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NCT Number: NCT05997836

Behavioral Health Interdisciplinary Program - Collaborative Chronic Care Model (BHIP-CCM) Enhancement Project 2.0

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.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

Key information

Conditions

Mental Health Behavior Personal Satisfaction Psychological Well-Being

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Northern Arizona VA Health Care System, Prescott, AZ, Prescott, Arizona, United States

Loading trial locations.

About this study

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:

  • BHIP team collaboration, as evidenced by improved scores in the Role Clarity and Team Primacy dimensions of the Team Development Measure (TDM)
  • 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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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.

Treatment and study plan

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

Other names: IF

Centralized Technical Assistance

Other

Centralized Technical Assistance involves having external experts available for ad hoc consultation related to collaborative BHIP care practices.

Other names: CTA

Primary outcomes

  1. Role Clarity and Team Primacy subdomains of the Team Development Measure (TDM)

    Time frame: Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration).

    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).

  2. Mental health hospitalization rate among Veterans treated within each BHIP team.

    Time frame: Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration).

    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).

Secondary outcomes

  1. Treatment cost

    Time frame: Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration).

    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).

  2. All-cause mortality

    Time frame: Primary comparison will be between pre-implementation facilitation and post-implementation facilitation (8 months after the pre-implementation administration).

    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).

  3. Treatment costs and hospitalization data compared to non-intervention sites

    Time frame: Post-facilitation (8 months after start of implementation facilitation) and post-sustainment (12 months after post-facilitation)

    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).

Sponsors and collaborators

Lead sponsor

VA Office of Research and Development

Fed

Collaborators

  • US Department of Veterans Affairs Office of Mental Health and Suicide Prevention

Registry information

Official study title

Behavioral Health Interdisciplinary Program - Collaborative Chronic Care Model (BHIP-CCM) Enhancement Project 2.0 (QUE 20-026)

Acronym: BHIP-CCM

Important dates

Study start
2023
Primary completion
2024
Study completion
2025
First posted
Aug 18, 2023
Registry last updated
Nov 6, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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