Design and methodology of a randomized clinical trial of home-based telemental health treatment for U.S. military personnel and veterans with depression

Luxton, David D.; O’Brien, Karen M.; Stanfill, Katherine; Jenkins‐Guarnieri, Michael A.; Johnson, Kristine; Wagner, Amy W.; Thomas, Elissa K.; Gahm, Gregory A.

doi:10.1016/j.cct.2014.04.002

Cited by 26 publications

(28 citation statements)

References 24 publications

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“…A number of evolving models of telepsychiatry, including collaborative care and consultation, have the potential to leverage scarce mental health resources in rural areas to reach more patients . Randomized clinical trials are underway to test the effectiveness of telepsychology service delivery for depressed elderly veterans and of home‐based telemental health treatment for military personnel and veterans with depression . The latter telemental health trial uses doctoral‐level clinical psychologists as the study's clinicians; other VA telehealth programs use teams that include psychiatric nurse practitioners and social workers in addition to psychiatrists and psychologists .…”

Section: Discussionmentioning

confidence: 99%

Utilization of Mental Health Services by Veterans Living in Rural Areas

Teich

Ali

Lynch

et al. 2016

The Journal of Rural Health

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While research indicates that recent efforts to improve MH service delivery have resulted in improved access to services, this study found that veterans' rates of MH treatment are lower in rural areas, compared to urban areas. Continued efforts to support the provision of behavioral health services to rural veterans are needed. Telemedicine, using rural providers to their maximum potential, and engagement with community stakeholder groups are promising approaches.

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Section: Discussionmentioning

confidence: 99%

Utilization of Mental Health Services by Veterans Living in Rural Areas

Teich

Ali

Lynch

et al. 2016

The Journal of Rural Health

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“…Participants are asked to make an activity to-do-list using the activity schedule. The sixth session is used to discuss the completion of the treatment, evaluate treatment progress, and teach participants to prevent recurrence using the knowledge and skills learned from treatment [ 24 ] ( Table 1 ). After each intervention, the behavioral activation intervention software that we developed assists individual self-learning (psychological knowledge of depression and behavioral activation), establishment of an activity schedule, and monitoring of daily emotional changes.…”

Section: Methodsmentioning

confidence: 99%

Guided Self-Help Behavioral Activation Intervention for Geriatric Depression: Protocol for Pilot Randomized Controlled Trial

Wang¹,

Zhou²,

Yang³

2020

JMIR Res Protoc

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Background Aging is a social concern. The increased incidence of depression in older populations in China poses a challenge to the health care system. Older adults who are depressed often suffer from a lack of motivation. Behavioral activation treatment, an evidence-based guided self-help treatment, is effective in reducing anhedonia and amotivation in depression; however, the efficacy of guided self-help behavioral activation in older adults with depression is not yet known. Objective The aim of this study is to pilot a self-help guided intervention for the treatment of depression in older adults. Methods This study has been designed as a pilot randomized controlled trial with inpatients (n=60; to be randomly allocated 1:1) between the ages of 60 and 70 and who have major depressive disorder. Patients attending clinical psychological clinics at the Mental Health Center of Chongqing will be randomized to either receive guided self-help behavioral activation (intervention) or to be on a 6-week waiting list (control). Participants in the treatment group will receive 6 sessions of guided self-help behavioral activation delivered over the telephone. The waiting list control group will receive the intervention after a period of 6 weeks. Exclusion criteria will be individuals who are at significant risk of harming themselves or others, who have a primary mental health disorder other than depression, or who have an intellectual disability that would hamper their ability to participate in the intervention. Effects of the treatment will be observed using outcomes in 3 domains: (1) clinical outcomes (symptom severity, recovery rate), (2) process variables (patient satisfaction, attendance, dropout), and (3) economic outcomes (cost and resource use). We will also examine mediators of outcomes in terms of patient variables (behavioral activation or inhibition motivation). We hypothesize that guided self-help behavioral activation will have a beneficial effect. Results The study was approved by the research ethics committee of the Mental Health Center of Chongqing in November 2019. As of July 2020, recruitment had not yet begun. Data collection is expected to be completed by December 2020. Data analysis is expected to be completed by June 2021. Results will then be disseminated to patients, to the public, to clinicians, and to researchers through publications in journals and presentations at conferences. Conclusions This will be the first study in China to investigate guided self-help interventions for patients who are older adults and who are depressed, a group which is currently underrepresented in mental health research. The intervention is modular and adapted from an empirically supported behavioral activation treatment for depression. The generalizability and broad inclusion criteria are strengths. Trial Registration Chinese Clinical Trial Register ChiCTR1900026066; http://www.chictr.org.cn/showprojen.aspx?proj=43548 International Registered Report Identifier (IRRID) PRR1-10.2196/18259

