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.

对退伍军人医疗保健的预期影响：退伍军人的行为健康问题有所增加 认识到迫切需要更可靠、有效和方便的手段来识别有需要的人， 研究表明，指导他们提供帮助，并确保他们得到最好的治疗。 当人们的建议和教育来自于与他们有联系的人时，他们的反应最为灵敏。 AboutFace 是为退伍军人开发、推出和最近更新的同伴教育资源 由国家 PTSD 中心 (NCPTSD) 基于 HSR&D 资助的试点数据进行分析。 退伍军人的个人故事，旨在提高心理健康治疗参与度 最近，包括 NCPTSD 在内的研究小组针对患有 PTSD 和相关合并症的退伍军人进行了研究。 根据 HSR&D 拨款 #PPO 14-360- 完成了 AboutFace 的可用性评估和试点可行性试验 1. 本研究的数据 (1) 指导 AboutFace 的改进，以增加 PTSD 治疗的开始和 参与；(2) 证明了所提议的研究方法的可行性。 研究发现可以增加退伍军人对创伤后应激障碍 (PTSD) 治疗的发起和参与，研究数据将具有广泛的意义 对克服护理患有创伤后应激障碍和其他污名化病症的退伍军人的障碍的影响。 背景：至少十分之一的退伍军人符合与其军事经历相关的创伤后应激障碍标准。 创伤后应激障碍 (PTSD) 的治疗方法已广泛普及，国家传播举措增加了退伍军人获得最佳治疗的机会 然而，大多数患有创伤后应激障碍 (PTSD) 的退伍军人寻求治疗的比例仍然很低； 由于被认为是耻辱和其他障碍而寻求心理健康服务 NCPTSD 已制定并启动。 AboutFace，一项公众意识活动，旨在帮助退伍军人认识 PTSD 并激励他们寻求帮助 自开发以来，AboutFace 已获得三项主要奖项并获得了数十项奖项。 尽管 AboutFace 在减少耻辱、改善态度方面具有巨大潜力。 寻求心理健康治疗，并增加 PTSD 治疗的启动和参与， 尚未在 VHA 实践环境中得到正式评估或有效实施。 需要有关 AboutFace 功效的数据并确定在 VHA 内有效实施的策略， 这项研究将使人们更深入地了解数字讲故事干预措施的作用和价值 改善各种遭受污名化状况的护理机会。 目标：该研究的主要目标是检验 AboutFace 对 a) 增加的影响 创伤后应激障碍 (PTSD) 治疗的启动和参与；b) 减少对心理的耻辱和消极态度 预计处于 AboutFace 状态的退伍军人将更有可能获得和获得医疗服务。 比接受强化常规护理 (eUC) 治疗 PTSD 的患者更完整的治疗 最后，定性治疗。 将与全国主要利益相关者进行访谈，为未来提供最佳实践 AboutFace 的实施。 方法：总共 376 名退伍军人进行了 PTSD 评估，并建议在 查尔斯顿 PTSD 诊所将随机招募参加该研究的退伍军人。 与 eUC 相比，所有退伍军人都将收到标准的 PTSD 教育材料，其中一半也将是随机的。 被分配接收 AboutFace 的治疗参与指数将进行比较 [即， 开始的治疗（是/否）、完成的疗程总数；]； 寻求心理健康治疗；以及 PTSD 症状和生活质量的变化。 将在基线、1 个月、3 个月和 6 个月的专题访谈中对这些指数进行评估。 与来自各种 PTSD 诊所（即，范围广泛）的 20-30 名 VA PTSD 临床团队主管一起进行 规模、地点和实践），为未来的实施和传播举措提供信息。