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Supported Online Self-Help for Veterans With Depression in Primary Care (SOS-Depression)

19 augustus 2026 bijgewerkt door: Lucinda B. Leung, MD, PhD, MPH, University of California, Los Angeles

Supported Online Self-Help for Veterans With Depression in Primary Care (SOS-Depression)

Depression is disabling and affects one in five Veterans. VA's Primary Care-Mental health Integration (PCMHI) enables specialists to support medication treatment in primary care, but timely and sufficient access to psychotherapy is unattainable despite Veteran preference for psychotherapy. This study aims to close the gap in psychotherapy access for VA primary care patients with depression by adapting PCMHI collaborative care models to improve uptake of peer-supported computerized cognitive behavioral therapy (cCBT).

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Background: VA's Primary Care-Mental Health Integration (PCMHI) is rooted in evidence-based collaborative care models, where care managers, mental health specialists, and primary care providers jointly treat depression in primary care. While PCMHI enabled specialists to support medication treatment in primary care, access to psychotherapy is not timely and sufficient. Alternative therapy modalities are needed. Peer-supported cCBT for depression has been shown to be effective but is not yet widely used within VA.

Significance/Impact: Depression is disabling and affects one in five Veterans. Psychotherapy is preferred by Veterans, but fraught with multilevel barriers (e.g., staff availability, patient travel to clinic, limited clinic hours). Without enhancing existing PCMHI models to enable better primary care patient access to effective psychotherapies, Veteran engagement in depression treatment is unlikely to improve.

Innovation: This study aims to close the gap in psychotherapy access for VA primary care patients with depression by adapting PCMHI collaborative care models to improve uptake of peer-supported computerized cognitive behavioral therapy (cCBT). cCBT is accessible 24/7 via the internet and has effectively treated depression in more than 30 trials. With peer specialist support, it is comparable to face-to-face psychotherapy. Peer support specialists and PCMHI teams can facilitate Veteran uptake of cCBT, using an evidence-based collaborative care model to provide the follow-up care management and mental health specialist back-up that characterizes the most effective cCBT trials.

Specific Aims/Methodology: This study involves 400 recent military service members and Veterans in VA Greater Los Angeles and San Diego. VA providers help service members undergoing discharge at military treatment facilities transition to the VA for care. Once at the VA, providers screen patients every year for depression. This randomized clinical trial will study the implementation and effectiveness of online therapy for depression. First, to help providers deliver and monitor online treatment, we will use three tested strategies for implementation: facilitators/coaches, quality improvement, and data monitoring/dashboards. Second, we will randomly assign patients who are newly diagnosed with depression to receive either: 1) online therapy supported by Veterans peers and VA PCMHI clinical teams (SOS-D intervention), or 2) online therapy supported by VA PCMHI clinical teams alone (enhanced usual care). Our research team will measure and compare depressive symptoms at the study start then at 3 months and 6 months across both groups. We will measure how much online therapy is used by each group. Third, through interviews we will compare the experiences of women Veterans and patients with TBI using online therapy to men Veterans and those without TBI.

Next Steps/Implementation: This research will demonstrate how online depression treatment can be given to military service members, Veterans, and civilians on a larger scale. Bringing Veteran peers onto VA clinical teams can enhance use of online therapy for depression and support Veteran recovery. Ensuring depression treatment is available immediately when needs are identified is important in preventing suicide.

Studietype

Ingrijpend

Inschrijving (Geschat)

400

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Locaties

  • Verenigde Staten
    • California
      • San Diego, California, Verenigde Staten, 92161
        • VA San Diego Healthcare System
      • West Los Angeles, California, Verenigde Staten, 90073-1003
        • VA Greater Los Angeles Healthcare System

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Beschrijving

Inclusion Criteria:

  • Must be enrolled in the VHA and currently receiving primary care services at VA Los Angeles or San Diego
  • Have access to computer (mobile or desktop), internet, telephone, and email
  • Able to read English text on a computer screen
  • Score 10 or higher on the PHQ-9

Exclusion Criteria:

  • Have moderate-high suicide risk (e.g. suicide flag) or active suicidality
  • Have other serious mental illness (e.g. bipolar disorder, psychosis)
  • Have medical disorder that would prevent/ interfere with participation (e.g. dementia/cognitive impairment, terminal illness)

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Onderzoek naar gezondheidsdiensten
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Enkel