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“…By reviewing and using the information obtained from the review of 15 similar articles,[1356910121517192127282930] requirements of TMH services were identified and a questionnaire was developed for the validate necessary TMH services. The questionnaire consisted of 2 parts and 29 questions, including demographic information (5 questions), and identified TMH service requirements (24 questions), which were based on the 5-point Likert scale (very much, much, no idea, low, and very low).…”

Section: Methodsmentioning

confidence: 99%

“…War is one of the factors affecting the prevalence, onset time, and course of mental-behavioral disorders. [1] Previous studies have shown that both war and stress-induced physical conditions affect the mental health of war victims. [23] The Iran–Iraq War was an armed conflict between Iran and Iraq, beginning on September 22, 1980, when Iraq invaded Iran and ending on August 20, 1988 and its consequences have led to psychological disorders as a common problem among warriors, veterans, and their families.…”

Section: Introductionmentioning

confidence: 99%

“…[89] For many veterans with movement limitations, factors such as distance and time are major barriers to accessing mental health services. [110] Currently, the advancements in information and communication technologies have revolutionized the methods of providing health services to veterans. [1112] Over the past decade, various aspects of telemedicine programs have been implemented to improve the access of combat veterans to health care around the world.…”

Section: Introductionmentioning

confidence: 99%

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Identifying and validating requirements of telemental health services for Iranian veterans

Safdari

Ahmadi

Bahaadinbeigy

et al. 2019

J Family Med Prim Care

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Background: The ability of timely access to mental health care is very important for combat veterans that are facing many barriers such as living in rural and remote areas and the lack of integration. Telemental health services improve the veterans’ health situation by providing mental health care from a distance. We aimed to identify the telemental health service requirements for Iranian veterans and validate them from the perspective of the statistical population. Methods: This descriptive cross-sectional study was conducted in 2018. In the first phase, a review was conducted in relevant databases, such as PubMed, Scopus, Ovid, Ebsco, and Web of Science. In the second phase, veterans, mental health providers, and telemedicine experts were consulted to validating of the identified telemental health service requirements by a researcher-made questionnaire. Analysis of collecting data was done using SPSS software. Results: By full-text reviewing of 15 related articles, the identified elements were justified in 2 main categories and 24 subcategories including telemental health services (17 items) and telemental health requirements (7 items). According to the findings, the highest score was related to “save health-care costs” (4.47) and “reduce transportation-related problems” (4.47). Moreover, the “feasible alternative to face-to-face care” (2.22) obtained the lowest score from the perspective of the statistical population. Conclusion: Due to the importance of accessibility and patient-based mental health services, more studies are needed to investigate the point of views of patients and specialists to better understand the concerns and barriers to the implementation and use of telemental health services.

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Design and methodology of a randomized clinical trial of home-based telemental health treatment for U.S. military personnel and veterans with depression

Cited by 26 publications

References 24 publications

Utilization of Mental Health Services by Veterans Living in Rural Areas

Utilization of Mental Health Services by Veterans Living in Rural Areas

Guided Self-Help Behavioral Activation Intervention for Geriatric Depression: Protocol for Pilot Randomized Controlled Trial

Identifying and validating requirements of telemental health services for Iranian veterans

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