Testing implementation support strategies to facilitate an evidence-based substance use and mental health care intervention in veterans treatment courts: A hybrid type III trial protocol

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry Pub Date : 2024-11-18 DOI:10.1016/j.ejpsy.2024.100282

David A. Smelson , Vera Yakovchenko , Kathryn E. Bruzios , Thomas Byrne , Megan Mccullough , Paige M. Shaffer , A. Rani Elwy

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引用次数: 0

Abstract

Background and Objectives

Veterans Treatment Courts (VTCs) are alternative to incarceration programs for veterans involved in the criminal legal system. VTC participants have high rates of co-occurring mental health and substance use disorders (COD). Maintaining Independence and Sobriety Through Systems Integration, Outreach and Networking – Criminal Justice (MISSIONCJ) is an evidence-based, multicomponent intervention offered alongside VTCs to support veterans’ complex needs. Multicomponent interventions are often difficult to implement nationally, let alone when care is offered and coordinated across multiple systems. This protocol offers an overview of an implementation-effectiveness trial of MISSIONCJ in VTCs.

Methods

This quality improvement (QI) project will involve an adaptive, randomized design, in which VA staff in four geographically-dispersed regions across the U.S. will be invited to participate and receive varying implementation facilitation (IF) support (i.e., low/passive and high/active) for implementing MISSIONCJ. Sites will have a 9-month run-in period (e.g., orientation) followed by 9-months of low/passive IF. Sites that meet an implementation benchmark will then be randomized to continue low/passive IF or discontinue; and sites that do not meet the benchmark will be randomized to continue low/passive IF, or receive high/active IF for 12-months. Implementation outcomes are based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework (e.g., reaching eligible veterans, adoption rates, fidelity to MISSIONCJ, and maintenance/sustainment). MISSIONCJ effectiveness outcomes include treatment engagement and COD improvements.

Discussion

This QI project aims to determine the most effective type and intensity of IF to increase MISSIONCJ, while improving outcomes among VTC participants. As the first national trial to implement MISSIONCJ in VTCs, it has important implications for the criminal legal and implementation science fields.

Trial Registration

ISRCTN registry, ISRCTN13576289, Registered 21 December 2022, https://www.isrctn.com/ISRCTN13576289

查看原文本刊更多论文

测试实施支持策略，以促进退伍军人治疗法庭采取循证药物使用和心理健康护理干预措施：第三类混合试验方案

背景和目标退伍军人治疗法庭（VTC）是针对涉及刑事法律系统的退伍军人的监禁替代计划。退伍军人治疗法庭的参与者同时患有精神健康和药物使用障碍 (COD) 的比例很高。通过系统集成、外联和联网保持独立和清醒--刑事司法项目（MISSIONCJ）是一项以证据为基础的多成分干预措施，与 VTC 同时提供，以支持退伍军人的复杂需求。多成分干预措施通常很难在全国范围内实施，更不用说在多个系统之间提供和协调护理了。方法该质量改进（QI）项目将采用适应性随机设计，邀请美国四个地理位置分散地区的退伍军人事务部工作人员参与，并在实施 MISSIONCJ 时接受不同的实施促进（IF）支持（即低/被动和高/主动）。各站点将有 9 个月的磨合期（如指导），然后是 9 个月的低度/被动 IF。然后，达到实施基准的站点将被随机分配到继续实施低效/被动式综合框架或停止实施；未达到基准的站点将被随机分配到继续实施低效/被动式综合框架或接受为期 12 个月的高效/主动式综合框架。实施结果基于 RE-AIM（覆盖、有效性、采用、实施、维持）框架（例如，覆盖符合条件的退伍军人、采用率、对 MISSIONCJ 的忠实度以及维持/持续性）。讨论该 QI 项目旨在确定最有效的 IF 类型和强度，以增加 MISSIONCJ，同时改善 VTC 参与者的治疗效果。作为首个在职业治疗中心实施 MISSIONCJ 的全国性试验，它对刑事法律和实施科学领域具有重要意义。试验注册ISRCTN 注册表，ISRCTN13576289，注册日期为 2022 年 12 月 21 日，https://www.isrctn.com/ISRCTN13576289。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Psychiatry PSYCHIATRY-

CiteScore

2.90

自引率

0.00%

发文量

审稿时长

43 days

期刊介绍： The European journal of psychiatry is a quarterly publication founded in 1986 and directed by Professor Seva until his death in 2004. It was originally intended to report “the scientific activity of European psychiatrists” and “to bring about a greater degree of communication” among them. However, “since scientific knowledge has no geographical or cultural boundaries, is open to contributions from all over the world”. These principles are maintained in the new stage of the journal, now expanded with the help of an American editor.