Whole Health in VA Mental Health: A Randomized Controlled Trial of Omnis Salutis

退伍军人管理局心理健康的整体健康：Omnis Salutis 的随机对照试验

• 批准号: 10538875
• 负责人: Samantha Hack
• 金额: --
• 依托单位: BALTIMORE VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-11-01 至 2026-10-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10538875
• 关键词: Afghanistan; Alcohol abuse; Anxiety; Anxiety Disorders; Appointment; Area; Caring; Cladribine; Communication; Communities; Complementary Health; Confusion; Data; Depressed mood; Depressive disorder; Diagnosis; Disease; Disease Management; District of Columbia; Dose; Dropout; Educational process of instructing; Electronic Health Record; Emotional; Equipment and supply inventories; Evaluation; Evidence based practice; Family; Fatigue; Feeling suicidal; Freedom; Frustration; Gender; Goals; Health; Health Services; Health Surveys; Healthcare; Healthcare Systems; Homelessness; Impairment; Integrative Medicine; Intervention; Iraq; Learning; Life; Link; Maryland; Mediating; Medical center; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methods; Mission; Modeling; Outcome; Pain; Participant; Patient-Centered Care; Personal Satisfaction; Persons; Physical Function; Post-Traumatic Stress Disorders; Process; Provider; Psyche structure; Race; Randomized; Randomized, Controlled Trials; Recommendation; Reporting; Research; Research Methodology; Research Personnel; Research Support; Role; Running; Sampling; Self Care; Self Efficacy; Services; Site; Social Functioning; Social Network; Social support; Societies; Stress; Substance Use Disorder; Suicide attempt; Surveys; Symptoms; System; Telephone; Testing; Time; Unemployment; Veterans; Well in self; West Virginia; active control; aspirate; care systems; clinical encounter; community based participatory research; community involvement; community reintegration; efficacy evaluation; efficacy testing; experience; falls; follow-up; functional disability; functional improvement; healing; health care settings; health goals; health service use; improved; improved outcome; mental function; military operation; operation; patient oriented; person centered; physical conditioning; primary care setting; programs; recruit; secondary analysis; skill acquisition; skills; social relationships; stress related disorder; suicide rate; tailored health care; telehealth; whole health

Anticipated Impacts on Veteran Healthcare: Recent Veterans of the Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn (OIF/OEF/OND) conflicts are presenting in VA care with high rates of stress related mental health disorders (posttraumatic stress disorder, depression, anxiety, and alcohol abuse), and reporting significant difficulties with social relationships and community reintegration. Surveys of recent Veterans show that Veterans want the VA to provide mental health care tailored to their concerns and reintegration priorities; while simultaneously, the VA has committed to transforming to a Whole Health patient- centered, system of care. Within this context, Omnis Salutis, a brief, Veteran-focused, Whole Health activation intervention, was developed with a stakeholder advisory panel of Veterans, clinicians, and researchers. Preliminary findings indicate that participation in Omnis Salutis was associated with improvements in physical, mental and social functioning among recent Veterans with stress related mental health disorders. Project Background: The term “recent Veterans” refers to Veterans who served in the OIF/OEF/OND military operations. Almost 60% (708,062) of recent Veterans who received VA care have been diagnosed with a mental health disorder, most commonly post-traumatic stress disorder (56%), depressive disorders (45%), anxiety disorders (44%), and substance use disorders (21%). Recent Veterans with stress-related mental health disorders experience impairment in functional domains of health (overcoming and managing disease), purpose (meaningful daily activities and participation in society), and community (positive relationships and social networks). Omnis Salutis is a three-session intervention in which Veterans learn about Whole Health and complete a brief Personal Health Inventory, practice creating and delivering MY MAP (Mission/Aspiration/Purpose) to communicate their health mission consistently to their providers and social supports; and identify both formal and informal healing relationships that support their health mission. Omnis Salutis was shown to be acceptable to and feasible in a previous small randomized controlled trial (n = 48). Additionally, analyses of the relationship between participation in Omnis Salutis and outcomes on the Veterans RAND 36-Item Health Survey found a large effect for Bodily Pain improvement, medium effect size for Social Functioning, small effect sizes for Physical Functioning, Emotional Well-Being, Energy/Fatigue, Role Limitations due to Emotional Problems, and General Health. These results are very promising and support further testing of Omnis Salutis. Project Objectives: The proposed research will test the efficacy of Omnis Salutis, a brief, Veteran-focused, Whole Health activation intervention, in a randomized controlled trial (n = 238). The primary aim of the study is to evaluate the efficacy of Omnis Salutis for improving the physical and social functioning of recent Veterans with stress-related disorders. The secondary aim is to evaluate the efficacy of Omnis Salutis for increasing Veteran engagement in care for stress-related disorders. There is an exploratory aim to Evaluate the processes that underlie the relationship between engagement in care and functioning. This study will provide support for Omnis Salutis as an evidence-based practice and for broader dissemination. Project Methods: We propose a randomized controlled trial in a sample of 238 Veterans with stress-related mental health disorders recruited from four VA medical centers in Maryland, Washington DC, and West Virginia. Veterans will be randomly assigned to receive three sessions of Omnis Salutis or three sessions of an active control, health, and wellness intervention. Both conditions will be delivered via as VA Video Connect (VVC) telehealth platform or telephone. Participants will complete assessments at baseline, 3-month follow-up, 6-month follow-up, and 12-month follow-up timepoints. Analyses will examine differences in change over time between the two intervention conditions.

