A Randomized Effectiveness Trial of a Systems-Level Approach to Stepped Care for War-Related PTSD
Abstract
The purpose of the STEPS UP (STepped Enhancement of PTSD Services Using Primary Care) trial is to compare centralized telephonic care management with preference-based stepped PTSD and depression care to optimized usual care. We hypothesize that the STEPS UP intervention will lead to improvements in (1) PTSD and depression symptom severity (primary hypothesis); (2) anxiety and somatic symptom severity, alcohol use, mental health functioning, work functioning; (3) costs and cost-effectiveness. We further hypothesize that qualitative data will show (4) patients, their family members, and participating clinicians find that the STEPS UP intervention is an acceptable, effective, and satisfying approach to deliver and receive PTSD and depression care. STEPS UP is a six-site, two-parallel arm (N = 1,500) randomized controlled effectiveness trial with quarterly follow-up for 12 months comparing centralized telephonic stepped-care management to optimized usual PTSD and depression care. In addition to the existing PTSD and depression treatment options, STEPS UP will include web-based cognitive behavioral self-management, telephone cognitive-behavioral therapy, continuous RN nurse care management, and computer-automated care management support. Both arms can refer patients for mental health specialty care as needed, preferred and available. The study will use sites currently running RESPECT-Mil, the Initiating PI's existing military primary care-mental health services practice network, to access site health care leaders and potential study participants at the 6-study sites.
Document Details
- Document Type
- Technical Report
- Publication Date
- Sep 01, 2010
- Accession Number
- ADA543713
Entities
People
- Lisa H. Jaycox
Organizations
- RAND Corporation