SuicideCAMSNCT00905827
Patient and Provider Outcomes of E-Learning Training in Collaborative Assessment and Management of Suicidality
A study testing CAMS in people with Suicide, run by US Department of Veterans Affairs at 5 sites in United States.
Trial summary
Suicide prevention among military Veterans has become a national priority; yet, there is a gap in suicide-specific intervention training for mental health students and professionals. Read more about this study
- Who is it for?
- Ages 22 to 80 yearsHealthy volunteers can take part
- Conditions the study is for
- Suicide
- What is being tested?
- CAMS
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 212 participants
- Where
- 5 sitesUnited States
- Study dates
- Jul 2010to Dec 2013
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 22 to 80 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Mental health providers, psychiatrist, social workers, psychologist, advanced practice nurses and case managers
Who cannot join
- Previous CAMS Training
Trial locations and contacts
5 sites in 1 country.
5 sites in 1 country
United States5 sites
VA Medical Center, Birmingham, AL
Birmingham, Alabama, 35233
Ralph H. Johnson VA Medical Center, Charleston, SC
Charleston, South Carolina, 29401-5799
Wm. Jennings Bryan Dorn VA Medical Center, Columbia SC
Columbia, South Carolina, 29209
Atlanta VA Medical and Rehab Center, Decatur, GA
Decatur, Georgia, 30033
VA Medical Center, Tuscaloosa
Tuscaloosa, Alabama, 35404
About this study
Suicide prevention among military Veterans has become a national priority; yet, there is a gap in suicide-specific intervention training for mental health students and professionals. The need for training in this area has become even more acute with the recent hiring by the Veterans Health Affairs (VHA) of thousands of clinicians to address the mental health needs of Veterans from all war eras. Since e-learning (online) education is more effective than traditional in-person (face-to-face) education for adult learners when methods, such as blended learning, are used, this mode of delivery may more easily meet the training and continuing education needs of busy medical professionals who may find it easier to fit online education into their daily schedules.
A well developed in-person training approach known as the Collaborative Assessment and Management of Suicidality (or CAMS) has been recommended in systematic reviews as an effective tool for assessing and managing suicidality, as well as decreasing providers' fears, improving their attitudes, increasing their knowledge, confidence, and competence, and dispelling myths. The overall aims of this project were to develop an e-learning alternative for the CAMS program, determine its effectiveness relative to in-person CAMS training, and assess factors that may relate to adoption and implementation of CAMS in general and specifically through e-learning and in-person modalities.
Read the detailed description
There were four specific aims:
- Refine a Collaborative Assessment and Management of Suicidality (or CAMS) e-learning course that covers the same material and meets the same learning objectives of CAMS in-person training.
- Test the effectiveness of the CAMS e-learning modality compared to the CAMS in-person modality and a concurrent non-intervention control in terms of provider evaluation and behavior. HO: Providers in each of the two CAMS arms will demonstrate higher levels of content mastery and confidence in acquired skills than providers in the no CAMS arm. H2: In the 12 months post-training, suicidal patients of providers in each of the two CAMS arms will receive higher rates of CAMS guideline concordant treatment, compared with providers in the no CAMS arm.
- Test the effectiveness of the CAMS e-Learning delivery compared to the CAMS in-person delivery and a concurrent non-intervention control in terms of patient outcomes. H3, 4, 5: In the 12 months post-training, suicidal patients of CAMS e-learning providers and CAMS in-person providers will be similar for health services use patterns, duration of high risk episodes, and number of high risk episodes per patient. H6: In the 12 months post training, suicidal patients of providers in the no CAMS arm will have higher rates of emergency room use and inpatient mental health admissions, have a longer average duration of high risk episodes, and have more high risk episodes per patient.
- Assess factors that facilitate or inhibit adoption of CAMS through e-Learning or In-person.
Of the 309 providers who met eligibility criteria, 230 consented and 212 completed the baseline assessments and were randomized. A total of 261 patients met eligibility criteria and information was abstracted on them.
