Behavioral Health Interdisciplinary Program - Collaborative Chronic Care Model (BHIP-CCM) Enhancement Project 2.0

NCT ID: NCT05997836

Last Updated: 2024-11-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

81424 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-07-14

Study Completion Date

2025-10-30

Brief Summary

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This quality improvement project aims to help outpatient mental health teams, known as Behavioral Health Interdisciplinary Program (BHIP) teams, adopt more collaborative care practices (consistent with the collaborative chronic care model or CCM). The investigators therefore aim to use two different implementation strategies -- centralized technical assistance and implementation facilitation -- to align BHIP teams' care practices more closely with the principles of the CCM.

Detailed Description

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This quality improvement project aims to help outpatient mental health teams, known as Behavioral Health Interdisciplinary Program (BHIP) teams, adopt more collaborative care practices (consistent with the collaborative chronic care model or CCM). The investigators therefore aim to use two different implementation strategies -- centralized technical assistance and implementation facilitation -- to align BHIP teams' care practices more closely with the principles of the CCM.

The two primary outcomes of this project are:

1. BHIP team collaboration, as evidenced by improved scores in the Role Clarity and Team Primacy dimensions of the Team Development Measure (TDM)
2. BHIP team clinical effectiveness, as evidenced by reduction in mental health hospitalizations among Veterans treated by the BHIP teams that have received the two types of implementation strategies described above.

Conditions

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Mental Health

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

CROSSOVER

This study will use a stepped wedge design, with participating medical centers assigned to one of four different waves. Wave 1 will begin the trial receiving implementation facilitation. Waves 2-4 will begin the trial receiving centralized technical assistance, and will then cross over to implementation facilitation.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Wave 1

Study design is a stepped wedge; Wave 1 begins by receiving Implementation Facilitation

Group Type OTHER

Implementation Facilitation

Intervention Type OTHER

Implementation Facilitation involves and External Facilitator (from outside of the participating medical center) and an Internal Facilitator (from inside the participating medical center) working together to help BHIP teams within the site adopt care practices that are more consistent with the CCM

Wave 2

Study design is a stepped wedge; Wave 2 begins by receiving Centralized Technical Assistance before crossing over to Implementation Facilitation

Group Type OTHER

Implementation Facilitation

Intervention Type OTHER

Implementation Facilitation involves and External Facilitator (from outside of the participating medical center) and an Internal Facilitator (from inside the participating medical center) working together to help BHIP teams within the site adopt care practices that are more consistent with the CCM

Centralized Technical Assistance

Intervention Type OTHER

Centralized Technical Assistance involves having external experts available for ad hoc consultation related to collaborative BHIP care practices.

Wave 3

Study design is a stepped wedge; Wave 3 begins by receiving Centralized Technical Assistance before crossing over to Implementation Facilitation

Group Type OTHER

Implementation Facilitation

Intervention Type OTHER

Implementation Facilitation involves and External Facilitator (from outside of the participating medical center) and an Internal Facilitator (from inside the participating medical center) working together to help BHIP teams within the site adopt care practices that are more consistent with the CCM

Centralized Technical Assistance

Intervention Type OTHER

Centralized Technical Assistance involves having external experts available for ad hoc consultation related to collaborative BHIP care practices.

Wave 4

Study design is a stepped wedge; Wave 4 begins by receiving Centralized Technical Assistance before crossing over to Implementation Facilitation

Group Type OTHER

Implementation Facilitation

Intervention Type OTHER

Implementation Facilitation involves and External Facilitator (from outside of the participating medical center) and an Internal Facilitator (from inside the participating medical center) working together to help BHIP teams within the site adopt care practices that are more consistent with the CCM

Centralized Technical Assistance

Intervention Type OTHER

Centralized Technical Assistance involves having external experts available for ad hoc consultation related to collaborative BHIP care practices.

Interventions

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Implementation Facilitation

Implementation Facilitation involves and External Facilitator (from outside of the participating medical center) and an Internal Facilitator (from inside the participating medical center) working together to help BHIP teams within the site adopt care practices that are more consistent with the CCM

Intervention Type OTHER

Centralized Technical Assistance

Centralized Technical Assistance involves having external experts available for ad hoc consultation related to collaborative BHIP care practices.

Intervention Type OTHER

Other Intervention Names

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IF CTA

Eligibility Criteria

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Inclusion Criteria

* Note that treatment assignment will be at the facility level, and given the stepped wedge design, sites in Waves 2-4 will cross over from Centralized Technical Assistance to Implementation Facilitation.
* At the provider level (for completing the TDM), the primary inclusion criterion is clinicians working on BHIP Teams at the participating medical centers.
* At the patient level (for mental health hospitalizations, costs, and all-cause mortality), the primary inclusion criterion is Veterans treated by the BHIP teams at the participating medical centers.
* Note that, for mental health hospitalizations, separate sites have been identified as comparators using a balancing algorithm.

Exclusion Criteria

* Patients with a diagnosis of dementia in the electronic medical record.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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US Department of Veterans Affairs Office of Mental Health and Suicide Prevention

UNKNOWN

Sponsor Role collaborator

VA Office of Research and Development

FED

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Christopher J. Miller, PhD

Role: PRINCIPAL_INVESTIGATOR

VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA

Sara J. Landes, PhD MA BA

Role: PRINCIPAL_INVESTIGATOR

Central Arkansas Veterans Healthcare System , Little Rock, AR

Locations

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Northern Arizona VA Health Care System, Prescott, AZ

Prescott, Arizona, United States

Site Status

Southern Arizona VA Health Care System, Tucson, AZ

Tucson, Arizona, United States

Site Status

VA Palo Alto Health Care System, Palo Alto, CA

Palo Alto, California, United States

Site Status

VA Greater Los Angeles Healthcare System, West Los Angeles, CA

West Los Angeles, California, United States

Site Status

Orlando VA Medical Center, Orlando, FL

Orlando, Florida, United States

Site Status

Richard L. Roudebush VA Medical Center, Indianapolis, IN

Indianapolis, Indiana, United States

Site Status

VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA

Boston, Massachusetts, United States

Site Status

Fayetteville VA Medical Center, Fayetteville, NC

Fayetteville, North Carolina, United States

Site Status

Jackson C. Montgomery VA Medical Center, Muskogee, OK

Muskogee, Oklahoma, United States

Site Status

Memphis VA Medical Center, Memphis, TN

Memphis, Tennessee, United States

Site Status

West Texas VA Health Care System, Big Spring, TX

Big Spring, Texas, United States

Site Status

VA North Texas Health Care System Dallas VA Medical Center, Dallas, TX

Dallas, Texas, United States

Site Status

Michael E. DeBakey VA Medical Center, Houston, TX

Houston, Texas, United States

Site Status

White River Junction VA Medical Center, White River Junction, VT

White River Junction, Vermont, United States

Site Status

Salem VA Medical Center, Salem, VA

Salem, Virginia, United States

Site Status

Clarksburg Louis A. Johnson VA Medical Center, Clarksburg, WV

Clarksburg, West Virginia, United States

Site Status

Huntington VA Medical Center, Huntington, WV

Huntington, West Virginia, United States

Site Status

Countries

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United States

Other Identifiers

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QUX 23-002

Identifier Type: -

Identifier Source: org_study_id

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