Developing a Telehealth Model to Improve Treatment Access for Rural Veterans With Substance Use Disorders

Study Overview
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Brief Summary
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This project will pilot-test and obtain stakeholder input on a telehealth-delivered substance use disorder (SUD) care model (with initial engagement and ongoing MI-CBT treatment) with the goal of increasing treatment utilization and improving outcomes for rural and non-rural Veterans with SUDs.

Official Title
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Using Telehealth to Expand Treatment Access for Veterans With Opioid Use Disorder (CDA 18-008)

Conditions
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Veterans, Substance Use, Substance Use Disorders, Substance Dependence

Intervention / Treatment
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* Behavioral: VetReach


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Veteran patients at the Ann Arbor VA Healthcare System Diagnostic and Statistical Manual of Mental Disorders (DSM-5) SUD diagnosis and/or substance use on average of 2 days a week over the past month Telephone access Able to provide informed consent Exclusion Criteria: Receiving SUD psychotherapy Inability to speak or understand English Substantial mental health instability or conditions that preclude informed consent (e.g., acute psychosis, cognitive deficits) or understanding of assessment or program content Prior alcohol withdrawal seizures or delirium tremens

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: MI-CBT Teletx<br>The intervention consists of an initial 30-60 min phone-delivered Engagement session that focuses on MI to help participants build self-efficacy and motivation to engage and to empower them to plan change and use Elicit-Provide-Elicit (EPE) to address treatment barriers (e.g., stigma, appeal, accessibility). Participants will then complete up to 8  50 minute Teletx weekly sessions via videoconference (or phone if needed). The intervention is highly patient-centered, by meeting and assessing patients where they are including in their unique context (i.e. rural community), helping them identify reasons and motivations for change, and centered around their goals (e.g. substance use reduction or abstinence). | Behavioral: VetReach<br>* Telehealth-delivered MI-CBT substance use disorder care model<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility of the intervention (engagement) | Percent (%) of participants engaging in the intervention (at least 3 completed sessions) | 8 weeks | 
| Acceptability of the telehealth intervention | Study-specific acceptability rating completed by participants (% with a positive rating, higher % is better) | 2 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Rural Health, Telehealth, Motivational Interviewing, Cognitive Behavioral Therapy