Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT03539068 |
| Other study ID # |
IIR 16-096 |
| Secondary ID |
|
| Status |
Completed |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
June 1, 2018 |
| Est. completion date |
May 31, 2023 |
Study information
| Verified date |
June 2023 |
| Source |
VA Office of Research and Development |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
OEF/OIF/OND war Veterans have unique post-deployment care needs that the VA is striving to
understand and address. Unfortunately, there is a significant disparity in utilization of
mental health (MH) care and VA access as most war Veterans don't seek needed care. New
interventions are urgently needed to address disparities in post-deployment MH treatment
engagement for war Veterans and to support VA's efforts to provide them with optimal access
and care. Online health interventions have been shown to be preferred by OEF/OIF combat
Veterans and have the potential to promote access to VA MH care. The investigators' research
team has developed a web-based interface (WEB-ED) evolved by feedback from Veterans that
screens for common post-deployment MH and readjustment concerns, provides tailored education
about positive screens, and facilitates linkage to VA resources. Data from the investigators'
prior studies demonstrate WEB-ED can be successfully implemented within VA and activate
Veterans to seek needed care. Furthermore, emerging evidence indicates that when patients are
educated about their health conditions and treatment alternatives using shared
decision-making (SDM), increased treatment participation and adherence, and better health
outcomes result. Next steps include: linking Veteran WEB-ED screening results to a VA secure
network so that a provider can access the results; and integrating a SDM interface to promote
Veteran-Provider partnerships in patient-centered care. This study will improve the
investigators' understanding of the most effective methods to reduce barriers to enrollment
in VA/MHV and transferring important medical information using My HealtheVet (MHV).
Furthermore, it will provide important information regarding how WEB-ED results can enhance
the capability of VA providers and transition patient advocates to use Veterans' screening
results to triage and engage Veterans in patient-centered MH care and promote VA provider
adoption of WEB-ED+ to facilitate patient engagement. Online screening, tailored education,
and links to geographically accessible VA resources has been shown to be preferred by
Veterans, providing recognition of treatable post-deployment MH concerns, and education that
reduces stigma. This study builds upon and augments this prior work with research to
understand and evaluate the processes needed to integrate WEB-ED+ into current VHA systems to
support efficient care delivery, facilitate patient-centered care, and address unmet need for
MH care while also resolving disparities in VA and VA MH care access and engagement for war
Veterans. WEB-ED+'s use of shared decision making is a key component for promoting these
benefits. WEB-ED+ represents a readily implementable and cost-effective intervention that,
with partner collaboration, can be integrated into VA systems through MHV. Findings have
important policy implications for several operational partners heavily invested in the
improved access and delivery of evidence-based mental health care for war Veterans.
Description:
OEF/OIF/OND war Veterans have unique post-deployment care needs that the VA is striving to
understand and address. Unfortunately, there is a significant disparity in utilization of
mental health (MH) care and VA access as most war Veterans don't seek needed care. New
interventions are urgently needed to address disparities in post-deployment MH treatment
engagement for war Veterans and to support VA's efforts to provide them with optimal access
and care. Online health interventions have been shown to be preferred by OEF/OIF combat
Veterans and have the potential to promote access to VA MH care. The investigators' research
team has developed a web-based interface (WEB-ED) evolved by feedback from Veterans that
screens for common post-deployment MH and readjustment concerns, provides tailored education
about positive screens, and facilitates linkage to VA resources. Data from the investigators'
prior studies demonstrate WEB-ED can be successfully implemented within VA and activate
Veterans to seek needed care. Furthermore, emerging evidence indicates that when patients are
educated about their health conditions and treatment alternatives using shared
decision-making (SDM), increased treatment participation and adherence, and better health
outcomes result. Next steps include: linking Veteran WEB-ED screening results to a VA secure
network so that a provider can access the results; and integrating a SDM interface to promote
Veteran-Provider partnerships in patient-centered care. The investigators propose a three
phase study to address the investigators' aims. Aim 1 (phase 1) the investigators will gather
qualitative information from key VA and Veteran informants to create an enhanced version
(WEB-ED+) of the investigators' Current WEB-ED that includes an eHealth and SDM interface.
Aim 2 (phase 2) will use a randomized controlled trial (RCT) to test WEB-ED+ vs. Current
WEB-ED in promoting VA MH care engagement. Aim 3 (phase 3) the investigators will employ a
process evaluation to determine the feasibility and acceptability of WEB-ED+ for both
Veterans and VA practitioner and to document the VA processes Veterans use to enroll and
engage in VA MH care. This study will improve the investigators' understanding of the most
effective methods to reduce barriers to enrollment in VA/MHV and transferring important
medical information using My HealtheVet (MHV). Furthermore, it will provide important
information regarding how WEB-ED results can enhance the capability of VA providers and
transition patient advocates to use Veterans' screening results to triage and engage Veterans
in patient-centered MH care and promote VA provider adoption of WEB-ED+ to facilitate patient
engagement. Online screening, tailored education, and links to geographically accessible VA
resources has been shown to be preferred by Veterans, providing recognition of treatable
post-deployment MH concerns, and education that reduces stigma. This study builds upon and
augments this prior work with research to understand and evaluate the processes needed to
integrate WEB-ED+ into current VHA systems to support efficient care delivery, facilitate
patient-centered care, and address unmet need for MH care while also resolving disparities in
VA and VA MH care access and engagement for war Veterans. WEB-ED+'s use of shared decision
making is a key component for promoting these benefits. WEB-ED+ represents a readily
implementable and cost-effective intervention that, with partner collaboration, can be
integrated into VA systems through MHV. Findings have important policy implications for
several operational partners heavily invested in the improved access and delivery of
evidence-based mental health care for war Veterans.
