Program Evaluation of Peer Specialists on VA PACTS: A Quality Improvement Project (QUE 15-289)
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 5,616
- 试验地点
- 50
- 主要终点
- Patient Activation Measure Change
研究概览
简要总结
In August 2014, the White House issued an Executive Action mandating that 25 VA medical centers place Peer Specialists (Veterans recovered from mental illness who are trained to support other Veterans with mental illness) on Primary Care Teams. Research shows that the success of adding new staff to existing teams can be improved by outside aid and facilitation. This quality improvement project will evaluate whether providing expanded support to half of the Primary Care Teams will lead to better outcomes when compared with teams that do not get extra support.
详细描述
Peer Specialists are individuals with mental illness currently deployed to serve Veterans in specialty mental health clinics based upon their lived experiences. Peer Specialist delivered interventions have been shown to improve patient activation in multiple studies. In August 2014, the White House issued an Executive Action mandating that 25 VA medical centers pilot the deployment of Peer Specialists in their Patient Aligned Care Teams (PACTs). This project expands upon this nationally mandated Peer Specialist pilot with the integration of a cluster randomized implementation trial. This quality improvement project will evaluate the impact of facilitated implementation vs. standard implementation to support on the deployment of Peer Specialists in PACTs.
The 25 sites will be divided into three cohorts (n=8,8,9). Each cohort will begin over three successive six-month blocks beginning in early 2016. Within each cohort, sites will be randomized to receive either facilitated or standard implementation. Facilitated Implementation sites will receive one year of support based on the i-PARIHS implementation model which includes training, implementation planning, ongoing external facilitation, feedback and consultation. Standard Implementation sites will receive written guidance and limited consultation by the investigators' team. The investigators will compare the groups on 1) the percent of their target population that actually received PS services; 2) ratings on PS workload productivity including ; 3) Peer Implementation and Services scores; 4) assessment of Veteran's change over time on the outcome variables of satisfaction, activation, and functioning ; 5) qualitative analysis of how well PSs were deployed and their impact.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Included sites must be VA PACT Primary Care Health teams with existing Peer Specialists who are able to include an existing Peer Specialist on their team for a minimum of 10 hours per week for one year
排除标准
- •Non VA PACT teams, VA sites without an existing Peer Specialists, and VA PACT primary care teams that cannot commit a Peer Specialist to Primary Care for a minimum of 10 hours per week are excluded
结局指标
主要结局
Patient Activation Measure Change
时间窗: Baseline, 6 months, 1 year
The Patient Activation Measure (PAM) is a 13-item survey that measures an individual's perceived ability to manage his or her illness and health behaviors and act as an effective patient. It has been shown to be reliable, valid, sensitive to change and correlates with measures of improved self-management. Scores for this outcome range from Zero to One Hundred with higher scores indicating higher levels of patient activation (better outcome).
次要结局
- Peer Fidelity Measure(6 months, 1 year)
- Team Development Measure(Baseline, 6 months, 1 year)
- Number of Unique Veterans Seen (Adjusted for Employment Period and Hours Worked Per Week)(one year, across two years)
- The Satisfaction Index-Mental Health(Baseline, 6 months, 1 year)
- Average Total Number of Services Provided-Adjusted (First Year Only and Across Both Years)(one year and across both years)
- Average Number of Visits Per Veteran Per Peer Specialist-Adjusted (First Year Only)(1st year only)
- Average Number of Visits Per Veteran Per Peer Specialist-Adjusted (Across Both Years)(across both years)
- Time to First Service(variable from baseline to time of first service delivered by Peer Specialists)