Randomized Controlled Trial of AboutFace: A Novel Video Storytelling Resource to Improve Access, Engagement, and Utilization of Mental Health Treatment among Veterans with PTSD

AboutFace 的随机对照试验：一种新颖的视频讲故事资源，可提高患有 PTSD 的退伍军人对心理健康治疗的获取、参与和利用

• 批准号: 9701021
• 负责人: ANOUK L GRUBAUGH
• 金额: --
• 依托单位: RALPH H JOHNSON VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-05-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9701021
• 关键词: Attitude; Award; Awareness; Caring; Clinic; Clinical; Data; Development; Disease; Education; Educational Materials; Enrollment; Ensure; Evidence based treatment; Funding; Future; Goals; Grant; Happiness; Health Services Accessibility; Healthcare; Improve Access; Intake; Intervention; Interview; Learning; Location; Mental Depression; Mental Health; Mental Health Services; Methodology; Methods; Military Personnel; Outcome; Pilot Projects; Post-Traumatic Stress Disorders; Process; Provider; Psyche structure; Quality of life; Randomized; Randomized Controlled Trials; Recommendation; Research; Research Design; Resources; Risk; Role; Services; Stigmatization; Strategic Planning; Symptoms; Trust; Update; Veterans; Visit; barrier to care; base; behavioral health; comorbidity; comparative efficacy; design; digital; education resources; evidence base; experience; feasibility trial; follow-up; health administration; help-seeking behavior; implementation strategy; improved; indexing; medical specialties; novel; peer; practice setting; programs; randomized controlled study; service delivery; social stigma; standard care; stress related disorder; treatment as usual; usability

Anticipated Impacts on Veterans Health Care: Behavioral health problems among Veterans have raised awareness of the critical need for more reliable, effective, and accessible means to recognize those in need, direct them to help, and ensure that they receive the best treatment available. Research has suggested that people are most responsive to advice and education when it comes from someone to whom they can relate. AboutFace is a peer education resource for Veterans that was developed, launched, and recently updated by the National Center for PTSD (NCPTSD) based on HSR&D funded pilot data. AboutFace features personal stories of Veterans and is designed to improve mental health treatment engagement among Veterans with PTSD and related comorbidities. The study team, which includes the NCPTSD, recently completed a usability assessment and pilot feasibility trial of AboutFace under HSR&D grant #PPO 14-360- 1. Data from this study (1) guided improvements to AboutFace for increasing PTSD treatment initiation and engagement; and (2) demonstrated the feasibility of the methodology for the proposed study. If AboutFace is found to increase Veterans’ initiation and engagement in PTSD treatment, study data will have broad implications for overcoming barriers to care for Veterans with PTSD and other stigmatized conditions. Background: At least 1 in 10 Veterans meet criteria for PTSD related to their military experience. Treatment for PTSD is widely available, and national dissemination initiatives have increased Veterans’ access to best- practice interventions. However, treatment-seeking remains strikingly low; most Veterans with PTSD do not seek mental health services due to perceived stigma and other barriers. NCPTSD developed and launched AboutFace, a public awareness campaign to help Veterans recognize PTSD and motivate them to seek evidence-based care. Since its development, AboutFace has earned three major awards and has had tens of thousands of visits. Despite the tremendous potential for AboutFace to reduce stigma, improve attitudes toward mental health treatment seeking, and to increase PTSD treatment initiation and engagement, it has yet to be formally evaluated or effectively implemented within VHA practice settings. In addition to providing needed data on the efficacy of AboutFace and identifying strategies for effective implementation within VHA, this study will provide a greater understanding of the role and value of digital storytelling interventions to improve access to care for a wide range of stigmatized conditions. Objectives: The primary objectives of the study are to examine the impact of AboutFace on a) increasing PTSD treatment initiation and engagement; and b) decreasing stigma and negative attitudes toward mental health services. It is anticipated that Veterans in the AboutFace condition will be more likely to access and complete treatment than those receiving enhanced Usual Care (eUC) for PTSD. Finally, qualitative interviews with key stakeholders across the nation will be conducted to inform best practices for future implementation of AboutFace. Methods: A total of 376 Veterans referred for a PTSD assessment and recommended for treatment in the Charleston PTSD clinic will be enrolled in the study. Veterans will be randomized to receive AboutFace versus eUC. All Veterans will receive standard PTSD educational materials, and half will also be randomly assigned to receive AboutFace. Comparisons will be made across indices of treatment engagement [i.e., initiated treatment (yes/no), total number of sessions completed;]; changes in stigma and attitudes toward seeking mental health treatment; and changes in PTSD symptoms and quality of life. Veterans will be assessed on these indices at baseline, 1-month, 3-month, and 6-months. Thematic interviews will be conducted with 20-30 VA PTSD Clinical Team Directors from a diverse range of PTSD clinics (i.e., ranging in size, location, and practice) to inform future implementation and dissemination initiatives.

