Clinical trial NCT05997836: Behavioral Health Interdisciplinary Program - Collaborative Chronic Care Model (BHIP-CCM) Enhancement Project 2.0
Official title: Behavioral Health Interdisciplinary Program - Collaborative Chronic Care Model (BHIP-CCM) Enhancement Project 2.0 (QUE 20-026)
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Mental Health
Keywords: collaborative care
Lead sponsor: VA Office of Research and Development
Sponsor class: FED
Collaborators: name: US Department of Veterans Affairs Office of Mental Health and Suicide Prevention
First posted: 2023-08-18
Enrollment: 81424
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: CROSSOVER
Intervention model description: 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 purpose: HEALTH_SERVICES_RESEARCH

Brief summary: 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: 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.

Eligibility criteria: 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.

Primary outcomes:
measure: Role Clarity and Team Primacy subdomains of the Team Development Measure (TDM)
timeFrame: Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration).
measure: Mental health hospitalization rate among Veterans treated within each BHIP team.
timeFrame: Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration).
Secondary outcomes:
measure: Treatment cost
timeFrame: Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration).
measure: All-cause mortality
timeFrame: Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration).
measure: Treatment costs and hospitalization data compared to non-intervention sites
timeFrame: Post-facilitation (8 months after start of implementation facilitation) and post-sustainment (12 months after post-facilitation)
Other outcomes:
Locations:
city: Prescott
country: United States
facility: Northern Arizona VA Health Care System, Prescott, AZ
state: Arizona
city: Tucson
country: United States
facility: Southern Arizona VA Health Care System, Tucson, AZ
state: Arizona
city: Palo Alto
country: United States
facility: VA Palo Alto Health Care System, Palo Alto, CA
state: California
city: West Los Angeles
country: United States
facility: VA Greater Los Angeles Healthcare System, West Los Angeles, CA
state: California
city: Orlando
country: United States
facility: Orlando VA Medical Center, Orlando, FL
state: Florida
city: Indianapolis
country: United States
facility: Richard L. Roudebush VA Medical Center, Indianapolis, IN
state: Indiana
city: Boston
country: United States
facility: VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
state: Massachusetts
city: Fayetteville
country: United States
facility: Fayetteville VA Medical Center, Fayetteville, NC
state: North Carolina
city: Muskogee
country: United States
facility: Jackson C. Montgomery VA Medical Center, Muskogee, OK
state: Oklahoma
city: Memphis
country: United States
facility: Memphis VA Medical Center, Memphis, TN
state: Tennessee
city: Big Spring
country: United States
facility: West Texas VA Health Care System, Big Spring, TX
state: Texas
city: Dallas
country: United States
facility: VA North Texas Health Care System Dallas VA Medical Center, Dallas, TX
state: Texas
city: Houston
country: United States
facility: Michael E. DeBakey VA Medical Center, Houston, TX
state: Texas
city: White River Junction
country: United States
facility: White River Junction VA Medical Center, White River Junction, VT
state: Vermont
city: Salem
country: United States
facility: Salem VA Medical Center, Salem, VA
state: Virginia
city: Clarksburg
country: United States
facility: Clarksburg Louis A. Johnson VA Medical Center, Clarksburg, WV
state: West Virginia
city: Huntington
country: United States
facility: Huntington VA Medical Center, Huntington, WV
state: West Virginia
Study officials:
affiliation: VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
name: Christopher J. Miller, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Central Arkansas Veterans Healthcare System , Little Rock, AR
name: Sara J. Landes, PhD MA BA
role: PRINCIPAL_INVESTIGATOR
References: