Summary

for females ages 18 years and up (full criteria)
at San Diego, California and other locations
study started
estimated completion:
Ariel J. Lang

Description

Summary

Implementation of Tailored Collaborative Care for Women Veterans (CCWV) is designed to enhance primary care-mental health integration for women Veterans, by tailoring services to women Veterans' and providers' needs and providing an evidence-based intervention, Coordinated Anxiety Learning and Management, to address anxiety and depression in a patient-centered approach. CCWV will be implemented in four of the Women's Health Practice-Based Research Network sites, with careful attention to local tailoring and adaptation to enhance the fit of the care model in varied local contexts.

Official Title

Implementation of Tailored Collaborative Care For Women Veterans (CCWV) (QUE 15-272)

Details

Background: Women Veterans are the fastest growing segment of Veterans Health Administration (VHA) users. This dramatic growth has created challenges for VHA. Gender disparities persist in cardiovascular (CV) and diabetes risk factor control, and rates of depression, anxiety, and mental health comorbidity are disproportionately high among women Veterans. Furthermore, a high rate of women Veterans' attrition from VA care, along with organizational barriers to care, substantiate that organizational changes are needed in order to engage and retain women Veteran VHA users in evidence-based, patient-centered care.

Objectives: The Enhancing Mental and Physical health of Women through Engagement and Retention (EMPOWER) QUERI addresses VHA Blueprint for Excellence Strategy 6, by advancing "personalized, proactive, patient-centered" care models, and Transformational Strategy 7.2.g by implementation of innovative care models in women Veterans' health care." The EMPOWER QUERI Program is designed to improve women Veterans' engagement and retention in evidence-based care for three high priority health conditions, i.e., prediabetes, cardiovascular, and mental health. To achieve this impact goal, the investigators propose a cohesive portfolio of projects with the following aims: (1) To use an evidence-based implementation strategy that emphasizes local tailoring of care models, multilevel stakeholder engagement, and systematic evaluation of complex implementation processes in order to enrich organizational capacity for innovations in women Veterans' VHA health care; (2) To implement personalized, proactive, patient-centered innovations in VHA women's health that are acceptable, feasible, satisfactory, relevant, and effective for both providers and patients, thereby encouraging women Veterans' engagement and retention and sustainability of the innovations; and, (3) To generate implementation "playbooks" for the investigators' partners that are scalable and serve as guidance for future implementation of a broader array of evidence-based women's health programs and policy.

Methods: Three projects will be conducted by an experienced multidisciplinary team. This trial pertains to "Implementation of Tailored Collaborative Care for Women Veterans," which will evaluate implementation of an evidence-based collaborative care model tailored to enhance provider- and system-level capabilities to address women Veterans' anxiety and depression treatment needs, thereby improving organizational primary care-mental health integration (PC-MHI) effectiveness and women Veterans' engagement and retention in PC-MHI. This implementation research study will use a nonrandomized stepped wedge design and will apply the evidence-based Replicating Effective Programs (REP) implementation strategy. Mixed methods implementation evaluation will focus on investigating primary implementation outcomes of adoption, acceptability, feasibility, and reach. Multilevel stakeholder engagement will be prioritized. Program-wide organizational-, provider-, and patient-level measures and tools will be utilized to enhance synergy, productivity, and impact.

As a coherent program of women's health implementation research and quality improvement, the proposed EMPOWER QUERI will constitute a major milestone in achieving Blueprint for Excellence (BPE) strategies and realizing women Veterans' engagement and, ultimately, empowerment in the VHA system.

Keywords

Anxiety Depression Stress Disorders, Post Traumatic Anxiety [F01.470.132] Depression [F01.145.126.350] Stress Disorders, Post-Traumatic [F03.950.750.500] Primary Health Care [N04.590.233.727] Mental Health [F02.418] Patient Participation [N05.300.150.600.620] Patient Satisfaction [N05.300.150.600.630] Patient Preference [N05.300.150.600.630.500] Physicians, Primary Care [M01.526.485.810.800] Physicians, Women [M01.526.485.810.820] Health Behavior [F01.145.488] Stress Disorders, Traumatic Stress Disorders, Post-Traumatic Collaborative Care for Women Veterans

Eligibility

You can join if…

Open to females ages 18 years and up

  • Women VA patients with possible or confirmed anxiety and/or depression and/or PTSD

You CAN'T join if...

  • Male gender
  • Cognitive impairment that would preclude completion of informed consent

Locations

  • VA San Diego Healthcare System, San Diego, CA
    San Diego California 92161 United States
  • VA Greater Los Angeles Healthcare System, West Los Angeles, CA
    West Los Angeles California 90073 United States

Details

Status
in progress, not accepting new patients
Start Date
Completion Date
(estimated)
Sponsor
VA Office of Research and Development
Links
Click here for more information about this study: Implementation of Tailored Collaborative Care For Women Veterans (CCWV) (QUE 15-272)
ID
NCT02950961
Phase
Phase 1
Lead Scientist
Ariel J. Lang
Study Type
Interventional
Last Updated
April 30, 2018