- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05484297
Increasing Social Connection Through Crisis Caring Contacts: A Pragmatic Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Lack of social connection is a common and powerful predictor of suicidal ideation, suicide attempts, functional decline, and death, even after adjustment for sociodemographic and clinical variables. Loneliness, specifically, is associated with a 26% increased likelihood of all-cause mortality. The urgency of addressing these problems is only amplified by the COVID-19 pandemic, which for some time may further increase loneliness, suicide, and other causes of mortality. Due to their risk for loneliness and negative health outcomes, a group of particular concern is older adults and patients with medical or psychiatric comorbidity who have poor treatment engagement.
Caring Contacts is an intervention that can address loneliness and treatment disengagement. It involves periodically sending brief messages to at-risk individuals with nondemanding expressions of care and concern. It is one of just two non-pharmacologic interventions to have evidence in randomized controlled trials (RCTs) for reducing rates of suicide. However, Caring Contacts has only been evaluated in a relatively narrowly indicated population of patients with acute psychiatric issues.
Major gaps in the understanding of Caring Contacts include whether it reduces loneliness, whether it can diminish causes of mortality besides suicide, and whether it is effective older Veterans and patients with treatment disengagement. The overarching objective of this project is to evaluate "Crisis Caring Contacts" (CCC), an adaptation of Caring Contacts tailored to Veterans at risk for lack of social connection and lapses in treatment amidst the COVID-19 pandemic and its aftermath.
Primary aims for this study are: 1) Among older Veterans with poor treatment engagement, evaluate the effectiveness of Crisis Caring Contacts in decreasing loneliness, compared to enhanced usual care; 2) Evaluate the effect of Crisis Caring Contacts on other important outcomes, including treatment engagement and suicidal ideation; 3) Explore potential moderators of treatment response to Crisis Caring Contacts; and 4) Explore the effect of Crisis Caring Contacts on all-cause mortality, suicide attempts, and drug overdoses.
Impact: This project will advance scientific understanding of key gaps related to the mechanisms and outcomes of Caring Contacts, while also evaluating a timely, pragmatic, low-cost, and scalable intervention for Veterans affected by lack of social connection and treatment engagement.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Aaron A Call
- Phone Number: (503) 220-8262
- Email: Aaron.Call@va.gov
Study Contact Backup
- Name: Alan R Teo, MD MS
- Phone Number: 52461 (503) 220-8262
- Email: Alan.Teo@va.gov
Study Locations
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Michigan
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Ann Arbor, Michigan, United States, 48105-2303
- Recruiting
- VA Ann Arbor Healthcare System, Ann Arbor, MI
-
Contact:
- Paul N Pfeiffer, MD MS
- Phone Number: 734-769-1000
- Email: Paul.Pfeiffer@va.gov
-
Sub-Investigator:
- Paul N Pfeiffer, MD MS
-
-
Oregon
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Portland, Oregon, United States, 97207-2964
- Recruiting
- VA Portland Health Care System, Portland, OR
-
Contact:
- Alan R Teo, MD MS
- Phone Number: 52461 (503) 220-8262
- Email: Alan.Teo@va.gov
-
Contact:
- Aaron A Call
- Phone Number: 503-220-8262
- Email: Aaron.Call@va.gov
-
Principal Investigator:
- Alan R. Teo, MD MS
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Washington
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Seattle, Washington, United States, 98108-1532
- Recruiting
- VA Puget Sound Health Care System Seattle Division, Seattle, WA
-
Contact:
- Mark Reger, PhD
- Phone Number: 253-583-3295
- Email: Mark.Reger@va.gov
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- age 50 years and above
- have at least four VA appointments in the prior 6-18 months in primary care or mental health
- have at least two comorbidities contained in the Elixhauser Index
- a) zero completed appointments in the past 6 months and zero appointments scheduled, or b) in the 90th percentile or higher in terms of no-shows or appointments canceled by patient in the prior 12 months
Exclusion Criteria:
- no valid mailing address
- no valid phone number
- inclusion in an existing Caring Contacts program
- diagnosis of neurocognitive disorder or other significant cognitive impairment indicative of inadequate decision-making capacity
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Treatment
Participants in the treatment arm will receive the intervention post cards
|
A series of post cards with Crisis Caring Contacts content sent over 10 months
|
Sham Comparator: Control
Participants in the control arm will receive the control post cards
|
A series of post cards intended to control for attention received but not including elements thought to be "active ingredients" in the intervention
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
UCLA Loneliness Scale, Version 3
Time Frame: 12-month follow-up
|
This scale has a score range from 20 -80, with higher scores representing greater degrees of loneliness.
|
12-month follow-up
|
Count of mental health or primary care visits over 12 months
Time Frame: The 12-month period from the date of randomization to 12-month follow-up
|
Treatment engagement will be assessed by counting VA outpatient visits to mental health or primary care during the 12 months after randomization.
Visits will be required to be linked to a chronic psychiatric or medical diagnosis, and occur at one of the study sites to count.
More visits will represent greater treatment engagement.
|
The 12-month period from the date of randomization to 12-month follow-up
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
PROMIS Short Form v2.0 ? Emotional Support 4a
Time Frame: 12-month follow-up
|
This scale has a range from 4 - 20, with higher scores representing greater perceived emotional support.
|
12-month follow-up
|
Trust in Public Healthcare System, Institutional Trust Subscale (adapted for VA)
Time Frame: 12-month follow-up
|
Adapted to assess trust in the VA specifically, this scale has a score range from 3 - 15, with higher scores representing more trust.
|
12-month follow-up
|
Depressive Symptom Index Suicidality Subscale (DSI-SS)
Time Frame: 12-month follow-up
|
This scale has a score range from 0 - 12, with higher scores representing greater degrees of suicidality.
|
12-month follow-up
|
Suicide Ideation Scale (SIS)
Time Frame: 12-month follow-up
|
This scale has a score range from 10 - 50, with higher scores representing greater degrees of suicidality.
|
12-month follow-up
|
Collaborators and Investigators
Investigators
- Principal Investigator: Alan R. Teo, MD MS, VA Portland Health Care System, Portland, OR
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- SDR 21-087
- 1I01HX003428-01 (U.S. NIH Grant/Contract)
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.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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