We developed the CAMS-e, conducted a pilot, revised the e-CAMS, delivered the training in the first site, and again revised it. There is little difference in satisfaction ratings between the two types of training deliveries on the VA Evaluation of Training. Findings show that there were some modest immediate improvements due to the two training conditions; however, the effects were only sustainable at three months for one question related to hospitalization beliefs.
To date, the project has had the following impacts:
- success in obtaining 6.5 continuing education units (CEUs) for the e-learning version
- invitations to place e-CAMS on the Department of Defense learning platforms
- VA Central Office has purchased a license to use the Suicide Status Form (SSF) as a clinical tool and template in the computerized electronic patient record system throughout the national VA. The template is in the developmental process.
- Efforts are underway to move the CAMS e-learning on to the VA Training Management System (TMS) which will facilitate system wide dissemination and has the potential to increase adoption in VAMC's or by providers.
Additional impacts may be evident with regard to improved care once we complete analysis of the patient outcomes and provider adherence data. We have also considered a short manuscript on economic analysis
- Conditions
- Suicide
- Being tested
- CAMS
- Keywords
- suicide, assessment, management, Provider Training, health services
- Medical subject headings
- Suicide
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CAMSBehavioural
Collaborative assessment management in suicidality
| Study group | Role | What they receive |
|---|---|---|
| Intervention 1: in person CAMS | Experimental | In person Collaborative Assessment and Management of Suicidality (CAMS) training for providers Receives: Behavioral: CAMS |
| Intervention 2: e-learning CAMS | Experimental | Online Collaborative Assessment and Management of Suicidality (CAMS) training for providers Receives: Behavioral: CAMS |
| Control: no training | No intervention | Control Group: no training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Provider Self-efficacy and Beliefs About Suicidality
Assessed beliefs and confidence in managing suicidal individuals. Using a 5-point Likert scale, there were 11 items that addressed the following: competence, reactions, beliefs, motivations, and CAMS as it relates to their practice. Scores ranged from 11-55 with questions were phrased so higher scores indicated more positive views.
Measured: post-training
Secondary outcomes (1)
Satisfaction With Training
Evaluation included 20 standard items assessing providers satisfaction with training, including items similar to other published satisfaction surveys. Survey items were rated using a five-point Likert scale indicating the degree to which respondents agreed or disagreed. Questions were always phrased positively so that agree or strongly agree is equivalent to a positive response.
Measured: post-training
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 May 2009 (estimated)
- Study startJul 2010
- Primary completionJul 2013
- Study completionDec 2013
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for SuicideStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 212 participants (actual)
Sponsor and investigators
- Lead sponsor
- US Department of Veterans Affairs
- Sponsor type
- US federal agency
- Collaborators
- Medical University of South Carolina, Washington Psychological Center
- Responsible party
- Sponsor
- Investigators
- Kathryn M. Magruder, PhD MPH BA, Principal investigator, Ralph H. Johnson VA Medical Center, Charleston, SC
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00905827
- Sponsor's protocol ID
- EDU 08-424
- Other IDs
- 19016
- Acronym
- CAMS
- Status last verified
- Oct 2014
- First submitted
- 19 May 2009
- Last updated
- 24 Apr 2015
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Pearson GS, Evans LK, Hines-Martin VP, Yearwood EL, York JA, Kane CF. Promoting the mental health of families. Nurs Outlook. 2014 May-Jun;62(3):225-7. doi: 10.1016/j.outlook.2014.04.003. No abstract available.
PubMed 24959633Puntil C, York J, Limandri B, Greene P, Arauz E, Hobbs D. Competency-based training for PMH nurse generalists: inpatient intervention and prevention of suicide. J Am Psychiatr Nurses Assoc. 2013 Jul-Aug;19(4):205-10. doi: 10.1177/1078390313496275.