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Actieve vergelijker: Enhanced Usual Care (EUC)
Participants in the enhanced usual care arm will receive access to computerized cognitive behavioral therapy (cCBT) supported by a care manager in addition to the usual care provided.
Gedragsmatig: Enhanced Usual Care (EUC)
Enhanced usual care includes all the usual depression care at the VA and access to an online therapy program with no peer support sessions. The online therapy program offered consists of several modules for depression care, specifically tailored for Veterans.
Experimenteel: Supported Online Self-help for Depression (SOS-Depression)
Participants in the intervention arm will receive computerized cognitive behavioral therapy (cCBT) supported by a care manager and a designated Peer support specialist in addition to the usual care provided.
Gedragsmatig: Supported Online Self-help for Depression (SOS-Depression)
Supported Online Self-help for Depression (SOS-Depression) includes all the usual depression care at the VA and access to an online therapy program with support sessions with a peer. The online therapy program consists of several modules for depression care, specifically tailored for Veterans.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Patient Health Questionnaire (PHQ-9)
Tijdsspanne: 3- and 6-month follow up
The Patient Health Questionnaire (PHQ-9) is a scale commonly used to measure and categorize depression symptoms. It is already administered as part of routine primary care at our study site. The minimum score is 0, the maximum is 27. A higher score indicates a worse outcome (i.e. more severe depression symptoms).
3- and 6-month follow up

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Behavioral Activation for Depression Scale (BADS-SF)
Tijdsspanne: 3- and 6-month follow up
The 9-item Behavioral Activation for Depression Scale (BADS-SF) will also be used to examine behavioral activation as an intermediary to depression symptomatology outcomes. The minimum score is 0, the maximum is 54. Higher scores indicate a better outcome (i.e., higher activation).
3- and 6-month follow up
Generalized Anxiety Disorder (GAD-7)
Tijdsspanne: 3- and 6-month follow up
The 7-item Generalized Anxiety Disorder (GAD-7) is among the most commonly used and best validated anxiety measures in primary care settings. The minimum score is 0, the maximum is 21. Higher scores indicate a worse outcome (i.e., more severe anxiety). For reference: scores of 0-4=minimal anxiety, 5-9=mild anxiety, 10-14=moderate anxiety, and 15-21=severe anxiety.
3- and 6-month follow up
World Health Organization Disability Assessment Schedule (WHODAS 2.0)
Tijdsspanne: 3- and 6-month follow up
The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) 12-item version is a brief self-report measure that will be used to assess functioning and disability across multiple domains of daily life. The minimum score is 0, and the maximum score is 48. Higher scores indicate greater disability.
3- and 6-month follow up

Andere uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Treatment Engagement
Tijdsspanne: 6-months
Treatment engagement will be conceptualized as the number of cCBT sessions completed. A higher number indicates more cCBT sessions completed, but isn't indicative of a better or worse outcome.
6-months

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

University of California, Los Angeles

Medewerkers

Congressionally Directed Medical Research Programs
San Diego Veterans Healthcare System
VA Greater Los Angeles Healthcare System

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

1 september 2026

Primaire voltooiing (Geschat)

1 maart 2029

Studie voltooiing (Geschat)

1 augustus 2029

Studieregistratiedata

Eerst ingediend

19 augustus 2026

Eerst ingediend dat voldeed aan de QC-criteria

19 augustus 2026

Eerst geplaatst (Werkelijk)

24 augustus 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

24 augustus 2026

Laatste update ingediend die voldeed aan QC-criteria

19 augustus 2026

Laatst geverifieerd

1 augustus 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • IRB-25-0799
  • HT9425-25-1-0831 (Ander subsidie-/financieringsnummer: Congressionally Directed Medical Research Programs (CDMRP))

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

JA

Beschrijving IPD-plan

The data collected during this clinical trial will be made available to the research community by depositing de-identified data into the NIMH Data Archive (NDA). All of the NIMH Common Data Elements (CDEs) will be collected for this study, following the NIMH expectations. In addition to the CDEs required by the NDA, we will also submit data elements covering demographics and health outcomes, healthcare services use, and satisfaction. We will use NIH-endorsed CDEs when possible.

  • Sex
  • Marital status
  • Ethnicity
  • Race
  • Level of education
  • Work status
  • Housing status
  • Behavioral Activation for Depression Scale (BADS-SF)
  • Alcohol Use Disorders Identification Test (AUDIT-C)
  • Columbia-Suicide Severity Rating Scale (C-SSRS)
  • Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5
  • Client Satisfaction Questionnaire (CSQ-I)
  • System Usability Scale (SUS)

IPD-tijdsbestek voor delen

In accordance with NDA guidelines, we will complete the Collections' Data Expected section within six months of the grant award. Thereafter we will submit data every 6 months in accordance with the NDA Data Sharing Terms and Conditions Post-Award Milestones.

IPD-toegangscriteria voor delen

UCLA is committed to the ideals of collaborative research, and as such, will adhere to the sponsors Grant Policy on Sharing of Unique Research Resources. The data collected for this research represent a valuable resource to the scientific community, and we will undertake all reasonable procedures to make them accessible to others, while respecting the special needs for confidentiality. The data collected during this clinical trial will be made available to the research community by depositing de-identified data into the NIMH Data Archive (NDA).

The NDA houses, harmonizes, and shares all human-subjects data collected as part of NIMH-funded projects with the goal of accelerating progress in the research of mental health. NDA is one database infrastructure that supports efforts to make data collected by different laboratories as consistent as possible and allow other researchers to access those data for secondary use. NDA stores and shares clinical/phenotypic, imaging, genomic, and othe

IPD delen Ondersteunend informatietype

  • LEERPROTOCOOL
  • SAP

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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