Walk-in-Therapie in der barrierearmen Grundversorgung
Integration einer kurzen narrativen Therapie in Kliniken mit geringer Barrierefreiheit zur Verbesserung der HIV-Prävention
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
Studientyp
Studientyp
Einschreibung (Tatsächlich)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Lydia Chwastiak
- Telefonnummer: 206-744-4840
- E-Mail: lchwast@uw.edu
Studienorte
-
-
Washington
-
Seattle, Washington, Vereinigte Staaten, 98104
- Harborview Medical Center
-
-
Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
Kriterien für die Patienteneinbeziehung:
- Muss mindestens einen Therapietermin in den [verblindeten] Kliniken absolviert haben
- Fähigkeit zur Einwilligung nach Aufklärung
- Fähigkeit, das Interview oder den Fragebogen auf Englisch auszufüllen
Ausschlusskriterien für Patienten:
- Unfähigkeit, eine Einverständniserklärung abzugeben
- Notwendigkeit einer dringenden psychischen Behandlung (z. B. drohende Gefahr, sich selbst oder anderen zu schaden, akuter Entzug, der eine medizinische Entgiftung erfordert)
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: N / A
- Interventionsmodell: Einzelgruppenzuweisung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
|
Experimental: Narrative Therapieintervention in einer Sitzung
Patienten in [verblindeten] Niedrigbarriere-Kliniken wird eine einzelne narrative Therapiesitzung mit einem ausgebildeten, lizenzierten Verhaltensmediziner angeboten.
|
Die vorgeschlagene narrative Therapieintervention in einer einzigen Sitzung wurde in begehbaren Therapiekliniken in der kanadischen Provinz Ontario weithin umgesetzt.
In diesen Kliniken sind 60-minütige Psychotherapiesitzungen, die auf narrativer Therapie basieren, auf Walk-in-Basis möglich.
Der Therapeut arbeitet mit einem Patienten zusammen, um gemeinsam einen nützlichen und sinnvollen Schwerpunkt für die Sitzung zu entwickeln, und verwickelt den Patienten dann in ein Gespräch, das respektvoll ist, aber seine Denkweise über das vorliegende Problem verändert.
Der Therapeut hebt die Werte und Fähigkeiten des Patienten hervor, dokumentiert sie und erstellt gemeinsam mit dem Patienten einen Aktionsplan.
Wenn der Therapeut zusätzlichen Behandlungsbedarf feststellt, wird dem Patienten eine externe Überweisung an spezialisierte psychiatrische Dienste angeboten.
Andere Namen:
|
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Number and Representativeness of Participants (Reach)
Zeitfenster: at enrollment
|
Number of patients who participated in research and had ≥1 session with the therapist; Representativeness of patients (with respect to age, gender, race/ethnicity, living situation, employment, insurance, education) who had ≥1 session with the therapist (compared to full clinic population).
|
at enrollment
|
|
Number of Participants That Completed Interviews by Interview Type (Reach, Effectiveness and Implementation)
Zeitfenster: 1 month
|
Staff, therapist and pilot participant in-depth interviews were conducted post-implementation by research team members.
They explored stakeholder perspectives on who was not reached, why they were not reached and opportunities for improvement (Reach); SSNT impact on clients (Effectiveness); acceptability and appropriateness of the intervention, and determinants of implementation (Implementation).
After interviews were collected, we used rapid deductive qualitative analysis to assess these outcomes, and generated a table with key findings.
|
1 month
|
|
Depression Symptoms Measured by Patient Health Questionnaire - 8 (PHQ-8) Score (Effectiveness)
Zeitfenster: 1 month
|
The PHQ-8 is a validated measure of depression symptom severity over the previous two weeks.
The total score ranges from 0-24 with higher scores reflecting more severe symptoms; a cut-off score of 10 has high sensitivity and specificity for clinically significant depressive symptoms.
It was completed by pilot participants immediately before and approximately one month after their first SSNT session.
|
1 month
|
|
Anxiety Symptoms Measured by Generalized Anxiety Disorder 7-item (GAD-7) Score (Effectiveness)
Zeitfenster: 1 month
|
The GAD-7 is a validated measure of anxiety symptom severity over the previous two weeks.
The total score ranges from 0-21 with higher score reflecting more severe symptoms; a cut-off score of 10 has good sensitivity and specificity for a diagnosis of generalized anxiety disorder.