PubMed 23950543Marshall E, York J, Magruder K, Yeager D, Knapp R, De Santis ML, Burriss L, Mauldin M, Sulkowski S, Pope C, Jobes DA. Implementation of online suicide-specific training for VA providers. Acad Psychiatry. 2014 Oct;38(5):566-74. doi: 10.1007/s40596-014-0039-5. Epub 2014 Feb 22.
PubMed 24563240York JA, Lamis DA, Pope CA, Egede LE. Veteran-specific suicide prevention. Psychiatr Q. 2013 Jun;84(2):219-38. doi: 10.1007/s11126-012-9241-3.
PubMed 23011459
Study at a glance
From the registry record, last updated by the sponsor on 24 Apr 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Patient and Provider Outcomes of E-Learning Training in Collaborative Assessment and Management of Suicidality
- ClinicalTrials.gov ID
- NCT00905827
- Acronym / sponsor ID
- CAMS / EDU 08-424
- Conditions
- Suicide
- Keywords
- suicide, assessment, management, Provider Training, health services
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 212 participants (actual)
- Lead sponsor
- US Department of Veterans AffairsUS federal agency
- Collaborators
- Medical University of South Carolina, Washington Psychological Center
- Study start
- Jul 2010
- Primary completion
- Jul 2013 (actual)
- Study completion
- Dec 2013 (actual)
- First posted
- 21 May 2009 (estimated)
- Results
- Posted 9 Jan 2015
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Suicide prevention among military Veterans has become a national priority; yet, there is a gap in suicide-specific intervention training for mental health students and professionals. The need for training in this area has become even more acute with the recent hiring by the Veterans Health Affairs (VHA) of thousands of clinicians to address the mental health needs of Veterans from all war eras. Since e-learning (online) education is more effective than traditional in-person (face-to-face) education for adult learners when methods, such as blended learning, are used, this mode of delivery may more easily meet the training and continuing education needs of busy medical professionals who may find it easier to fit online education into their daily schedules.
A well developed in-person training approach known as the Collaborative Assessment and Management of Suicidality (or CAMS) has been recommended in systematic reviews as an effective tool for assessing and managing suicidality, as well as decreasing providers' fears, improving their attitudes, increasing their knowledge, confidence, and competence, and dispelling myths. The overall aims of this project were to develop an e-learning alternative for the CAMS program, determine its effectiveness relative to in-person CAMS training, and assess factors that may relate to adoption and implementation of CAMS in general and specifically through e-learning and in-person modalities.
Detailed description
There were four specific aims:
- Refine a Collaborative Assessment and Management of Suicidality (or CAMS) e-learning course that covers the same material and meets the same learning objectives of CAMS in-person training.
- Test the effectiveness of the CAMS e-learning modality compared to the CAMS in-person modality and a concurrent non-intervention control in terms of provider evaluation and behavior. HO: Providers in each of the two CAMS arms will demonstrate higher levels of content mastery and confidence in acquired skills than providers in the no CAMS arm. H2: In the 12 months post-training, suicidal patients of providers in each of the two CAMS arms will receive higher rates of CAMS guideline concordant treatment, compared with providers in the no CAMS arm.
- Test the effectiveness of the CAMS e-Learning delivery compared to the CAMS in-person delivery and a concurrent non-intervention control in terms of patient outcomes. H3, 4, 5: In the 12 months post-training, suicidal patients of CAMS e-learning providers and CAMS in-person providers will be similar for health services use patterns, duration of high risk episodes, and number of high risk episodes per patient. H6: In the 12 months post training, suicidal patients of providers in the no CAMS arm will have higher rates of emergency room use and inpatient mental health admissions, have a longer average duration of high risk episodes, and have more high risk episodes per patient.
- Assess factors that facilitate or inhibit adoption of CAMS through e-Learning or In-person.
Of the 309 providers who met eligibility criteria, 230 consented and 212 completed the baseline assessments and were randomized. A total of 261 patients met eligibility criteria and information was abstracted on them.
