P. Wylie Ambulatory Care Center, Columbus, OH | Columbus | Ohio |
United States | Atlanta VA Medical and Rehab Center, Decatur, GA | Decatur | Georgia |
United States | John D. Dingell VA Medical Center, Detroit, MI | Detroit | Michigan |
United States | North Florida/South Georgia Veterans Health System, Gainesville, FL | Gainesville | Florida |
United States | Edward Hines Jr. VA Hospital, Hines, IL | Hines | Illinois |
United States | Lexington VA Medical Center, Lexington, KY | Lexington | Kentucky |
United States | VA Northern Indiana Health Care System Marion Campus, Marion, IN | Marion | Indiana |
United States | VA Palo Alto Health Care System, Palo Alto, CA | Palo Alto | California |
United States | Philadelphia VA Medical Center, Philadelphia, PA | Philadelphia | Pennsylvania |
United States | VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA | Pittsburgh | Pennsylvania |
United States | St. Louis VA Medical Center John Cochran Division, St. Louis, MO | Saint Louis | Missouri |
United States | Salisbury W.G. (Bill) Hefner VA Medical Center, Salisbury, NC | Salisbury | North Carolina |
United States | San Francisco VA Medical Center, San Francisco, CA | San Francisco | California |
United States | Syracuse VA Medical Center, Syracuse, NY | Syracuse | New York |
United States | Maine VA Medical Center, Augusta, ME | Togus | Maine |
United States | Southern Arizona VA Health Care System, Tucson, AZ | Tucson | Arizona |
United States | VA Connecticut Healthcare System West Haven Campus, West Haven, CT | West Haven | Connecticut |
United States | West Palm Beach VA Medical Center, West Palm Beach, FL | West Palm Beach | Florida |
United States | White River Junction VA Medical Center, White River Junction, VT | White River Junction | Vermont |
Lead Sponsor | Collaborator |
---|---|
VA Office of Research and Development | US Department of Veterans Affairs |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | 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 | Team Development Measure | The Team Development Measure is a 31 item self-report survey that evaluates the degree to which a team has and uses the components needed for highly effective teamwork including cohesiveness, communication, role clarity, and goals and means clarity. All components min scores are zero % and maximum is 100%; higher percentages mean positive responses. | Baseline, 6 months, 1 year | |
Secondary | Peer Fidelity Measure | The Peer Fidelity Measure assesses: a) peer specialist services and b) peer specialist implementation. The first part has 5 domains of peer services critical to the VA's peer support model (e.g., being a role model that recovery is possible; share personal recovery story). The second has 7 domains of implementation factors shown to either help or hinder PS deployment (e.g., role clarity, support for PS at higher organizational levels, regular supervision). Each domain has 1-2 questions (responses ranging from 1= not at all through 5=Very much with higher scores indicating higher fidelity. Min Value=1 and Max value =5. The Peer Fidelity Measure will be administered to both Peer Specialists and their supervisors. Analyses looked at discrepancies (difference in difference) between Peer Specialists and their Supervisors at each time point. Min discrepancy score is -4 and Max discrepancy score is 4. (calculated as Peer Specialist minus Peer Supervisor score) | 6 months, 1 year | |
Secondary | The Satisfaction Index-Mental Health | The Satisfaction Index-Mental Health is a 12-item, unidimensional measure of patient satisfaction with care. It has been used with Veteran populations and has been shown to be valid, reliable, and sensitive to change in a sample of Veterans with mental illnesses being treated in primary care settings. It will be administered to Veterans who receive care from the Peer Specialists involved in the project. Minimum score is 12 and the maximum score is 72; higher scores mean more satisfaction. | Baseline, 6 months, 1 year | |
Secondary | Number of Unique Veterans Seen (Adjusted for Employment Period and Hours Worked Per Week) | This adjusted workload variables took into consideration both the employment period (many PSs did not start immediately or may have left prior to the end of the 2 years) and weekly hours worked (varying from one hour to 40 hours per week). Visits during each PS's employment period were divided by the total number of hours worked, then multiplied by 40 to calculate adjusted values for operationalization above. Because this variable was significantly skewed, we used a log transformation to improve their distributional properties. Differences between intervention conditions were then compared with a series of Analyses of Covariance models with age, gender and race as covariates. Since these variables are measured at the PS level, the covariates were the average across the Veterans sesn by each PS (mean age, percent White and percent male). N's are number of Veterans | one year, across two years | |
Secondary | Average Number of Visits Per Veteran Per Peer Specialist-Adjusted (Across Both Years) | See Variable 5 above for details about adjustment. Since this variable this is a Veteran level variable, a General Linear Mixed Model (GSLMM) was used with PS specified as a random effect and Veteran age, race and gender.
N's are number of Veterans |
across both years | |
Secondary | Average Total Number of Services Provided-Adjusted (First Year Only and Across Both Years) | This adjusted workload variables took into consideration both the employment period (many PSs did not start immediately or may have left prior to the end of the 2 years) and weekly hours worked (varying from one hour to 40 hours per week). Visits during each PS's employment period were divided by the total number of hours worked, then multiplied by 40 to calculate adjusted values for operationalization above. Because this variable was significantly skewed, we used a log transformation to improve their distributional properties. Differences between intervention conditions were then compared with a series of Analyses of Covariance models with age, gender and race as covariates. Since these variables are measured at the PS level, the covariates were the average across the Veterans sesn by each PS (mean age, percent White and percent male). N's are number of Veterans | one year and across both years | |
Secondary | Time to First Service | This variable represents count of days from time study at each site started (baseline) until first service was delivered. | variable from baseline to time of first service delivered by Peer Specialists | |
Secondary | Average Number of Visits Per Veteran Per Peer Specialist-Adjusted (First Year Only) | See Variable 5 above for details about adjustment. Since this variable this is a Veteran level variable, a General Linear Mixed Model (GSLMM) was used with PS specified as a random effect and Veteran age, race and gender.
N's are number of Veterans |
1st year only |
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