Web-SUCCEED Program for Chronic Conditions in Veterans

(Web-SUCCEED Trial)

Overseen By Mary B Walsh, RN

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Defibrillator, Hemodialysis, Organ transplant, Cancer, Dementia, others

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

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 4

Duration: 6 weeks

560 Participants Needed

Trial Summary

What is the purpose of this trial?

The majority of Veterans will suffer from at least one chronic illness, often at great emotional and personal cost. Self-management is critical to improving physical and emotional outcomes, and many chronically ill Veterans receive self-management assistance from an informal caregiver, and both Veterans and informal caregivers experience individual and interpersonal stress as they navigate this journey. Yet, current clinical practices are not designed to effectively support the needs of both Veterans and their informal caregiver. Furthermore, self-management practices often require in-person visits, limiting access for Veterans and informal caregivers who live in rural areas, those with a physical disability, or those with financial challenges. This project tests a web-based, self-guided, behavioral intervention that targets the stress coping needs of Veterans with chronic illness and their informal caregivers. Results from this study could provide an important solution to the problem of poor self-management, which complicates the lives and prognosis of many Veterans.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on a web-based program for stress coping, so it's unlikely that medication changes are required.

What data supports the effectiveness of the Web-SUCCEED treatment for chronic conditions in veterans?

Research shows that eHealth interventions, like Web-SUCCEED, can improve self-care in chronic conditions such as diabetes and heart disease, leading to better quality of life and health outcomes. Additionally, self-management programs have been effective in improving health-related outcomes for cancer survivors and arthritis patients, suggesting potential benefits for veterans with chronic conditions. ^{1 2 3 4 5}

Is the Web-SUCCEED Program safe for managing chronic conditions in veterans?

The available research on eHealth interventions, which includes programs like Web-SUCCEED, suggests they are generally safe and can improve self-care and quality of life for people with chronic conditions. However, specific safety data for Web-SUCCEED itself is not detailed in the provided studies. ^{1 2 4 6 7}

How is the Web-SUCCEED treatment different from other treatments for chronic conditions in veterans?

Web-SUCCEED is unique because it uses an online platform to provide personalized support and social interaction, making it accessible and cost-effective for veterans managing chronic conditions. This approach leverages the internet's 24/7 availability to enhance self-care through goal setting, feedback, and peer support, which is not typically offered in traditional treatments. ^{1 2 6 8 9}

Research Team

Ranak B Trivedi, PhD MA MS

Principal Investigator

VA Palo Alto Health Care System, Palo Alto, CA

Eligibility Criteria

This trial is for Veterans with at least one chronic condition manageable on an outpatient basis and their primary caregivers who live together. Both must use the internet regularly, feel overwhelmed by managing the health condition, but not be in a situation involving interpersonal violence or severe cognitive deficits.

Inclusion Criteria

I have a chronic condition that can be managed outside the hospital.

Conditions disproportionately high among Veterans (pain, mental health conditions) are also included

I may have conditions like joint pain, heart disease, diabetes, kidney issues, or depression.

Exclusion Criteria

Dyads will be further screened by the study staff for internet use, self-management distress, and interpersonal violence

Veterans who have participated in the Stanford CDSMP program, and caregivers who have participated in the Building Better Caregiver program will be excluded

I do not have a major heart device, am not on dialysis, haven't had or am waiting for an organ transplant, am not undergoing cancer treatment, do not have a short life expectancy, do not suffer from major cognitive issues, do not have a substance use problem, do not rely mainly on a paid caregiver, and am not experiencing severe mental health issues.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in the web-SUCCEED program or enhanced usual care for self-management of chronic illness

6 weeks

Virtual engagement through web-based platform

Follow-up

Participants are monitored for stress, quality of life, and self-management outcomes

6 months

Assessments at 4 weeks and 6 months

Treatment Details

Interventions

• Web-SUCCEED

Trial Overview The study is testing Web-SUCCEED, a web-based program aimed to help Veterans with chronic illnesses and their caregivers manage stress and improve self-management without needing to travel for in-person visits.

Participant Groups

Group I: Web-SUCCEED+Enhanced Usual Care Experimental Treatment 1 Intervention

web-SUCCEED, usual care, psychoeducational materials and resources for caregivers.

Group II: Enhanced Usual Care Active Control 1 Intervention

Usual care, enhanced by psychoeducational materials and resources for caregivers.

Web-SUCCEED is already approved in United States for the following indications:

Approved in United States as Web-SUCCEED for:

• Chronic health conditions
• Stress management for veterans and caregivers

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Findings from Research

eHealth interventions significantly improve self-care in patients with chronic conditions like type-2 diabetes, cardiovascular disease, and chronic obstructive pulmonary disease, as shown in a review of eight systematic reviews involving 41,579 participants.

These interventions not only enhance self-care but also lead to better clinical outcomes, such as improved HbA1C levels, blood pressure, and overall quality of life, highlighting the importance of tailoring eHealth strategies to specific health goals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of eHealth Interventions on the Improvement of Self-Care in Chronic Patients: An Overview of Systematic Reviews. Renzi, E., Baccolini, V., Migliara, G., et al.[2022]

The Cancer Thriving and Surviving (CTS) program, an adaptation of the Chronic Disease Self-management Program, was successfully delivered to 244 cancer survivors across 27 workshops, demonstrating high attendance and participant satisfaction (95% would recommend it).