We developed the CAMS-e, conducted a pilot, revised the e-CAMS, delivered the training in the first site, and again revised it. There is little difference in satisfaction ratings between the two types of training deliveries on the VA Evaluation of Training. Findings show that there were some modest immediate improvements due to the two training conditions; however, the effects were only sustainable at three months for one question related to hospitalization beliefs.
To date, the project has had the following impacts:
- success in obtaining 6.5 continuing education units (CEUs) for the e-learning version
- invitations to place e-CAMS on the Department of Defense learning platforms
- VA Central Office has purchased a license to use the Suicide Status Form (SSF) as a clinical tool and template in the computerized electronic patient record system throughout the national VA. The template is in the developmental process.
- Efforts are underway to move the CAMS e-learning on to the VA Training Management System (TMS) which will facilitate system wide dissemination and has the potential to increase adoption in VAMC's or by providers.
Additional impacts may be evident with regard to improved care once we complete analysis of the patient outcomes and provider adherence data. We have also considered a short manuscript on economic analysis
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Intervention 1: in person CAMS | Experimental | Behavioral: CAMSIn person Collaborative Assessment and Management of Suicidality (CAMS) training for providers |
| Intervention 2: e-learning CAMS | Experimental | Behavioral: CAMSOnline Collaborative Assessment and Management of Suicidality (CAMS) training for providers |
| Control: no training | No intervention | –Control Group: no training |
Who may qualify
- Ages
- 22 to 80 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Mental health providers, psychiatrist, social workers, psychologist, advanced practice nurses and case managers
Key exclusion criteria (1 listed)
- Previous CAMS Training
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| CAMSCollaborative assessment management in suicidality | Behavioural | Intervention 1: in person CAMS, Intervention 2: e-learning CAMS |
Primary outcome
Provider Self-efficacy and Beliefs About Suicidality
Time frame: post-training
Assessed beliefs and confidence in managing suicidal individuals. Using a 5-point Likert scale, there were 11 items that addressed the following: competence, reactions, beliefs, motivations, and CAMS as it relates to their practice. Scores ranged from 11-55 with questions were phrased so higher scores indicated more positive views.
1 secondary outcome
Satisfaction With Training
Time frame: post-training
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Apr 2015.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publication: PubMed 24959633Pearson GS, Evans LK, Hines-Martin VP, Yearwood EL, York JA, Kane CF. Promoting the mental health of families. Nurs Outlook. 2014 May-Jun;62(3):225-7. doi: 10.1016/j.outlook.2014.04.003. No abstract available.
- Results publication: PubMed 23950543Puntil C, York J, Limandri B, Greene P, Arauz E, Hobbs D. Competency-based training for PMH nurse generalists: inpatient intervention and prevention of suicide. J Am Psychiatr Nurses Assoc. 2013 Jul-Aug;19(4):205-10. doi: 10.1177/1078390313496275.
- Results publication: PubMed 24563240Marshall E, York J, Magruder K, Yeager D, Knapp R, De Santis ML, Burriss L, Mauldin M, Sulkowski S, Pope C, Jobes DA. Implementation of online suicide-specific training for VA providers. Acad Psychiatry. 2014 Oct;38(5):566-74. doi: 10.1007/s40596-014-0039-5. Epub 2014 Feb 22.
- Results publication: PubMed 23011459York JA, Lamis DA, Pope CA, Egede LE. Veteran-specific suicide prevention. Psychiatr Q. 2013 Jun;84(2):219-38. doi: 10.1007/s11126-012-9241-3.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Kathryn M. Magruder, PhD MPH BA principal investigator
Ralph H. Johnson VA Medical Center, Charleston, SC
5 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing CAMS in people with Suicide, run by US Department of Veterans Affairs at 5 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 24 Apr 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 5 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 9 Jan 2015). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Provider Self-efficacy and Beliefs About Suicidality (time frame: post-training). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00905827, which also lists 4 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Apr 2015.