A Hybrid Effectiveness Implementation Trial Evaluating Behavioral Treatments for Insomnia for Socioeconomically Disadvantaged Adults in Primary Care
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Suzanne Bertisch, MD, MPH
- Phone Number: 857-307-0355
- Email: sbertisch@bwh.harvard.edu
Study Locations
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Massachusetts
-
Boston, Massachusetts, United States, 02115
- Recruiting
- Brigham and Women's Hospital
-
Contact:
- Carolina Dos Santos
- Phone Number: 617-278-0746
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Aged 18 years or older
- Meet clinical diagnostic criteria for insomnia (DSM-V criteria)
- Insomnia severity score > 10
- Eligible to receive care through publicly-supported medical assistance (e.g. Commonwealth Connector plan; MassHealth. For participants >65 years old on Medicare, they will be asked about insurance coverage prior to initiating Medicare, OR
- Identify as racial or ethnic minority
- Has capacity for informed consent (SDT<9)
Exclusion Criteria:
- Untreated, current major depressive disorder (PHQ-8≥ 20)
- History of bipolar disorder or psychosis
- Active alcohol abuse (Alcohol Use Disorders Identification Test, AUDIT-C) or drug abuse (Drug Abuse Screening Test, DAST-2 ≥1)
- Excessive daytime sleepiness (Epworth Sleepiness Scale score ≥ 16)
- Seizure within the past 1 year
- Main sleep period outside of 8pm - 11am
- Regular nightshift work (5 overnight shifts/month, defined as working between midnight-5am)
- Untreated, previously diagnosed moderate to severe sleep apnea
- Severe medical condition, which may require hospitalizations over the next 6 months
- Active suicidal ideation, if elicited passively during screening
- Pregnant or planning to become pregnant (self-reported)
- Participation in other studies that may impact the benefit or safety of the intervention, as determined by the study PI
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Tele-Brief Behavioral Treatment for Insomnia
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Brief Behavioral Treatment for Insomnia (BBTI) comprises of up to five weekly intervention visits by phone, delivered by a variety of practitioners without formal training in sleep.
|
|
Active Comparator: Tele-Cognitive-Behavioral Therapy for Insomnia
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Cognitive-Behavioral Therapy for Insomnia (CBTI) is a multicomponent strategy delivered by trained mental health clinicians over 6 to 12 weeks.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Insomnia severity index, ISI
Time Frame: 3 months
|
The Insomnia Severity Index is a 7-item self-report questionnaire assessing the nature, severity, and impact of insomnia in the last month.
A 5-point Likert scale is used to rate each item (e.g., 0 = no problem; 4 = very severe problem), yielding a total score ranging from 0 to 28.
The total score is interpreted as follows: absence of insomnia (0-7); sub-threshold insomnia (8-14); moderate insomnia (15-21); and severe insomnia (22-28).
|
3 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Insomnia severity index, ISI
Time Frame: 6- and 12-months
|
The Insomnia Severity Index is a 7-item self-report questionnaire assessing the nature, severity, and impact of insomnia in the last month.
A 5-point Likert scale is used to rate each item (e.g., 0 = no problem; 4 = very severe problem), yielding a total score ranging from 0 to 28.
The total score is interpreted as follows: absence of insomnia (0-7); sub-threshold insomnia (8-14); moderate insomnia (15-21); and severe insomnia (22-28).
|
6- and 12-months
|
|
Quality of Life and Symptoms - Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health
Time Frame: 3-months
|
The PROMIS Global Health measures assess an individual's physical, mental and social health.
The measure produces two scores: Physical and Mental Health from 4 items each.
Item responses are combined to yield a T-score with a population mean of 50 and standard deviation of 10.
|
3-months
|
|
Quality of Life and Symptoms - Generic-quality of life
Time Frame: 3-months
|
Generic-quality of life will be assessed by the change in the Euroqol - 5 Dimensions (EQ-5D) questionnaire.
The questionnaire comprises of 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression.
Each dimension has 3 levels: no problems, some problems, and extreme problems.
There is no total score or range.
|
3-months
|
|
Generalized Anxiety Disorder (GAD-7)
Time Frame: 3-months
|
GAD-7 measures self-reported anxiety disorder.
The measure includes 7-items with higher scores indicating anxiety.
The minimum score is 0 and the maximum score is 21.
|
3-months
|
|
Patient Health Questionnaire for depression (PHQ-8)
Time Frame: 3-months
|
PHQ-8 measures self-reported current depression.
The measure includes 8-items with higher scores indicating depression.
The minimum score is 0 and the maximum score is 24.
|
3-months
|
|
Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Impairment, 8a
Time Frame: 3-months
|
PROMIS Sleep Impairment measures self-reported perceptions of alertness, sleepiness, and tiredness during usual waking hours, and the perceived functional impairments during wakefulness associated with sleep problems or impaired alertness during the past seven days.
The measure includes 8-items with higher scores indicating greater sleep impairment.
The minimum score is 8 and the maximum score 40.
Item responses are combined to yield a T-score with a population mean of 50 and standard deviation of 10.
|
3-months
|
|
Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance, 8b
Time Frame: 3-months
|
PROMIS Sleep Disturbance measures self-reported sleep quality and associated daytime functioning during the past seven days.
The measure includes 8-items with higher scores indicating greater sleep disturbance.
The minimum score is 8 and the maximum score is 40.
Item responses are combined to yield a T-score with a population mean of 50 and standard deviation of 10.
|
3-months
|
|
Diary reported sleep duration
Time Frame: 3-months
|
Self-reported sleep duration with be measured using sleep diary
|
3-months
|
|
Diary-reported sleep efficiency
Time Frame: 3-months
|
Self-reported sleep efficiency with be measured using sleep diary
|
3-months
|
|
Number of participants with hypnotic use self-reported from the sleep diary
Time Frame: 3-months
|
Hypnotic use will be measured by the number of participants who self-reported use on the sleep diary
|
3-months
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2023P000106
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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