Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT03898271 |
| Other study ID # |
14-15004 |
| Secondary ID |
|
| Status |
Completed |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
October 1, 2015 |
Study information
| Verified date |
October 2020 |
| Source |
San Francisco Veterans Affairs Medical Center |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
The overall goal of this project is improve access to and engagement in quality care for
military service personnel and Veterans suffering with posttraumatic stress (PTS). Veterans
often present to their primary care providers with symptoms of PTS and related physical
problems; however, most primary care providers have not been trained to care for Veterans
with PTS or communicate with them in ways that motivate them to engage in care.
In this study instigators propose to design, test and prepare to implement a Virtual World
PTS and Motivational Interviewing training for primary care providers by taking the following
steps: (1) partner with stakeholders to iteratively design the training which takes full
advantage of the affordances of Virtual World technology to enhance training interactivity,
effectiveness, and durability, (2) perform a randomized control trial to compare the virtual
world training with an online training, and (3) summarize the findings and prepare for
implementation and dissemination of the new training by soliciting feedback from primary care
providers who participated in the training and from original project stakeholders.
Description:
The overall goal of this project is improve access to and engagement in quality care for
military service personnel and Veterans suffering with posttraumatic stress (PTS). Veterans
who have PTS symptoms after military service are often resistant to referrals to mental
health care because of the warrior culture of stoicism coupled with the stigma of seeking
mental health care. Also, Veterans living in rural or remote areas may not have access to
trained mental health professionals. Thus, Veterans often present to their primary care
providers with symptoms of PTS and related physical problems. Unfortunately, most primary
care providers have not been trained to care for Veterans with PTS or communicate with them
in ways that motivate them to engage in care. This can result in missed opportunities to
intervene to prevent what may become chronic mental and physical health problems in the
future, which affect not only the warfighter, but also their families, partners and children.
In a prior project funded by the Department of Defense (DoD), study investigators created and
tested a web-based training program to teach primary care providers about how to assess for
and manage PTS which proved successful in a small pilot study. Nevertheless, primary care
providers who participated in the training reported that the training was not interactive and
engaging enough and about 30% did not complete it. Moreover, the pilot study did not use gold
standard methods to measure study outcomes and because project stakeholders, namely the
Veterans Administration (VA) and the DoD, did not participate in the development of the
training, investigators were not able to easily implement and disseminate it to primary care
clinicians who work in these healthcare systems.
Virtual World technology is a three-dimensional immersive and highly interactive online
experience in which users enter virtual environments as self-styled representations of
themselves, known as avatars. Virtual Worlds are used in some of the most popular and
engaging commercially-available video games. Virtual World technology is also increasingly
being used for educational activities, particularly in learning about mental health problems
and communication techniques. This is because experiences like mental health symptoms such as
re-experiencing or intrusive thoughts (flashbacks) can be simulated, and participants (as
avatars) can practice and receive feedback on new communication skills without feeling
self-conscious. Learners can also practice motivational interviewing techniques such as using
a stylized virtual scale to literally weigh the pros and cons (represented as blocks) of a
particular behavior change. These interactive activities afforded by Virtual World technology
can be used to make the learning experience far more memorable and enduring.
In this study, investigators propose to design, test and prepare to implement a Virtual World
PTS and Motivational Interviewing training by taking the following steps: (1) partner with
stakeholders to iteratively design the training so that is responsive to stakeholder needs
and takes full advantage of the affordances of Virtual World technology to enhance training
interactivity, effectiveness, and durability, (2) add a more robust evaluation component,
including a randomized control trial with stronger provider and patient outcomes to achieve
more valid results, and (3) summarize findings and prepare for implementation and
dissemination of the new training by soliciting feedback from primary care providers who
participated in the training and from original project stakeholders.
