E-health Implementation (Iowa)

NCT ID: NCT03954184

Last Updated: 2025-02-07

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

View full results

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

23659 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-09-03

Study Completion Date

2023-06-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This research will test a technology adoption framework to increase use of the A-CHESS smartphone app. The project, based in Iowa, will compare a control condition (using a typical product training approach to software implementation that includes user tutorials and instruction on administrative and clinical protocols, followed by access to on-line support) to the typical product training combined with NIATx-TI.

Terms - A-CHESS: Addiction Comprehensive Health Enhancement Support System NIATx-TI: Network for the Improvement of Addiction Treatment-Technology Implementation

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Patient-centered e-health has failed to achieve its promise despite considerable consumer interest in technology and research supporting its potential. E-health adoption rates in healthcare are poor, with specialty substance use disorder (SUD) treatment having the lowest technology adoption rate of any sector. Implementation science can address this emerging gap in the e-health field by augmenting existing models, that explain organizational and individual e-health behaviors retrospectively, with prospective models that can guide implementation. The organizational planning discipline, with its decades of research, could provide a cross-disciplinary "jump start" to developing an e-health implementation model for health organizations. Henry Mintzberg, a respected pioneer in this field, describes 2 beneficial approaches to planning: the deliberate approach, which is grounded in pre-implementation planning, and the emergent approach that is grounded in adapting to the environment as the plan is implemented. The proposed e-health implementation model, called the Network for the Improvement of Addiction Treatment-Technology Implementation (NIATx-TI) Framework, incorporates both approaches.

NIATx-TI was piloted in the Iowa Rural Health Information Technology Initiative (IRHIT) with 14 of Iowa's 105 SUD treatment sites and resulted in a 2-fold increase in patients receiving distance treatment. The framework's deliberate component includes using an organizational technology assessment and patient simulation. These tools identify and address assets and barriers to incorporate into the technology's implementation protocol. The framework's emergent component includes using a project team to uncover and prioritize implementation barriers as they arise, develop changes to address identified barriers, and monitor selected adoption measures, while receiving monthly coaching.

This project, based in Iowa, will compare a control condition (using a typical product training approach to software implementation that includes user tutorials and instruction on administrative and clinical protocols, followed by access to on-line support) to the typical product training combined with NIATx-TI. While e-health spans many modalities and health disciplines, this project will focus on the implementing Addiction Comprehensive Health Enhancement Support System (A-CHESS), an evidence-based SUD treatment recovery app developed by our Center for a disease that affects 21.5 million and kills 136,000 Americans annually: substance use disorder. A mobile app was selected, as opposed to another e-health technology, because of the near ubiquitous daily use of mobile technology and because mobile e-health adoption requires supportive participation of both health centers and patients.

In response to the COVID-19 pandemic, the study team added a study component focused on describing how patients are responding to receiving remote treatment (e.g., telehealth). The study team will also seek to understand how using A-CHESS mitigates COVID-19 associated anxiety and loneliness among those with substance use disorders.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Substance Use Disorders

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

TAU/Control

Sites in the Treatment as Usual (TAU)/Control Arm will receive product training/online support. Sites in the TAU/Control Arm will participate in a one-day product implementation or training session.

Group Type NO_INTERVENTION

No interventions assigned to this group

NIATx-TI Framework

Sites in the NIATx-TI Arm will receive product training/online support, and training in the NIATx-TI framework. The NIATx-TI framework will include a pre-implementation (planning) phase, and post-implementation (problem-solving) phase, with training delivered by a NIATx-TI coach.

Group Type EXPERIMENTAL

NIATx-TI with Product Training/On-line Support

Intervention Type BEHAVIORAL

NIATx-TI framework includes the product training as well as a preimplementation phase and a post-implementation phase. A NIATx-TI coach will provide the training for this arm. The coach will also assist the organizations with applying the NIATx-TI framework.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

NIATx-TI with Product Training/On-line Support

NIATx-TI framework includes the product training as well as a preimplementation phase and a post-implementation phase. A NIATx-TI coach will provide the training for this arm. The coach will also assist the organizations with applying the NIATx-TI framework.

Intervention Type BEHAVIORAL

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Must be 18+ years old
* Understand English
* Have a SUD diagnosis
* Have access to a smartphone
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University of Iowa

OTHER

Sponsor Role collaborator

Iowa Department of Public Health

UNKNOWN

Sponsor Role collaborator

National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role collaborator

University of Wisconsin, Madison

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Todd Molfenter, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University of Wisconisn-Madison

David Gustafson, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University of Wisconsin, Madison

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Zion Recovery Services

Adel, Iowa, United States

Site Status

Prairie Ridge Integrated Behavioral Healthcare

Algona, Iowa, United States

Site Status

Community and Family Resources

Ames, Iowa, United States

Site Status

Area Substance Abuse Council

Anamosa, Iowa, United States

Site Status

UCS Healthcare

Ankeny, Iowa, United States

Site Status

Zion Recovery Services

Atlantic, Iowa, United States

Site Status

Area Substance Abuse Council

Belle Plaine, Iowa, United States

Site Status

Community and Family Resources

Boone, Iowa, United States

Site Status

Alcohol and Drug Dependency Services (ADDS)

