Maintaining Implementation Through Dynamic Adaptations (MIDAS) Suicide Prevention 2.0 Clinical Telehealth

Not Applicable

Active, not recruiting

• Conditions: Suicidal Self-directed Violence; Suicidal Preparatory Behavior
• Interventions: Behavioral: Academic Detailing (AD); Behavioral: LEAP

• Registration Number: NCT06011759
• Lead Sponsor: VA Office of Research and Development

Brief Summary

Scientific advances are constantly leading to better treatments. However, it is quite challenging for healthcare systems, including VA, to ask very busy providers to change the way they practice. The MIDAS QUERI program helps providers improve the way they treat VA patients. This project will focus on increasing referrals to the Suicide Prevention 2.0 Clinical Telehealth (SP 2.0) initiative through the delivery of Academic Detailing and LEAP (a team-based quality improvement program). SP 2.0 provides accessible, evidence-based suicide prevention treatment to all Veterans with a history of suicidal self-directed violence or preparatory behaviors in the past 12 months.

Detailed Description

Sustained integration of evidence-based practices (EBPs) is a challenge within many healthcare systems, especially in settings that have already strived but failed to achieve longer-term goals. The Veterans Affairs (VA) Maintaining Implementation through Dynamic Adaptations (MIDAS) Quality Enhancement Research Initiative (QUERI) program was funded as a series of trials to test multi-component implementation strategies to sustain optimal use of EBPs. The current project focuses on increasing referrals to the Suicide Prevention 2.0 Clinical Telehealth (SP 2.0) initiative.

The investigators have recruited 4 sites for this non-randomized intervention project. Sites have agreed to participate in pre-implementation interviews to gather information regarding barriers and facilitators to use of the SP 2.0 initiative. Sites will then be provided with tailored feedback regarding interview findings and potential use of Academic Detailing and LEAP to address these. Sites may then select to receive either Academic Detailing and/or LEAP which will be provided by MIDAS QUERI. Sites will be compared to control sites which will be matched based on similar baseline referral rates. Primary outcome will be rate of SP 2.0 referral adjusted for pre-intervention rate.

Study Timeline

• Study Start: 2022-11-01
• Study First Submitted: 2023-08-16
• Study First Submitted QC: 2023-08-24
• Study First Posted: 2023-08-25
• Status Verified: 2024-08
• Last Update Submitted: 2024-08-01
• Last Update Posted: 2024-08-02
• Primary Completion: 2024-08-29
• Study Completion: 2025-09-30

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 4

Inclusion Criteria

Note- the investigators are recruiting clinics/medical centers - not individual patients. Prior to implementation, the investigators will work with sites to ensure they have met the preconditions necessary to begin sustained optimization of the EBP:

• 1. a team leader or champion
• 2. an identified department with service leadership buy-in and control over the processes/practices impacted by the implementation
• 3. readily accessible data to measure process and impact of the implementation and use of the EBP
• 4. availability of required resources

Exclusion Criteria

• N/A

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Intervention	Academic Detailing (AD)	A multi-faceted implementation intervention including qualitative interviews and feedback and optional delivery of Academic Detailing and/or LEAP.
Intervention	LEAP	A multi-faceted implementation intervention including qualitative interviews and feedback and optional delivery of Academic Detailing and/or LEAP.

Primary Outcome Measures

Name	Time	Method
SP2Clin metric	Baseline to 12-months post-baseline	The percentage of reported suicide behavior events in the past 4 quarters that had an SP 2.0 Consult submitted. This is calculated by the number of suicide behavior event days among cohort with at least one Suicide Prevention Telehealth Program Consult submitted divided by the number of suicide behavior event days among eligible VHA Veterans within the past four quarters.

Secondary Outcome Measures

Name	Time	Method
Referral to SP 2.0 Clinic	Baseline to 12-months post-baseline	Change in number of referrals to the Suicide Prevention 2.0 Clinical Telehealth (SP 2.0) initiative.

Trial Locations

Locations (1)

VA Ann Arbor Healthcare System, Ann Arbor, MI; 🇺🇸 Ann Arbor, Michigan, United States