It was completed by pilot participants immediately before and approximately one month after their first SSNT session.
|
1 month
|
|
Psychological Well-being Measured by World Health Organization-Five Well-Being Index (WHO-5) Score (Effectiveness)
Zeitfenster: 1 month
|
The WHO-5 is a validated measure of psychological well-being that asks how often someone felt cheerful, calm, active, fresh, and interested in life over the last two weeks.
Total score range is 0-25, with a higher score indicating greater well-being.
A score below 13 suggests the need to screen for depression.
It was completed by pilot participants immediately before and approximately one month after their first SSNT session.
|
1 month
|
|
Individual's Resilience Measured by Trait Resilience From the State-Trait Assessment of Resilience Scale (STARS) (Effectiveness)
Zeitfenster: 1 month
|
Trait Resilience from STARS assesses an individual's resilience within a variety of demanding contexts.
The 7-item questionnaire has a 4-point Likert scale response range of "Disagree" to "Strongly Agree;" total score ranges from 7-28, with higher scores reflecting greater resilience.
It was completed by pilot participants immediately before and approximately one month after their first SSNT session.
|
1 month
|
|
Social Connectedness Measured by The Social Connectedness Scale (Effectiveness)
Zeitfenster: 1 month
|
The Social Connectedness Scale is a reliable and valid 6-item self-report measure based on Kohut's self-psychology theory.
Total scores range from 6-36, with higher scores reflecting a greater sense of social connectedness.
Validation studies have shown good internal reliability and test stability over two-week period.
It was completed by pilot participants immediately before and approximately one month after their first SSNT session.
|
1 month
|
|
General Health Measured by General Health Domain From the 36-Item Medical Outcomes Study Short Form Survey (SF-36) (Effectiveness)
Zeitfenster: 1 month
|
The single-item General Health domain from the 36-Item Medical Outcomes Study Short Form Survey (SF-36) asks "In general, would you say your health is:" and has a five-point Likert scale response range from Excellent (1) to Poor (5).
This single item has been validated as an indicator of health perception, differentiating between healthy and ill groups, and is reliable and valid across diverse populations, including people experiencing homelessness.
It was completed by pilot participants immediately before and approximately one month after their first SSNT session.
|
1 month
|
|
Understanding of Problem Item From Brief Services Evaluation (Effectiveness)
Zeitfenster: 1 month
|
The Brief Services Evaluation (BSE) was developed as part of the evaluation plan for an SSNT multisite program in Canada.
Outcomes include understanding of problem, awareness of one's own strengths and skills, ideas to address problem, and awareness of community resources and social support.
Each item is scored on a 6-point Likert scale from 1 to 6, with higher scores representing better outcomes.
We report item-level changes and significance levels, as done in the Canadian study.
The BSE was completed by pilot participants immediately before and one month after their first SSNT session.
|
1 month
|
|
Possession of Skills Needed to Solve Problem Item From Brief Services Evaluation (Effectiveness)
Zeitfenster: 1 month
|
The Brief Services Evaluation (BSE) was developed as part of the evaluation plan for an SSNT multisite program in Canada.
Outcomes include understanding of problem, awareness of one's own strengths and skills, ideas to address problem, and awareness of community resources and social support.
Each item is scored on a 6-point Likert scale from 1 to 6, with higher scores representing better outcomes.
We report item-level changes and significance levels, as done in the Canadian study.
The BSE was completed by pilot participants immediately before and one month after their first SSNT session.
|
1 month
|
|
Awareness of Strengths Item From Brief Services Evaluation (Effectiveness)
Zeitfenster: 1 month
|
The Brief Services Evaluation (BSE) was developed as part of the evaluation plan for an SSNT multisite program in Canada.
Outcomes include understanding of problem, awareness of one's own strengths and skills, ideas to address problem, and awareness of community resources and social support.
Each item is scored on a 6-point Likert scale from 1 to 6, with higher scores representing better outcomes.
We report item-level changes and significance levels, as done in the Canadian study.
The BSE was completed by pilot participants immediately before and one month after their first SSNT session.
|
1 month
|
|
Ideas About How to Solve Problem Item From Brief Services Evaluation (Effectiveness)
Zeitfenster: 1 month
|
The Brief Services Evaluation (BSE) was developed as part of the evaluation plan for an SSNT multisite program in Canada.
Outcomes include understanding of problem, awareness of one's own strengths and skills, ideas to address problem, and awareness of community resources and social support.
Each item is scored on a 6-point Likert scale from 1 to 6, with higher scores representing better outcomes.
We report item-level changes and significance levels, as done in the Canadian study.
