Participatory Systems Engagement for Addiction and Mental Health Care

Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Palo Alto Veterans Institute for Research
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests new methods to assist Veterans with addiction and mental health issues, such as opioid and alcohol misuse, depression, and PTSD. The goal is to determine if involving patients and healthcare teams in planning and decision-making can enhance access to effective treatments. Researchers will compare this new approach, called Participatory System Dynamics—a collaborative planning and decision-making method—with traditional methods that focus on data review. VA clinics with potential for improvement in mental health care quality may be suitable participants. As an unphased trial, this study offers Veterans the chance to contribute to innovative approaches in mental health care.

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. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that these methods are safe for addiction and mental health care?

Research shows that Participatory System Dynamics (PSD) involves people in a system to help create and test changes before implementation. This method has been applied in areas like mental health services to understand and improve operations. Studies have not identified any direct safety issues with PSD, as it primarily involves data analysis and decision-making. PSD focuses on collaborating with people to enhance services, without involving medications or medical procedures, thus minimizing traditional safety risks.

Similarly, the Audit and Feedback (AF) approach, which uses data to improve service quality, presents no known safety concerns. Like PSD, AF aims to enhance processes without involving physical treatments.

Both PSD and AF seek to improve health service delivery, particularly in mental health and addiction care. As these methods do not involve invasive procedures, they are considered safe for participants.12345

Why are researchers excited about this trial?

Researchers are excited about Participatory System Dynamics (PSD) and Audit and Feedback (AF) because these approaches aim to improve addiction and mental health care by involving entire healthcare systems and feedback loops. Unlike traditional treatments that focus primarily on individual therapy or medication, PSD engages clinics in understanding and optimizing their own processes collectively. Meanwhile, AF uses structured feedback to enhance clinical performance by providing clinics with insights into their practices compared to benchmarks. Both methods offer a fresh approach to tackling the complexities of mental health and addiction by enhancing systemic collaboration and data-driven improvements.

What evidence suggests that Participatory System Dynamics is effective for addiction and mental health care?

Research has shown that Participatory System Dynamics (PSD), one of the approaches studied in this trial, can enhance how healthcare systems deliver addiction and mental health treatments. PSD unites patients, healthcare providers, and policymakers to improve understanding and planning of treatment methods. This approach uses insights from these groups, along with data and simulation models, to expand the availability of effective treatments, helping to prevent relapse, overdose, and suicide. Studies indicate that involving all these groups leads to better decision-making and more effective care. By improving how treatments are implemented, PSD aims to ensure that more patients receive the necessary help. Another approach tested in this trial is Audit and Feedback (AF), which provides clinics with data on their performance to improve care quality.16789

Who Is on the Research Team?

LE

Lindsey E Zimmerman, PhD

Principal Investigator

National Center for PTSD, Dissemination & Training Division

Are You a Good Fit for This Trial?

This trial is for VA divisions and outpatient clinics that are below the median in quality for treating depression, PTSD, and opioid use disorder. They must have at least a year's worth of data from 2018 but not be involved in other specific VA improvement programs or scheduled for EHR updates during the study.

Inclusion Criteria

Must be below the overall VA quality median (as assessed by the Strategic Analytics for Improvement and Learning or SAIL), which includes 3 of 8 SAIL measures associated with four evidence-based psychotherapies and three evidence-based pharmacotherapies for depression, PTSD, and opioid use disorder.
VA divisions and community-based outpatient clinics (CBOCs) or 'clinics' from regional VA health systems

Exclusion Criteria

Clinics with less than 12 months of data in 2018
Clinics already involved in Office of Veterans Access to Care (OVACS) quality improvement program at baseline
Clinics where the VA Cerner electronic health record (EHR) implementation rollout will occur during the project period (Veterans Integrated Services Networks (VISNs) 20, 21, 22, and 7)
See 2 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participatory System Dynamics (PSD) and Audit and Feedback (AF) interventions are implemented across 24 sites to test effectiveness in improving evidence-based practice reach.

12 months

Follow-up

Participants are monitored for the effectiveness of interventions and data is collected for analysis.

6 months

What Are the Treatments Tested in This Trial?

Interventions

  • Participatory System Dynamics
Trial Overview The trial tests Participatory System Dynamics (PSD), which involves patients, providers, and policymakers to improve care access against standard methods like Audit and Feedback (AF). It aims to see if PSD can enhance treatment reach within veteran healthcare services.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: Participatory System Dynamics (PSD)Experimental Treatment1 Intervention
Group II: Audit and Feedback (AF)Experimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Palo Alto Veterans Institute for Research

Lead Sponsor

Trials
58
Recruited
8,800+

Citations

Participatory System Dynamics Modeling - PubMed CentralParticipatory system dynamics modeling (PSD) triangulates stakeholder expertise, data and simulation of implementation plans prior to attempting change.
Participatory System Dynamics for Evidence-based ...Participatory system dynamics modeling meets this need by triangulating stakeholder perspectives, administrative data and model simulations, conferring rigor ...
Local Participatory Systems Dynamics to Increase Reach of ...Research evidence has established highly effective treatments that prevent relapse, overdose and suicide, but even with policy mandates, performance metrics, ...
Participatory System Dynamics vs Audit and FeedbackThis study tests participatory business engineering methods that engage patients, providers and policy makers against the status quo approaches, such as data ...
Insights from system dynamics applications in addiction ...System dynamics (SD) methods broaden, test, and improve understanding of complex systems and can help inform effective action.
Examining the Impact of Youth Mental Health Services ...Methods: Participatory system dynamics modeling was used to investigate the impact of MH services capacity growth trajectories and digital ...
Participatory Methods for Systems Modeling of Youth ...Sophisticated decision analysis methods are needed to better understand the dynamic and multisector drivers of youth mental health. System modeling can help ...
Participatory systems modelling for youth mental health: agility ...Whilst system dynamics modelling utilises academic literature and data sets to build and validate the model structure, participatory systems ...
Examining the Impact of Youth Mental Health Services ...Participatory system dynamics modeling was used to investigate the impact of MH services capacity growth trajectories and digital interventions on YMH outcomes, ...
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