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| Name | Class |
|---|---|
| US Department of Veterans Affairs Office of Mental Health and Suicide Prevention | UNKNOWN |
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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.
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:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Wave 1 | Other | Study design is a stepped wedge; Wave 1 begins by receiving Implementation Facilitation |
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| Wave 2 | Other | Study design is a stepped wedge; Wave 2 begins by receiving Centralized Technical Assistance before crossing over to Implementation Facilitation |
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| Wave 3 | Other | Study design is a stepped wedge; Wave 3 begins by receiving Centralized Technical Assistance before crossing over to Implementation Facilitation |
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| Wave 4 | Other | Study design is a stepped wedge; Wave 4 begins by receiving Centralized Technical Assistance before crossing over to Implementation Facilitation |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Implementation Facilitation | Other | Implementation Facilitation involves and External Facilitator (from outside of the participating medical center) and an Internal Facilitator (from inside the participating medical center) working together to help BHIP teams within the site adopt care practices that are more consistent with the CCM |
| Measure | Description | Time Frame |
|---|---|---|
| Role Clarity and Team Primacy subdomains of the Team Development Measure (TDM) | The TDM is a measure of team functioning, and the two listed subdomains represent the co-primary outcome for the study. Note that, due to the stepped wedge design, only Wave 3 and Wave 4 sites will also have a pre-centralized technical assistance administration of the TDM. Also note that the primary time frame for this outcome, as listed above, will be post-implementation facilitation (8 months after the pre-implementation administration). Secondary analysis will also investigate one year post-implementation facilitation (20 months after the pre-implementation administration). | Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration). |
| Mental health hospitalization rate among Veterans treated within each BHIP team. | Mental health hospitalizations represent a measure of clinical effectiveness (co-primary outcome for the study). Note that, due to the stepped wedge design, only Wave 3 and Wave 4 sites will also have a pre-centralized technical assistance calculation of the mental health hospitalization rate. Also note that the primary time frame for this outcome, as listed above, will be post-implementation facilitation (8 months after the pre-implementation administration). Secondary analysis will also investigate one year post-implementation facilitation (20 months after the pre-implementation administration). | Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration). |
| Measure | Description | Time Frame |
|---|---|---|
| Treatment cost | The investigators will calculate estimated treatment costs for Veterans treated by participating BHIP teams. Note that the primary time frame for this outcome, as listed above, will be post-implementation facilitation (8 months after the pre-implementation administration). Secondary analysis will also investigate one year post-implementation facilitation (20 months after the pre-implementation administration). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Christopher J. Miller, PhD | VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA | Principal Investigator |
| Sara J. Landes, PhD MA BA | Central Arkansas Veterans Healthcare System , Little Rock, AR | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Northern Arizona VA Health Care System, Prescott, AZ | Prescott | Arizona | 86313 | United States | ||
| Southern Arizona VA Health Care System, Tucson, AZ |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42332779 | Derived | Miller CJ, Sullivan JL, Stolzmann K, Raciborski RA, Brown M, Bailey HM, Connolly SL, Morena AL, Dougherty M, Henderson A, Rehmert A, Sippel LM, Kim B. Implementing the collaborative chronic care model for mental health: a nonrandomized clinical trial. Implement Sci Commun. 2026 Jun 22. doi: 10.1186/s43058-026-00995-y. Online ahead of print. |
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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.
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| Centralized Technical Assistance | Other | Centralized Technical Assistance involves having external experts available for ad hoc consultation related to collaborative BHIP care practices. |
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| Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration). |
| All-cause mortality | The investigators will calculate all-cause mortality for Veterans treated by participating BHIP teams. Note that the primary time frame for this outcome, as listed above, will be post-implementation facilitation (8 months after the pre-implementation administration). Secondary analysis will also investigate one year post-implementation facilitation (20 months after the pre-implementation administration). | Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration). |
| Treatment costs and hospitalization data compared to non-intervention sites | For mental health hospitalization and treatment costs, the investigators will compare results from intervention sites to other sites that did not undergo implementation facilitation (i.e. sites from outside the trial that are similar to intervention sites on variables like facility complexity and urban/rural location). | Post-facilitation (8 months after start of implementation facilitation) and post-sustainment (12 months after post-facilitation) |
| Tucson |
| Arizona |
| 85723-0001 |
| United States |
| VA Palo Alto Health Care System, Palo Alto, CA | Palo Alto | California | 94304-1207 | United States |
| VA Greater Los Angeles Healthcare System, West Los Angeles, CA | West Los Angeles | California | 90073-1003 | United States |
| Orlando VA Medical Center, Orlando, FL | Orlando | Florida | 32827 | United States |
| Richard L. Roudebush VA Medical Center, Indianapolis, IN | Indianapolis | Indiana | 46202-2884 | United States |
| VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA | Boston | Massachusetts | 02130-4817 | United States |
| Fayetteville VA Medical Center, Fayetteville, NC | Fayetteville | North Carolina | 28301-3856 | United States |
| Jackson C. Montgomery VA Medical Center, Muskogee, OK | Muskogee | Oklahoma | 74401 | United States |
| Memphis VA Medical Center, Memphis, TN | Memphis | Tennessee | 38104-2127 | United States |
| West Texas VA Health Care System, Big Spring, TX | Big Spring | Texas | 79720 | United States |
| VA North Texas Health Care System Dallas VA Medical Center, Dallas, TX | Dallas | Texas | 75216-7167 | United States |
| Michael E. DeBakey VA Medical Center, Houston, TX | Houston | Texas | 77030-4211 | United States |
| White River Junction VA Medical Center, White River Junction, VT | White River Junction | Vermont | 05001-3833 | United States |
| Salem VA Medical Center, Salem, VA | Salem | Virginia | 24153-6404 | United States |
| Clarksburg Louis A. Johnson VA Medical Center, Clarksburg, WV | Clarksburg | West Virginia | 26301-4155 | United States |
| Huntington VA Medical Center, Huntington, WV | Huntington | West Virginia | 25704-9300 | United States |
| ID | Term |
|---|---|
| D000092862 | Psychological Well-Being |
| ID | Term |
|---|---|
| D010549 | Personal Satisfaction |
| D001519 | Behavior |
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