Local Participatory Systems Dynamics to Increase Reach of Evidence Based Addiction and Mental Health Care

Conditions

• Alcohol Use Disorder
• Depression
• Opioid Use Disorder
• PTSD

Eligibility Criteria

Sex

ALL

Age

18 Years - N/A

Healthy Volunteers

Accepted

Interventions

• Participatory System Dynamics (PSD) — OTHER
  Participatory system dynamics is a facilitated health care quality improvement or evidence-based practice implementation strategy that includes frontline addiction and mental health staff running simulations of clinic improvement strategies to find the best approaches for improving the reach of evidence-based psychotherapy and evidence-based pharmacotherapy.
• Audit and Feedback (AF) — OTHER
  Audit and feedback is a health care quality improvement or evidence-based practice implementation strategy that includes frontline addiction and mental health staff reviewing clinical care team data to find the best approaches for improving the reach of evidence-based psychotherapy and evidence-based pharmacotherapy.

Study Details

The most common reasons Veterans seek VA addiction and mental health care is for help with opioid and alcohol misuse, depression and PTSD. Research evidence has established highly effective treatments that prevent relapse, overdose and suicide, but even with policy mandates, performance metrics, and electronic health records to fix the problem, these treatments may only reach 3-28% of patients. This study tests participatory business engineering methods (Participatory System Dynamics) that engage patients, providers and policy makers against the status quo approaches, such as data review, and will determine if participatory system dynamics works, why it works, and whether it can be applied in many health care settings to guarantee patient access to the highest quality care and better meet the addiction and mental health needs of Veterans and the U.S. population.

Key Dates

Start date

Feb 1, 2019

Status verified

Apr 2026

Primary completion

Jul 31, 2026

Completion

Jan 29, 2027

Study Design

Enrollment

720 participants (estimated)

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

HEALTH_SERVICES_RESEARCH

Arms

• Experimental: Participatory System Dynamics (PSD)
  12 clinics assigned to PSD
• Experimental: Audit and Feedback (AF)
  12 clinics assigned to AF

Primary Outcome Measure

Proportion of patients diagnosed with alcohol use disorder, depression, opioid use disorder, or PTSD who meet evidence-based psychotherapy and pharmacotherapy initiation and course measures divided by total number of patients with these diagnoses [ Time Frame: Pre-/Post- 12-month period average of evidence-based practice reach (24 months total observation) ]

Locations (1)

Find similar trials in Palo Alto, CA

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