eScreening for Mental Health in Veterans

Overseen By Erin Almklov, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Not involved in eScreening

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new electronic screening (eScreening) system to detect mental health issues, such as suicidal thoughts, in veterans. The goal is to determine if eScreening can identify these problems more quickly and effectively than traditional methods. The trial will also explore the best way to implement this tool in VA clinics. Veterans who have faced mental health challenges and are part of VA Transition Care Management may find this relevant. As an unphased trial, it offers veterans the chance to contribute to innovative mental health solutions that could improve care in VA clinics.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that the eScreening program is safe for Veterans?

Research shows that eScreening is an online tool enabling Veterans to complete health check-ups from home. VA clinics have successfully used it to gather information about mental and physical health. Studies have found the tool easy to use and well-received by Veterans. Reports of negative effects from using eScreening are absent, making it a safe choice for remote health assessments.

Evidence from other VA clinics indicates that the Multicomponent Implementation Strategy, which uses a combination of methods to introduce mental health programs, effectively reaches Veterans. This approach has improved access to mental health care in various settings. While specific safety data for this strategy isn't detailed, no evidence suggests harmful effects from its use in related programs. Overall, both the eScreening tool and the implementation strategy appear safe and easy to use based on current evidence. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the eScreening for mental health in veterans because it offers a modern approach to identifying mental health needs using digital tools. Unlike traditional methods that often require in-person visits, eScreening allows veterans to assess their mental health status online, making it more accessible and convenient. Additionally, the multicomponent implementation strategy ensures that this digital solution is rolled out in a structured way, allowing for gradual integration into existing care systems and providing a robust framework to evaluate its effectiveness compared to current practices. This trial could potentially streamline the mental health screening process, making it easier and faster for veterans to get the help they need.

What evidence suggests that eScreening is effective for mental health in veterans?

Research has shown that eScreening, implemented in this trial, effectively identifies and addresses suicidal thoughts and other mental health issues among veterans. Veterans report high satisfaction with the system, appreciating its ease of use and improved access to health services. The eScreening tool efficiently collects mental and physical health information, aiding healthcare providers in better supporting veterans. It uses technology that allows veterans to report their health status on a mobile tablet. This approach has shown promise in enhancing mental health care within the Veterans Health Administration. ^{6 7 8 9 10}

Who Is on the Research Team?

James Pittman, PhD MSW

Principal Investigator

VA San Diego Healthcare System, San Diego, CA

Are You a Good Fit for This Trial?

This trial is for VA staff involved in implementing eScreening, a system to detect mental health issues like depression and PTSD in Veterans. Participants must be able to give informed consent and play a role in the eScreening process at their site.

Inclusion Criteria

I understand the details of the clinical trial and can consent.

Staff inclusion criteria: Direct or indirect involvement with implementation of eScreening at the site

You are involved in the implementation of eScreening at the site.

Exclusion Criteria

Staff exclusion criteria: Not involved in or directly impacted by eScreening involvement at each site

Timeline for a Trial Participant

Start-up

Planning and site randomization, including training and material finalization

6 months

Pre-implementation

Gathering pre-implementation information and preparing for eScreening implementation

3 months

Active Implementation

eScreening software provision, training, and ongoing blended facilitation

9 months

Sustainment

Continued use and support of eScreening post-implementation

9 months

Follow-up

Monitoring and evaluation of eScreening effectiveness and referral rates

9 months

What Are the Treatments Tested in This Trial?

Interventions

• eScreening
• Multicomponent Implementation Strategy

Trial Overview The study tests how well eScreening works compared to usual screening methods for identifying mental health symptoms among Veterans. It also examines the effectiveness of a multi-component strategy for rolling out eScreening across VA Transition Care Management clinics.

How Is the Trial Designed?

Group I: Stepped-wedge Experimental Treatment 2 Interventions

This stepped-wedge trial relies on sequential roll-out of eScreening to participating sites over time, while using other sites as controls until they begin implementation.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11697935/

Mixed method study of feasibility and acceptability ... We aimed to evaluate the feasibility and acceptability of using electronic screening, eScreening, as part of a process involving remote symptom screening.

2. marketplace.va.gov marketplace.va.gov/innovations/e-screening

eScreening - Diffusion Marketplace - VA.gov Results. • Veterans are highly satisfied with eScreening, including its usability, information security, and impact on health services • 90% of ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6712612/

Implementing eScreening technology in four VA clinics The eScreening program is a technology-based, self-screening tool that has shown promise for the efficient and effective collection of mental and physical ...

4. clinicaltrials.gov clinicaltrials.gov/study/NCT04506164

Effectiveness and Implementation of eScreening in Post 9/ ... Electronic screening is effective for timely detection of, and intervention for, suicidal ideation and other mental health symptoms. The VA eScreening ...

5. tandfonline.com tandfonline.com/doi/abs/10.1080/21635781.2021.1994490

Electronic Screening to Support Measurement Based Care eScreening provides customized and automated self-report mental and physical health screening via mobile tablet for veterans seen in Veterans Health ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9565186/

Mental Health Reform: Design and Implementation of a ... There is an urgent need to optimize mental health and wellbeing outcomes for veterans and their families through an improved system.

7. hsrd.research.va.gov hsrd.research.va.gov/research/citations/pubbriefs/articles.cfm?RecordID=964

Intervention Helps Identify Specialty Mental Health Patients ... Study investigators used a multicomponent implementation strategy to implement FLOW at a very large VA community-based outpatient clinic in Texas. FINDINGS ...

8. frontiersin.org frontiersin.org/journals/health-services/articles/10.3389/frhs.2023.1210286/full

Expanding access to evidence-based psychotherapy in VA ... This paper reports findings from a demonstration project that used a multifaceted implementation program to train and support VHA providers in delivering a ...

9. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10614153/

implementation of the brief cognitive behavioral therapy for ... Implementation efforts of Brief CBT resulted in rapid uptake and significant clinical impact on Veterans. Rural outreach efforts, including ...

10. journals.sagepub.com journals.sagepub.com/doi/10.1177/26334895211004607

Consensus on strategies for implementing high priority ... This study elicited expert recommendations to identify which of 73 discrete implementation strategies were considered essential for implementing three mental ...