Virtual Insomnia Patients (VIPs) to Accelerate Dissemination of Precision Diagnosis and Treatment of Insomnia
Abstract
Background: Insomnia (i.e., inability to sleep at least 3 nights per week for at least 3 months) is rapidly increasing in the military (73-fold increase from 2000 to 2009). Our group found that 20% of active-duty Service Members (e.g., 441,000 across branches) had insomnia pre-deployment, 74% while deployed, and 33% post- deployment, making it one of the most common disorders in military personnel. Insomnia puts Warfighters at risk for many other physical problems (e.g., obesity, pain, heart disease, immune functioning, vitality) and mental health problems (e.g., depression, suicidality, substance abuse, PTSD). Medications are the most commonly used treatment for insomnia in military populations, which is problematic because the potential side effects can have major implications for military personnel. This is especially problematic during deployments, which may require individuals to awaken quickly and respond immediately. Furthermore, Cognitive Behavioral Therapy for Insomnia (CBTI) is the first-line recommended treatment for insomnia but there are not enough providers trained to deliver CBTI. This is partially because there are very few training opportunities. To address this gap, in the previously funded research (W81XWH-17-1-0165; Principal Investigator PI: Taylor), our team developed, tested, and launched the user-friendly and engaging CBTIweb training platform to increase provider access to CBTi training. In the 16 months since CBTIweb was made available online, 1,488 (93/mo) have completed all training and passed a comprehensive post-test. Thus, CBTIweb is helping address the shortage of providers trained in CBTI. However, after didactic training in a new intervention (e.g., CBTI), therapists are required by ethics boards to obtain supervised clinical training to achieve competence. Traditionally, new/student psychological and medical health trainees gain practical experience through a stepwise combination of (1) role-playing with other students or human standardized patients (HSPs, i.e., persons recruited and trained to exhibit the characteristics of a real patient) followed by (2) treatment of real volunteer patients (often at low/no-cost training clinics), both under close supervision or consultation by an expert. While HSPs can be trained to play the part of an insomnia patient, they are limited by high costs, training efforts, inconsistencies in the actors ability to accurately depict patients and high turnover from year to year. This same predicament is faced by all current evidence-based psychotherapies being rolled out in the Department of Veterans Affairs and Department of Defense (DOD) (e.g., CBT for depression, CPT and PE for PTSD, Motivational Interviewing for substance abuse). Virtual Standardized Patients (VSPs) can reduce cost, ensure standardization and realistically model symptoms. Our team has developed VSPs that provide an ideal means for providers to practice assessment and treatment, even in a deployed setting. VSPs are easily accessible to anyone with a web connection, can be efficiently disseminated across different communities, always show up for appointments, and the therapist can receive real-time performance checks and feedback based on fidelity ratings. Objective: The overall objective of this grant is to extend the PI s previous DOD-funded projects (PI Parsons: W81XWH-14-C-0016; W911NF-04-D-0005; W911NF-09-2-0048; W81XWH-10-2-0075) to develop Virtual Insomnia PatientsTM (VIPs) and assess the usability, functionality and training outcomes and then integrate VIPs into the CBTIweb (W81XWH-17-1-0165; PI: Taylor) platform to revolutionize current training approaches. Specific Aims: Aim 1 is to use an iterative design process to develop and assess usability and functionality of VIPs that can be integrated into CBTIweb to revolutionize current training approaches. Aim 2 is to launch the VIPs platform and compare training outcomes (i.e., Diagnostic Accuracy and
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252311080
Entities
People
- Thomas D Parsons
Organizations
- Arizona State University
- United States Army