The Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) for serious mental illness in community mental health part 1: study protocol for a hybrid type 2 effectiveness-implementation cluster-randomized trial

Trials

Study Protocol

Daniel J. Buysse¹  Marlen Diaz²  Rafael Esteva Hache²  Allison G. Harvey²  Laurel D. Sarfan²  Krista Fisher²  Julia M. Spencer²  Emma R. Agnew²  Shayna A. Howlett²  Catherine A. Callaway²  Lu Dong³  Amy M. Kilbourne⁴ 

[1] Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA;Department of Psychology, University of California, Berkeley, Berkeley, CA, USA;RAND Corporation, Santa Monica, CA, USA;University of Michigan and VA Ann Arbor Healthcare System, Ann Arbor, MI, USA;

关键词: Transdiagnostic;    Sleep;    Circadian;    Serious mental illness;    Implementation;    Adaptation;    Community mental health;   

DOI  :  10.1186/s13063-023-07148-9

 received in 2022-12-12, accepted in 2023-02-08,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSerious mental illness (SMI) can have devastating consequences. Unfortunately, many patients with SMI do not receive evidence-based psychological treatment (EBPTs) in routine practice settings. One barrier is poor “fit” between EBPTs and contexts in which they are implemented. The present study will evaluate implementation and effectiveness outcomes of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) implemented in community mental health centers (CMHCs). TranS-C was designed to target a range of SMI diagnoses by addressing a probable mechanism and predictor of SMI: sleep and circadian problems. We will investigate whether adapting TranS-C to fit CMHC contexts improves providers’ perceptions of fit and patient outcomes.MethodsTranS-C will be implemented in at least ten counties in California, USA (N = 96 providers; N = 576 clients), via facilitation. CMHC sites are cluster-randomized by county to Adapted TranS-C or Standard TranS-C. Within each county, patients are randomized to immediate TranS-C or usual care followed by delayed treatment with TranS-C (UC-DT). Aim 1 will compare TranS-C (combined Adapted and Standard) with UC-DT on improvements in sleep and circadian problems, functional impairment, and psychiatric symptoms. Sleep and circadian problems will also be tested as a mediator between treatment condition (combined TranS-C versus UC-DT) and functional impairment/psychiatric symptoms. Aim 2 will evaluate whether Adapted TranS-C is superior to Standard TranS-C with respect to provider perceptions of fit. Aim 3 will evaluate whether the relation between TranS-C treatment condition (Adapted versus Standard) and patient outcomes is mediated by better provider perceptions of fit in the Adapted condition. Exploratory analyses will (1) compare Adapted versus Standard TranS-C on patient perceptions of credibility/improvement and select PhenX Toolkit outcomes and (2) evaluate possible moderators.DiscussionThis trial has the potential to (a) expand support for TranS-C, a promising transdiagnostic treatment delivered to patients with SMI in CMHCs; (b) take steps toward addressing challenges faced by providers in delivering EBPTs (i.e., high caseloads, complex patients, poor fit); and (c) advance evidence on causal strategies (i.e., adapting treatments to fit context) in implementation science.Trial registrationClinicaltrials.gov NCT04154631. Registered on 6 November 2019. https://clinicaltrials.gov/ct2/show/NCT04154631

【 授权许可】

CC BY   
© The Author(s) 2023

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