Burlington, Iowa, United States

Site Status

Area Substance Abuse Council

Cedar Rapids, Iowa, United States

Site Status

Prairie Ridge Integrated Behavioral Healthcare

Charles City, Iowa, United States

Site Status

Jackson Recovery Centers

Cherokee, Iowa, United States

Site Status

Prelude Behavioral Health Services

Clarence, Iowa, United States

Site Status

Zion Recovery Services

Clarinda, Iowa, United States

Site Status

Community and Family Resources

Clarion, Iowa, United States

Site Status

Heartland Family Services

Council Bluffs, Iowa, United States

Site Status

Area Substance Abuse Council

De Witt, Iowa, United States

Site Status

Jackson Recovery Centers

Denison, Iowa, United States

Site Status

UCS Healthcare

Des Moines, Iowa, United States

Site Status

House of Mercy

Des Moines, Iowa, United States

Site Status

Prelude Behavioral Health Services

Des Moines, Iowa, United States

Site Status

Substance Abuse Services Center

Dubuque, Iowa, United States

Site Status

Prairie Ridge Integrated Behavioral Healthcare

Forest City, Iowa, United States

Site Status

Community and Family Resources

Fort Dodge, Iowa, United States

Site Status

Heartland Family Services

Glenwood, Iowa, United States

Site Status

Zion Recovery Services

Greenfield, Iowa, United States

Site Status

Prairie Ridge Integrated Behavioral Healthcare

Hampton, Iowa, United States

Site Status

Community and Family Resources

Humboldt, Iowa, United States

Site Status

House of Mercy

Indianola, Iowa, United States

Site Status

Prelude Behavioral Services

Iowa City, Iowa, United States

Site Status

ADDS

Keokuk, Iowa, United States

Site Status

UCS Healthcare

Knoxville, Iowa, United States

Site Status

Jackson Recovery Centers

Le Mars, Iowa, United States

Site Status

Heartland Family Services

Logan, Iowa, United States

Site Status

Area Substance Abuse Council

Maquoketa, Iowa, United States

Site Status

Prelude Behavioral Health Services

Marengo, Iowa, United States

Site Status

Prairie Ridge Integrated Behavioral Healthcare

Mason City, Iowa, United States

Site Status

ADDS

Mount Pleasant, Iowa, United States

Site Status

House of Mercy

Newton, Iowa, United States

Site Status

Zion Recovery Services

Perry, Iowa, United States

Site Status

Community and Family Resources

Pocahontas, Iowa, United States

Site Status

Zion Recovery Services

Red Oak, Iowa, United States

Site Status

Community and Family Resources

Rockwell City, Iowa, United States

Site Status

Zion Recovery Services

Shenandoah, Iowa, United States

Site Status

Jackson Recovery Centers

Sioux City, Iowa, United States

Site Status

Prelude Behavioral Services

Tipton, Iowa, United States

Site Status

Area Substance ABuse Council

Vinton, Iowa, United States

Site Status

ADDS

Wapello, Iowa, United States

Site Status

Community and Family Resources

Webster City, Iowa, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Fleddermann K, Molfenter T, Vjorn O, Horst J, Hulsey J, Kelly B, Zawislak K, Gustafson DH, Gicquelais RE. Patient Preferences for Mobile Health Applications to Support Recovery. J Addict Med. 2023 Jul-Aug 01;17(4):394-400. doi: 10.1097/ADM.0000000000001137. Epub 2023 Jan 18.

Reference Type RESULT
PMID: 37579096 (View on PubMed)

Fleddermann K, Molfenter T, Jacobson N, Horst J, Roosa MR, Boss D, Ross JC, Preuss E, Gustafson DH. Clinician Perspectives on Barriers and Facilitators to Implementing e-Health Technology in Substance Use Disorder (SUD) Treatment Facilities. Subst Abuse. 2021 Oct 26;15:11782218211053360. doi: 10.1177/11782218211053360. eCollection 2021.

Reference Type RESULT
PMID: 34720585 (View on PubMed)

Gustafson D Sr, Horst J, Boss D, Fleddermann K, Jacobson N, Roosa M, Ross JC, Gicquelais R, Vjorn O, Siegler T, Molfenter T. Implementation of Smartphone Systems to Improve Quality of Life for People With Substance Use Disorder: Interim Report on a Randomized Controlled Trial. JMIR Hum Factors. 2022 Jul 14;9(3):e35125. doi: 10.2196/35125.

Reference Type DERIVED
PMID: 35834315 (View on PubMed)

White VM, Molfenter T, Gustafson DH, Horst J, Greller R, Gustafson DH Jr, Kim JS, Preuss E, Cody O, Pisitthakarm P, Toy A. NIATx-TI versus typical product training on e-health technology implementation: a clustered randomized controlled trial study protocol. Implement Sci. 2020 Oct 23;15(1):94. doi: 10.1186/s13012-020-01053-4.

Reference Type DERIVED
PMID: 33097097 (View on PubMed)

Provided Documents

Download supplemental materials such as informed consent forms, study protocols, or participant manuals.

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

A195010

Identifier Type: OTHER

Identifier Source: secondary_id

ENGR/INDUSTRIAL ENGR

Identifier Type: OTHER

Identifier Source: secondary_id

1R01DA044159-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

3R01DA044159-02S1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

Protocol version: 02-15-2021

Identifier Type: OTHER

Identifier Source: secondary_id

2020-0833

Identifier Type: OTHER

Identifier Source: secondary_id

2018-0997

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

VA Integrated Medication Manager
NCT01787175 COMPLETED NA