Hybrid 1 randomized controlled trial of an integrated stepped-care mental health intervention for traumatic injury patients.

Autor: Espeleta HC; Medical University of South Carolina, College of Nursing, USA. Electronic address: espeleta@musc.edu., Witcraft SM; Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, USA., Raffa T; George Washington University Hospital, USA., Kartiko S; The George Washington University School of Medicine and Health Sciences, USA., Dawson D; Medical University of South Carolina, College of Nursing, USA., Becerra G; Medical University of South Carolina, College of Nursing, USA., Roisman H; George Washington University Hospital, USA., Hughes-Halbert C; University of Southern California, Department of Population and Public Health Sciences, USA., Mueller M; Medical University of South Carolina, College of Nursing, USA., Powell E; Medical University of South Carolina, College of Nursing, USA., Brock T; The George Washington University School of Medicine and Health Sciences, USA., Sarani B; The George Washington University School of Medicine and Health Sciences, USA., Ruggiero KJ; Medical University of South Carolina, College of Nursing, USA.
Jazyk: angličtina
Zdroj: Contemporary clinical trials [Contemp Clin Trials] 2024 Nov; Vol. 146, pp. 107694. Date of Electronic Publication: 2024 Sep 17.
DOI: 10.1016/j.cct.2024.107694
Abstrakt: Background: Annually, nearly 3 million individuals in the US are hospitalized after experiencing a traumatic injury (e.g., serious automobile crash, gunshot wound, stab injury). Many traumatically injured patients experience a trajectory of resilience. However, 20-40 % develop mental health problems such as posttraumatic stress disorder and depression; population estimates exceed 600,000 patients annually. Most trauma centers do not provide direct services to address mental health recovery, but the 2022 American College of Surgeons guidelines have established this as a priority. Cost-effective interventions are needed that meet the needs of patients at each stage of the recovery process while achieving sustainability at the level of implementation. This protocol paper describes a study that rigorously tests the Trauma Resilience and Recovery Program (TRRP), a scalable, sustainable technology-enhanced intervention to support the mental health recovery of patients who have experienced a traumatic injury.
Methods: We describe a randomized controlled trial with 1-year follow up of TRRP vs. enhanced usual care with 350 traumatically injured patients, including recruitment and retention procedures, assessment, implementation and fidelity monitoring, and statistical plans.
Conclusion: Novel components of our design include integration of technology-based elements, use of a stepped-care model, and implementation in a trauma center that did not previously have a mental health program. Data collected address the impact of TRRP and inform improvements to the model and its implementation in preparation for large-scale testing and implementation initiatives. This body of work is critical to informing the field as it continues to move toward national standards and recommendations.
Trial Registration: NCT05497115Clinicaltrials.gov.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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