Mental health and chaplain co-led group-based treatment of moral injury in Veterans receiving care in the United States Veterans Health Administration system. Other
Conditions
Interventions
Enrolled sites will enter an 18-month implementation phase. For the initial 6 months of implementation (implementation phase A), a Community of Practice (COP), lower intensity strategy will be used am
and 2) simultaneously support preparation for implementation among new sites and sustainment at existing sites (via facilitated individual and group calls).
Following the 6 months, both new and su
or (b) Dynamic Diffusion Network (DDN) facilitation (higher intensity strategy) for months 6-12 (implementation phase B).
At the end of the 18-month implementation phase, post-implementation and/or s
Sponsors
United States Department of Veterans Affairs
Eligibility
Sex/Gender
All
Age
0 Years to 1 Years
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 led by teams of 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 (community of practice or network-based structured implementation facilitation) 4. Willing and able to obtain facility-level leadership support and approval to participate 5. Invited by DDN QUERI staff to participate in a quality improvement program
Exclusion criteria
Exclusion criteria: Must meet all inclusion criteria noted above, including being invited to participate in QI program by DDN QUERI staff
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Percentage of group visits measured using Electronic patient attendance lists at Each scheduled group (approximately 10-16 sessions over approximately 3-4 months) | — |
Secondary
| Measure | Time frame |
|---|---|
| Patient retention of 80% or more measured using Electronic health record and provider-reported attendance at 18 months and 24 months;Number and type of core and adaptable components of moral injury groups measured using descriptions of group session content via quarterly reports and qualitative interviews at 18 months;Description of quality improvements efforts undertaken by participating facilities measured using facility self-report at 18 months;Moral injury group clinical effectiveness (moral injury outcomes, PTSD symptomatology, depressive symptomatology including suicidality, and mental well-being ) measured using electronic patient record at prior to or during first group session and during or following last group session (pre/post);Factors influencing implementation and sustainment measured using surveys and semi-structured interviews at at start and completion of the 18-month implementation phase;Implementation cost measured using facility self-report at 18 months | — |
Countries
United States of America
Contacts
Public ContactBrandolyn White
Outcome results
None listed