The program's feasibility and acceptability suggest it could be an effective self-management support tool for cancer survivors, potentially improving their health-related outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adaptation of the chronic disease self-management program for cancer survivors: feasibility, acceptability, and lessons for implementation. Risendal, B., Dwyer, A., Seidel, R., et al.[2021]

The community-based lay-led Arthritis Self-Management Program (ASMP) significantly reduced pain and increased the use of cognitive coping methods and aerobic exercise among participants with chronic inflammatory arthritis, with evaluations conducted at 6 weeks and 3 months after the program.

The study involved 65 participants and demonstrated that shared-care collaboration between hospitals and community organizations can effectively support patients, leading to improvements in self-efficacy and overall health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A pilot evaluation of Arthritis Self-Management Program by lay leaders in patients with chronic inflammatory arthritis in Hong Kong. Leung, YY., Kwan, J., Chan, P., et al.[2021]

The revised Partners in Health (PIH) scale, tested on 904 participants with chronic illnesses, effectively measures self-management through a validated 4-factor model, which includes knowledge of illness, patient-health professional partnership, symptom management, and coping strategies.

The PIH scale is a useful tool for health professionals to assess and promote self-management in patients, although further research is needed to establish its reliability and validity over time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Measuring chronic condition self-management in an Australian community: factor structure of the revised Partners in Health (PIH) scale. Smith, D., Harvey, P., Lawn, S., et al.[2018]

The Spanish version of the Self-Care of Chronic Illness Inventory (SC-CII-Sp) has been validated as a reliable tool for assessing self-care behaviors in older adults with chronic multimorbidity, based on a study involving 1260 participants over nearly two years.

The SC-CII-Sp consists of three sub-scales that effectively measure different aspects of self-care, demonstrating good internal consistency and validity, making it a valuable resource for healthcare professionals working with Spanish-speaking older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Spanish version of the Self-Care of Chronic Illness Inventory: A validation study amongst community-dwelling older adults with chronic multimorbidity. Hernández-Padilla, JM., Dobarrio-Sanz, I., Fernández-Sola, C., et al.[2023]

Patients using self-management digital interventions (DIs) for chronic conditions like hypertension and asthma reported feeling more reassured and engaged in their health management, leading to more meaningful consultations with healthcare professionals (HCPs).

Healthcare professionals noted improved clinical control and appreciated patients' enhanced understanding of their conditions, indicating that DIs can effectively support both patient self-management and HCP oversight.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using digital interventions for self-management of chronic physical health conditions: A meta-ethnography review of published studies. Morton, K., Dennison, L., May, C., et al.[2022]

Chronic conditions affect a large portion of the US adult population, leading to significant healthcare costs, with 86% of the $2.7 trillion spent annually on their treatment.

Self-management interventions for chronic diseases have been shown to improve quality of life and reduce healthcare utilization, especially when based on systematic theories or models that consider various behavioral influences.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interventions to Support Behavioral Self-Management of Chronic Diseases. Allegrante, JP., Wells, MT., Peterson, JC.[2020]

A new website for diabetes self-management, called D-NET, was developed and used by 111 individuals over 10 weeks, with a total of 21,046 logins, indicating strong engagement.

Users reported high satisfaction with the site, particularly enjoying the social support features and information pages, highlighting the Internet's potential to provide effective and accessible support for diabetes management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and use of an Internet support service for diabetes self-management. McKay, HG., Feil, EG., Glasgow, RE., et al.[2018]

Online peer support interventions are gaining recognition as effective and cost-effective methods for helping adults manage chronic health conditions, especially given the increasing internet access among Canadians.

This scoping review aims to identify key characteristics of these online interventions, which could inform the development of future programs to enhance their effectiveness and sustainability.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Online peer support interventions for chronic conditions: a scoping review protocol. Munce, SEP., Shepherd, J., Perrier, L., et al.[2022]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

The Impact of eHealth Interventions on the Improvement of Self-Care in Chronic Patients: An Overview of Systematic Reviews. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Adaptation of the chronic disease self-management program for cancer survivors: feasibility, acceptability, and lessons for implementation. [2021]

3. Germany pubmed.ncbi.nlm.nih.gov

A pilot evaluation of Arthritis Self-Management Program by lay leaders in patients with chronic inflammatory arthritis in Hong Kong. [2021]

4. Netherlands pubmed.ncbi.nlm.nih.gov

Measuring chronic condition self-management in an Australian community: factor structure of the revised Partners in Health (PIH) scale. [2018]

5. England pubmed.ncbi.nlm.nih.gov

Spanish version of the Self-Care of Chronic Illness Inventory: A validation study amongst community-dwelling older adults with chronic multimorbidity. [2023]

6. Ireland pubmed.ncbi.nlm.nih.gov

Using digital interventions for self-management of chronic physical health conditions: A meta-ethnography review of published studies. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Interventions to Support Behavioral Self-Management of Chronic Diseases. [2020]

8. United States pubmed.ncbi.nlm.nih.gov

Feasibility and use of an Internet support service for diabetes self-management. [2018]

9. England pubmed.ncbi.nlm.nih.gov

Online peer support interventions for chronic conditions: a scoping review protocol. [2022]