Moral injury Not Applicable
Conditions
Interventions
Participating VA facilities, primarily represented by mental health-chaplain dyads, will be randomized into one of two implementation support strategies (i.e. network-based structured implementation f
Sponsors
United States Department of Veterans Affairs
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Healthcare facilities in the Veterans Health Administration will be randomly assigned as part of this quality improvement evaluation. The work of these facilities will be directed by teams led by individuals who are: 1. VHA-employed healthcare chaplain or VHA employed mental health provider 2. Willing and able to co-lead mental health and chaplain co-led collaborative moral injury group(s) for Veterans in VHA setting 3. Willing and able to be randomly assigned to one of two implementation support conditions (technical assistance or network-based structured implementation facilitation) 4. Willing and able to obtain clinic-level leadership and facility-level leadership support and approval to participate 5. Invited by DDN QUERI staff to participate in this QI program
Exclusion criteria
Exclusion criteria: Must meet all inclusion criteria noted above, including being invited to participate in this QI program by DDN QUERI staff
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Appropriate dose/adherence to group attendance determined by the electronic health record indicating that a patient attended 80% or more of intended moral injury group sessions at the end of the study | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Number and type of core and adaptable components of moral injury groups as measured by descriptions of group session contents provided by facilities in a combination of quarterly reports, qualitative interviews conducted with team members approximately 1 year after the beginning of implementation, and examples/descriptions of group materials and processes provided by participating facilities over approximately 1.5 years as they go through the implementation strategy (e.g. preparation and implementation phases). 2. Number and goal of initiated of quality improvements efforts undertaken by participating facilities as measured by self-report from the facility on quarterly reports for one year. 3. Intervention/moral injury group clinical effectiveness as measured by depressive symptomatology measured using the Patient Health Questionnaire-9 prior to or during the first session of moral injury group therapy and during or following the final session of moral injury group therapy (pre/post). 4. Process evaluation utilizing survey (Organizational Readiness for Change) and qualitative data from semi-structured qualitative interviews conducted at the start and completion of the one-year implementation phases to capture components of the Consolidated Framework for Implementation Research (CFIR). 5. Cost of the implementation strategy and intervention will be measured based on self-reported participant activities captured using reports of both implementation and intervention activities conducted by specific individuals over the course of the Dynamic Diffusion Network or technical assistance. | — |
Countries
United States of America
Contacts
Public ContactBrandolyn;Summer White;Anderson
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Outcome results
None listed