The BSE was completed by pilot participants immediately before and one month after their first SSNT session.
|
1 month
|
|
Knowledge About Social Supports to Help Item From Brief Services Evaluation (Effectiveness)
Zeitfenster: 1 month
|
The Brief Services Evaluation (BSE) was developed as part of the evaluation plan for an SSNT multisite program in Canada.
Outcomes include understanding of problem, awareness of one's own strengths and skills, ideas to address problem, and awareness of community resources and social support.
Each item is scored on a 6-point Likert scale from 1 to 6, with higher scores representing better outcomes.
We report item-level changes and significance levels, as done in the Canadian study.
The BSE was completed by pilot participants immediately before and one month after their first SSNT session.
|
1 month
|
|
Knowledge About Community Resources to Help Item From Brief Services Evaluation (Effectiveness)
Zeitfenster: 1 month
|
The Brief Services Evaluation (BSE) was developed as part of the evaluation plan for an SSNT multisite program in Canada.
Outcomes include understanding of problem, awareness of one's own strengths and skills, ideas to address problem, and awareness of community resources and social support.
Each item is scored on a 6-point Likert scale from 1 to 6, with higher scores representing better outcomes.
We report item-level changes and significance levels, as done in the Canadian study.
The BSE was completed by pilot participants immediately before and one month after their first SSNT session.
|
1 month
|
|
Service Utilization (Implementation)
Zeitfenster: 1 month
|
Service utilization was measured as the number of SSNT sessions received by each neighbor
|
1 month
|
|
Fidelity to SSNT (Implementation)
Zeitfenster: during SSNT session
|
Therapists' session notes were analyzed for the presence of two fidelity indicators: whether the note indicated that the session had a beginning, middle, and end, and whether narrative therapy skills were used.
|
during SSNT session
|
|
Acceptability Measured by Single Session Impression and Feedback Tool (SSIFT) (Implementation)
Zeitfenster: immediately post-session
|
The Single Session Impression and Feedback Tool (SSIFT) is considered as an indicator of acceptability.
Developed for walk-in clinics implementing SSNT, it includes eight items on a 7-point scale (range 1-7) that invite feedback from participants on their perception of the process and outcome of the SSNT intervention.
Six items focus on how collaborative the service was, one on the degree of hope the conversation engendered, and one on the conversation's usefulness.
We report the mean across the eight items, and higher scores indicate more favorable impressions of the SSNT intervention.
As the SSIFT was designed as a therapist feedback tool, its psychometric properties have not been reported.
This evaluation was completed by pilot participants immediately after their first SSNT session.
|
immediately post-session
|
|
Acceptability Measured by Acceptability of Intervention Measure (AIM) (Implementation)
Zeitfenster: 1 month
|
The Acceptability of Intervention Measure (AIM) is a valid and reliable 4-item patient-reported outcome measure that measures the acceptability of an intervention.
Responses to items are a 5-point Likert scale from Completely Disagree (1) to Completely Agree (5).
We report the mean across the 4 items, and a higher score indicates greater intervention acceptability (range 1-5).
The AIM was completed 1-month after pilot participants' first SSNT session.
|
1 month
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Mitarbeiter
Mitarbeiter
Ermittler
Ermittler
- Hauptermittler: Lydia Chwastiak, University of Washington
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Tatsächlich)
Primärer Abschluss
Studienabschluss (Tatsächlich)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Durch Blut übertragene Infektionen
- Urogenitale Erkrankungen
- Genitalerkrankungen
- Psychische Störungen
- Erkrankungen des Immunsystems
- Infektionen
- RNA-Virusinfektionen
- Viruserkrankungen
- Übertragbare Krankheiten
- Sexuell übertragbare Krankheiten, viral
- Sexuell übertragbare Krankheiten
- Lentivirus-Infektionen
- Retroviridae-Infektionen
- Immunologische Mangelsyndrome
- Chemisch induzierte Störungen
- Langsame Viruserkrankungen
- HIV-Infektionen
- Substanzbezogene Störungen
- Erworbenes Immunschwächesyndrom
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- STUDY00018557
- 3P30MH123248-03 (US NIH Stipendium/Vertrag)
Plan für individuelle Teilnehmerdaten (IPD)
Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?
Beschreibung des IPD-Plans
IPD-Sharing-Zeitrahmen
IPD-Sharing-Zugriffskriterien
Art der unterstützenden IPD-Freigabeinformationen
- STUDIENPROTOKOLL
- SAFT
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .