Terapia walk-in nell'assistenza primaria a bassa barriera
Integrazione della terapia narrativa breve nelle cliniche a bassa barriera per migliorare la prevenzione dell’HIV
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
Tipo di studio
Tipo di studio
Iscrizione (Effettivo)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Lydia Chwastiak
- Numero di telefono: 206-744-4840
- Email: lchwast@uw.edu
Luoghi di studio
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Washington
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Seattle, Washington, Stati Uniti, 98104
- Harborview Medical Center
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Criteri di inclusione dei pazienti:
- Avrà completato almeno un appuntamento terapeutico presso le cliniche [Blinded].
- Capacità di fornire il consenso informato
- Capacità di completare l'intervista o il questionario in inglese
Criteri di esclusione dei pazienti:
- Impossibilità di fornire il consenso informato
- Necessità di cure urgenti per la salute mentale (ad esempio, rischio imminente di danni a sé stessi o agli altri, astinenza acuta che richiede disintossicazione medica)
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: N / A
- Modello interventistico: Assegnazione di gruppo singolo
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
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Sperimentale: Intervento di terapia narrativa a sessione singola
Ai pazienti delle cliniche a bassa barriera [in cieco] verrà offerta una singola sessione di terapia narrativa con un operatore sanitario comportamentale autorizzato e qualificato.
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L'intervento di terapia narrativa proposto a sessione singola è stato ampiamente implementato nelle cliniche di terapia walk-in nella provincia dell'Ontario, in Canada.
In queste cliniche sono disponibili sessioni di psicoterapia di 60 minuti, basate sulla terapia narrativa.
Il terapeuta collabora con un paziente per co-sviluppare un focus utile e significativo per la sessione e quindi coinvolge il paziente in una conversazione rispettosa ma che cambia il suo modo di pensare al problema presentato.
Il terapista evidenzia e documenta i valori e le capacità del paziente e lavora con lui per creare un piano d'azione.
Se il terapista identifica ulteriori necessità di trattamento, al paziente viene offerto un rinvio esterno a servizi specialistici di salute mentale.
Altri nomi:
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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Number and Representativeness of Participants (Reach)
Lasso di tempo: at enrollment
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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).
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at enrollment
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Number of Participants That Completed Interviews by Interview Type (Reach, Effectiveness and Implementation)
Lasso di tempo: 1 month
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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.
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1 month
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Depression Symptoms Measured by Patient Health Questionnaire - 8 (PHQ-8) Score (Effectiveness)
Lasso di tempo: 1 month
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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.
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1 month
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Anxiety Symptoms Measured by Generalized Anxiety Disorder 7-item (GAD-7) Score (Effectiveness)
Lasso di tempo: 1 month
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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.
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1 month
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Psychological Well-being Measured by World Health Organization-Five Well-Being Index (WHO-5) Score (Effectiveness)
Lasso di tempo: 1 month
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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.
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1 month
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Individual's Resilience Measured by Trait Resilience From the State-Trait Assessment of Resilience Scale (STARS) (Effectiveness)
Lasso di tempo: 1 month
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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.
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1 month
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Social Connectedness Measured by The Social Connectedness Scale (Effectiveness)
Lasso di tempo: 1 month
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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.
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1 month
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General Health Measured by General Health Domain From the 36-Item Medical Outcomes Study Short Form Survey (SF-36) (Effectiveness)
Lasso di tempo: 1 month
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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.
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1 month
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Understanding of Problem Item From Brief Services Evaluation (Effectiveness)
Lasso di tempo: 1 month
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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.
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1 month
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Possession of Skills Needed to Solve Problem Item From Brief Services Evaluation (Effectiveness)
Lasso di tempo: 1 month
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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.
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1 month
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Awareness of Strengths Item From Brief Services Evaluation (Effectiveness)
Lasso di tempo: 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.
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1 month
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Ideas About How to Solve Problem Item From Brief Services Evaluation (Effectiveness)
Lasso di tempo: 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.
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1 month
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Knowledge About Social Supports to Help Item From Brief Services Evaluation (Effectiveness)
Lasso di tempo: 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.
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1 month
|
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Knowledge About Community Resources to Help Item From Brief Services Evaluation (Effectiveness)
Lasso di tempo: 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.
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1 month
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Service Utilization (Implementation)
Lasso di tempo: 1 month
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Service utilization was measured as the number of SSNT sessions received by each neighbor
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1 month
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Fidelity to SSNT (Implementation)
Lasso di tempo: during SSNT session
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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.
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during SSNT session
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Acceptability Measured by Single Session Impression and Feedback Tool (SSIFT) (Implementation)
Lasso di tempo: immediately post-session
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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.
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immediately post-session
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Acceptability Measured by Acceptability of Intervention Measure (AIM) (Implementation)
Lasso di tempo: 1 month
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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.
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1 month
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Collaboratori e investigatori
Sponsor
Sponsor
Collaboratori
Collaboratori
Investigatori
Investigatori
- Investigatore principale: Lydia Chwastiak, University of Washington
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Effettivo)
Completamento primario
Completamento dello studio (Effettivo)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Infezioni a trasmissione ematica
- Malattie urogenitali
- Malattie genitali
- Disordini mentali
- Malattie del sistema immunitario
- Infezioni
- Infezioni da virus a RNA
- Malattie virali
- Malattie trasmissibili
- Malattie sessualmente trasmissibili, virali
- Malattie trasmesse sessualmente
- Infezioni da lentivirus
- Infezioni da retroviridae
- Sindromi da deficit immunologico
- Disturbi indotti chimicamente
- Malattie da virus lenti
- Infezioni da HIV
- Disturbi Correlati a Sostanze
- Sindrome da immunodeficienza acquisita
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- STUDY00018557
- 3P30MH123248-03 (Sovvenzione/contratto NIH degli Stati Uniti)
Piano per i dati dei singoli partecipanti (IPD)
Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?
Descrizione del piano IPD
Periodo di condivisione IPD
Criteri di accesso alla condivisione IPD
Tipo di informazioni di supporto alla condivisione IPD
- STUDIO_PROTOCOLLO
- LINFA
Informazioni su farmaci e dispositivi, documenti di studio
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