对资深医疗保健的预期影响：最近对持久自由行动的退伍军人，行动 伊拉克自由与行动新黎明（OIF/OEF/OND）冲突正在以高率的VA护理中呈现 与压力相关的心理健康障碍（创伤后应激障碍，抑郁症，焦虑和酗酒）， 并报告社会关系和社区重返社会的巨大困难。最近的调查 退伍军人表明，退伍军人希望弗吉尼亚州提供针对他们的关注和 重新整合优先事项；同时，弗吉尼亚州已致力于转变为整个健康患者 - 中心，护理系统。在这种情况下，Omnis Salutis是一个简短的，以资深的，全健康的健康激活 干预是由退伍军人，临床医生和研究人员的利益相关者咨询小组开发的。 初步发现表明参与Omnis Salutis与身体的改善有关 最近患有与压力相关的心理健康障碍的退伍军人之间的心理和社会功能。 项目背景：“最近的退伍军人”一词是指在OIF/OEF/OND军事的退伍军人 运营。近60％（708,062）最近接受VA护理的退伍军人被诊断出患有 心理健康疾病，最常见的创伤后应激障碍（56％），抑郁症（45％）， 焦虑症（44％）和药物使用障碍（21％）。最近的退伍军人与压力有关的精神 健康障碍在健康域（克服和管理疾病）中经历损害， 目的（有意义的日常活动和参与社会）和社区（积极的关系和 社交网络）。 Omnis Salutis是一种三演奏干预措施，退伍军人了解整个健康 并完成简短的个人健康清单，练习创建和交付我的地图 （任务/愿望/目的）将其健康使命一致地传达给提供者和社会 支持；并确定支持其健康使命的正式和非正式康复关系。 Omnis 在先前的小型随机对照试验（n = 48）中，Salutis被证明是可以接受的，并且是可行的。 此外，分析参与Omnis Salutis与退伍军人的结果之间的关系 兰德36项健康调查发现，对身体疼痛的改善有很大的影响，对社会的中等效果大小 功能，身体功能的小效应大小，情感健康，能量/疲劳，角色 由于情绪问题和一般健康而造成的局限性。这些结果非常有前途和支持 Omnis Salutis的进一步测试。 项目目标：拟议的研究将测试Omnis Salutis的效率，Omnis Salutis是一个简短的，以资深人士为中心的效率 在随机对照试验中（n = 238）中，全健康激活干预措施。该研究的主要目的是 评估Omnis Salutis在改善最近退伍军人的身体和社会功能方面的效率 与压力有关的疾病。第二个目的是评估Omnis Salutis的效率 退伍军人参与与压力有关的疾病的照顾。有一个探索目的来评估 流程是在护理​​和功能工作之间的关系的基础。这项研究将提供 支持Omnis Salutis作为循证实践和更广泛的传播。 项目方法：我们在238名退伍军人的样本中提出了一项随机对照试验 从马里兰州，华盛顿特区和西部的四个VA医疗中心招募的心理健康障碍 弗吉尼亚。退伍军人将被随机分配接受三个会议的Omnis Salutis或三个会议 积极控制，健康和健康干预。这两个条件都将通过VA视频连接进行交付 （VVC）远程医疗平台或电话。参与者将在基线3个月的随访中完成评估， 6个月的随访和12个月的随访时间点。分析将检查随着时间的变化差异 在两个干预条件之间。