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The Healing and Empowerment Actions for Recovery From Trauma (HEART) Trial (HEART)

7. maj 2026 opdateret af: Stephanie Di Stasi
The HEART Trial aimed to determine if wrap-around psychosocial support for patients who sustain moderate to severe trauma requiring orthopedic surgery intervention improves outcomes for patients (Aim 1), care-partners (Aim 2), and healthcare workers (Aim 3) as well as explore implementation strategies to improve health systems' capabilities and capacity to integrate psychosocial support services. The comparators represent real healthcare options for patients, caregivers, and healthcare workers. The HEART Trial is a multicenter pragmatic, stepped-wedge cluster randomized, hybrid type I comparative effectiveness-implementation superiority trial. The study intervention (C-TRP) is a trauma-focused psychosocial intervention, with each site serving as its own control (TRP).

Studieoversigt

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

804

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Colorado
      • Aurora, Colorado, Forenede Stater, 80045
        • University of Colorado Anschutz
        • Kontakt:
          • Nicholas Alfonso, MD
          • Telefonnummer: 7208481900
    • Maryland
      • Baltimore, Maryland, Forenede Stater, 21218
        • Johns Hopkins University
      • Baltimore, Maryland, Forenede Stater, 21201
        • R Adams Cowley Shock Trauma Center
        • Kontakt:
    • Minnesota
      • Minneapolis, Minnesota, Forenede Stater, 55404
    • New Hampshire
      • Lebanon, New Hampshire, Forenede Stater, 03756
    • Ohio
      • Columbus, Ohio, Forenede Stater, 43210
    • Tennessee
      • Nashville, Tennessee, Forenede Stater, 37203
        • Vanderbilt University

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Patients:

Inclusion Criteria:

  1. Age >= 18 years
  2. Anticipated hospital length of stay > 72 hours
  3. Moderate to severe orthopaedic trauma treated surgically for 1 or more injuries
  4. GCS >= 13 at the time of enrollment
  5. Willing and able to meet with Evellere coach while hospitalized or via the telephone within 72 hours of discharge (intervention cohort only)

Exclusion Criteria:

  1. Non-english speaking (must be sufficiently fluent in English to consent and complete surveys without interpretive services)
  2. Prior to index hospitalization, patient must not be receiving home services or be independent in daily tasks
  3. Any penetrating brain injury
  4. Patients with significant burn injury
  5. Prior cognitive impairment
  6. Hospital death or imminent death
  7. Hospice care at time of trauma or selection for hospice during initial hospital admission or do not resuscitate or comfort care only before index visit
  8. Prisoner/ inmate or police/ security intervention during hospitalization
  9. No reliable internet access at baseline
  10. Psychosis
  11. Trauma presentation is a result of suicide attempt/ self-harm

Care Partners

Inclusion criteria:

  1. Identified by the enrolled patient as a primary source of support during their recovery. A care partner can be in person or supporting remotely.
  2. Age >= 18 years
  3. Willing and able to meet with an Evellere coach during patient hospitalization or via telephone within 72 hours of discharge (intervention cohort only)

Exclusion criteria:

  1. Non-english speaking (must be sufficiently fluent in English to consent and complete surveys without interpretive services)
  2. Paid professionals or home healthcare providers whose support is provided as part of employment (e.g., nurses, aides, case managers)
  3. Already enrolled as a care partner for another participant in the HEART Trial
  4. Hospitalized at time of patient enrollment
  5. No reliable internet access at baseline

Healthcare Workers

Inclusion criteria:

  1. Age > 18 years
  2. Currently employed (full-time, part-time) at a participating trauma center in a role type associated with trauma care (e.g., engaged in clinical care navigation, behavioral health, rehabilitation, recovery coordination, etc.)
  3. Provides or supports care for orthopedic trauma patients for ≥20% of their clinical time
  4. Expected to remain employed at the trauma center for >12 months after enrollment

Exclusion criteria:

  1. Are contracted staff or traveling temporary staff
  2. Are students or trainees
  3. No reliable internet access at baseline

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Sekventiel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Trauma recovery Programming (TRP)
Every trauma system adheres to a standardized protocol, aligned with credentialing requirements of ATS and The Joint Commission. Locally, this involves tailored referrals by hospital teams at time of discharge, based on specific needs of the patient. Additionally, a standard after-visit summary, with discharge instructions, is provided to the patient. It is a routine practice for the discharge team to review these instructions with the patient to address any questions. After discharge, the responsibility for managing the recovery process shifts to the patient and/or their care-partner. This includes calling physician offices for specific questions. However, social services and resources to navigate the process are limited after discharge.
Every trauma system adheres to a standardized protocol, aligned with credentialing requirements of ATS and The Joint Commission. Locally, this involves tailored referrals by hospital teams at time of discharge, based on specific needs of the patient. Additionally, a standard after-visit summary, with discharge instructions, is provided to the patient. It is a routine practice for the discharge team to review these instructions with the patient to address any questions. After discharge, the responsibility for managing the recovery process shifts to the patient and/or their care-partner. This includes calling physician offices for specific questions. However, social services and resources to navigate the process are limited after discharge.
Eksperimentel: Comprehensive trauma recovery programming (C-TRP)
A multicomponent, patient-focused intervention that follows the standardized recovery protocol (TRP) with added resiliency coaching, peer support, education, and navigation resources. C-TRP begins during hospitalization and continues throughout recovery, allowing patients and care-partners to engage based on their needs and preferences. Upon enrollment, patients are connected with a local resiliency coach from Evellere for optional in-person support. Coaching provides a holistic approach to ensure safety, connection, and recovery planning, including referrals to site-specific or community providers for depression, anxiety, or PTSD as needed. Education is delivered through online resources, print materials, mobile apps, and peer and coach guidance. The intervention is delivered by Evellere using the Trauma Responsive Continuum of Care (TRCC)™ model, supporting collaboration with health systems and addressing psychosocial needs while enabling medical teams to focus on physical trauma ca
A multicomponent, patient-focused intervention that follows the standardized recovery protocol (TRP) with added resiliency coaching, peer support, education, and navigation resources. C-TRP begins during hospitalization and continues throughout recovery, allowing patients and care-partners to engage based on their needs and preferences. Upon enrollment, patients are connected with a local resiliency coach from Evellere for optional in-person support. Coaching provides a holistic approach to ensure safety, connection, and recovery planning, including referrals to site-specific or community providers for depression, anxiety, or PTSD as needed. Education is delivered through online resources, print materials, mobile apps, and peer and coach guidance. The intervention is delivered by Evellere using the Trauma Responsive Continuum of Care (TRCC)™ model, supporting collaboration with health systems and addressing psychosocial needs while enabling medical teams to focus on physical trauma car

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
PROMIS-Anxiety
Tidsramme: 5-7 weeks and 12-14 weeks post enrollment
The primary outcome for aims 1 (patients) and 2 (care partners) is anxiety, measured using PROMIS-Anxiety at 5-7 weeks and 12-14 weeks post-enrollment
5-7 weeks and 12-14 weeks post enrollment

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Maslach Burnout Inventory
Tidsramme: 6 months and 12 months
The primary outcome for Aim 3 (healthcare workers) is burnout, measured using Maslach Burnout Inventory (MBI) at 6 months and 12 months.
6 months and 12 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. juli 2026

Primær færdiggørelse (Anslået)

1. august 2030

Studieafslutning (Anslået)

1. marts 2032

Datoer for studieregistrering

Først indsendt

7. maj 2026

Først indsendt, der opfyldte QC-kriterier

7. maj 2026

Først opslået (Faktiske)

13. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

13. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

7. maj 2026

Sidst verificeret

1. maj 2026

Mere information

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Kliniske forsøg med Standard of Care (Investigator Selected)

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