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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to assist Veterans with chronic illnesses, such as musculoskeletal pain, cardiovascular disease, or depression, in managing their conditions through a web-based program called Web-SUCCEED. The program provides tools for stress management and self-care, supporting both Veterans and their informal caregivers, particularly those who face challenges accessing in-person care. Participants must have had an outpatient visit related to their condition in the past year and have a primary caregiver living with them. The trial compares usual care, enhanced with educational materials, to the new web-based program to determine which is more effective. As an unphased trial, this study offers Veterans access to innovative care solutions that could enhance their quality of life.

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 prior data suggests that this web-based intervention is safe for Veterans and their caregivers?

Research has shown that the Web-SUCCEED program helps Veterans and their caregivers manage stress and chronic illness. This online program allows participants to proceed at their own pace, focusing on skills to cope with stress and enhance self-care.

In terms of safety, as a behavioral program, it involves no medications or physical procedures, eliminating concerns about drug side effects. The program centers on learning and practicing new skills, which is generally manageable. Importantly, studies have demonstrated that these online programs effectively support both Veterans and their caregivers without causing harm. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Web-SUCCEED program because it offers a novel approach to managing chronic conditions in veterans by integrating digital tools with traditional care. Unlike standard treatments that focus solely on medical intervention, Web-SUCCEED combines usual care with psychoeducational materials and online resources for caregivers, enhancing support beyond the clinical setting. This holistic approach aims to empower both patients and caregivers, potentially improving health outcomes by providing accessible and comprehensive care tools.

What evidence suggests that the Web-SUCCEED program is effective for managing chronic conditions in Veterans?

Research has shown that the Web-SUCCEED program helps Veterans with long-term illnesses manage their conditions more effectively. In this trial, participants will receive either Enhanced Usual Care or the Web-SUCCEED program combined with Enhanced Usual Care. Studies have found that online, self-guided programs can effectively lower stress and improve coping skills for people with ongoing health issues. Web-SUCCEED specifically aids Veterans and their caregivers in managing stress and depression, common challenges in dealing with long-term illnesses. Early tests showed promising results in enhancing participants' ability to manage their health. This program could be a valuable tool for Veterans and their caregivers, especially for those who struggle to access in-person support. ^{1 2 5 6 7}

Who Is on the Research Team?

Ranak B Trivedi, PhD MA MS

Principal Investigator

VA Palo Alto Health Care System, Palo Alto, CA

Are You a Good Fit for This Trial?

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.

Participants must have a primary caregiver who lives with the Veteran

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

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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 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]

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 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]

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]

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]

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]

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]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT06001541

Web-based Program to Improve Self-management Among ... This project tests a web-based, self-guided, behavioral intervention that targets the stress coping needs of Veterans with chronic illness and their informal ...

2. reporter.nih.gov reporter.nih.gov/search/IOgP0rajz0CjrOoZEV2lVw/project-details/10976421

A web-based program to improve chronic illness ... - NIH RePORTER Specific Aims: With investments from VA HSR&D, we have developed and successfully pilot tested a new theoretically-derived technology called Web-based Self-care ...

3. research.va.gov research.va.gov/for_veterans/web_succeed.cfm

Web-SUCCEED Study Web-SUCCEED involves learning about chronic health condition management, how to manage stress or symptoms of depression, and practicing skills people need to ...

4. framilyveteranhealth.stanford.edu framilyveteranhealth.stanford.edu/projects

Projects | Framily and Mental Health Lab - Stanford University Web-SUCCEED Study. A randomized clinical trial to evaluate the effectiveness of web-SUCCEED (Web-based Self-management Using Collaborative Coping ...

5. researchgate.net researchgate.net/publication/369785006_Adapting_a_telephone-based_dyadic_self-management_program_to_be_delivered_over_the_web_Methodology_and_usability_testing_Preprint?_tp=eyJjb250ZXh0Ijp7InBhZ2UiOiJzY2llbnRpZmljQ29udHJpYnV0aW9ucyIsInByZXZpb3VzUGFnZSI6bnVsbCwic3ViUGFnZSI6bnVsbH19

(PDF) Adapting a telephone-based, dyadic self-management ... Objective This study aimed to describe the methodology used to adapt a telephone-based, facilitated, and dyadic self-management program called Self-care Using ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8680320/

A Web-Based Self-Management Intervention for Veterans ... Web-SUCCEED is a dyadic intervention for patients and their caregivers designed to improve self-management through improving dyadic stress coping.

7. hsrd.research.va.gov hsrd.research.va.gov/publications/forum/spring23/default.cfm?ForumMenu=spring23-6

Technology-Enabled Dyadic Intervention Can Meet the Needs ... In conclusion, we successfully adapted web-SUCCEED using a systematic and rigorous process involving a multidisciplinary team of experts, Veteran and caregiver ...