对退伍军人卫生保健的预期影响：退伍军人的行为健康问题已经增加 意识到对更可靠，有效和可访问的方法的批判性需求，以认识到有需要的人， 指示他们提供帮助，并确保他们获得最佳的治疗方法。研究表明 当人们来自与之建立联系的人时，人们对建议和教育最有反应。 Faceface是用于开发，启动和最近更新的退伍军人的同行教育资源 由基于HSR＆D资助的试点数据的国家PTSD（NCPTSD）中心。 FACE FAMETION 退伍军人的个人故事，旨在改善心理健康治疗的参与 具有PTSD和相关合并症的退伍军人。最近包括NCPTSD的研究团队 完成了HSR＆d赠款#PPO #PPO 14-360-的可用性评估和试点可行性试验 1。这项研究的数据（1）指导改进了有关增加PTSD治疗计划和 订婚; （2）证明了该方法对拟议研究的可行性。如果Face 发现可以增加退伍军人的主动性和参与PTSD治疗，研究数据将广泛 克服有PTSD和其他污名化条件的退伍军人的障碍的影响。 背景：至少有十分之一的退伍军人符合与他们的军事经验有关的PTSD标准。治疗 对于PTSD而言，广泛可用，国家传播计划增加了退伍军人获得最佳的机会 练习干预措施。但是，寻求治疗仍然很低。大多数具有PTSD的退伍军人没有 由于感知到的污名和其他障碍，寻求心理健康服务。 NCPTSD开发并启动 关于Face，一项公众意识运动，以帮助退伍军人认识PTSD并激励他们寻求 循证护理。自从其开发以来，Adoutface获得了三个主要奖项，并获得了数十个奖项 数千次访问。尽管面积有很大的潜力减少污名，但提高态度 寻求心理健康治疗，并增加PTSD治疗计划和参与，它具有 然而，将在VHA实践设置中进行正式评估或有效实施。除了提供 关于面域有效性的需要数据，并确定VHA内有效实施的策略， 这项研究将对数字讲故事干预措施的作用和价值有更深入的了解 改善对各种污名化条件的护理机会。 目的：研究的主要目标是检查大约面对a的影响a） PTSD治疗计划和参与； b）减少对心理的污名和负面的遗嘱 卫生服务。可以预期，处于围场条件下的退伍军人将更有可能访问和 完全治疗比接受PTSD的那些接受增强的常规护理（EUC）。最后，定性 将对全国主要利益相关者进行访谈，以为未来提供最佳实践 实现aboutface。 方法：共有376名退伍军人参考了PTSD评估，建议在 Charleston PTSD诊所将参加该研究。退伍军人将被随机接收到Faceface 与EUC。所有退伍军人将获得标准的PTSD教育材料，一半也将是随机的 分配给接收方案。将在治疗参与指数中进行比较[即 开始治疗（是/否），完成的会话总数；]；污名和与会者的变化 寻求心理健康治疗；以及PTSD症状和生活质量的变化。退伍军人会 在基线，1个月，3个月和6个月时对这些指数进行评估。主题访谈将是 由来自PTSD诊所的潜水员系列的20-30 VA PTSD临床团队主管（即 在规模，位置和实践中），以告知未来的实施和传播计划。