DepressionPhase 1NCT01231711
Improving Quality-of-life and Depressive Symptoms of Combat Veterans Via Internet-based Intervention
A Phase 1 study testing Vets Prevail in people with Depression and Post-Traumatic Stress Disorder, run by Prevail Health Solutions, LLC at 1 site in United States.
Trial summary
Background: Current military involvement in Afghanistan (Operation Enduring Freedom - OEF) and Iraq (Operation Iraqi Freedom - OIF) has created unforeseen burdens on the mental health and well-being of US service women and men. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Depression, Post-Traumatic Stress Disorder, Functional Status
- What is being tested?
- Vets Prevail
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- 1 siteUnited States
- Study dates
- Sep 2009to Jun 2010
- Phase
- Phase 1
- Are there results?
- None posted in the registry
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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- >=18 years of age
- A veteran of the U.S. military having served in the Iraq or Afghanistan theaters in the last 5 years.
- CES-D(20) score >8
- Access to high-speed internet
- Own a cell phone with text message capability
- speak and read the English language
Who cannot join
- psychiatric hospitalizations within past 10 years
- any past suicide attempt
- diagnoses of schizophrenia or bipolar disorder
- CES-D(20) score >36
- discontinued or altered dosage of medication within 10 days prior to enrollment
- score >=2 on the alcohol/drug assessment
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Improving Quality-of-life and Depressive Symptoms for OEF/OIF Combat Veterans: Assessing the Benefits of Interactive, Internet-based Psychotherapy and Peer-to-peer Support
Background: Current military involvement in Afghanistan (Operation Enduring Freedom - OEF) and Iraq (Operation Iraqi Freedom - OIF) has created unforeseen burdens on the mental health and well-being of US service women and men. Although OEF/OIF service members and veterans are at high risk of developing sub-threshold combat stress and depressive symptoms or full disorders in the post-deployment period, only a small fraction ever receive care. The VETS PREVAIL Intervention, which combines Cognitive-Behavioral-Therapy-based (CBT-based) coping skills training with peer-to-peer support and counseling, was specifically designed to offer the returning OEF/OIF service member or veteran an accessible and confidential first step to care.
Evaluation Study: RISE Consulting, lead by Dr. Benjamin W. Van Voorhees, MD, MPH, was contracted to supervise a pilot study of potential benefit, feasibility and safety of the VETS PREVAIL Intervention. The study would consist of a single group pre/post comparison study of N=50 recent OEF/OIF veterans in the frame work of a phase 1 clinical trial (phase 1). Feasibility (adherence and satisfaction), evidence of clinical benefit would be evaluated through changes in the following clinical self-report measures: i) symptoms of depressed mood (Center for Epidemiologic Studies Depression Scale, CES-D), ii) post traumatic stress disorder (Post Traumatic Stress Disorder Checklist-Military, PCL-M), and iii) functional status (Short Form 12, SF-12), as well as changes in key attitudes toward mental health care seeking (intent to seek treatment, mental health self-efficacy and stigma).
Read the detailed description
Intervention overview content and design:
The intervention, VETS PREVAIL, will empower the user to gain control over life problems through enhancement of coping strategies, self-care, social support, and a repertoire of problems solving skills in an interactive internet intervention. This intervention will have two components: internet delivery of the intervention and brief person-to-person electronic contact structured around ensuring effective motivation, engagement, and completion. The coaching model for the person-to-person contact will be based on motivational interviewing with masters level social workers , as well as contact with peers who have completed the Vet-to-Vet certificate program offered by the Depression and Bipolar Support Alliance (DBSA). The internet component is focused on combat stress, self-assessment, coping strategies, problem solving, and social support.
Trainer Role:
During the 6 weeks of Vets Prevail a trainer, a masters level social worker, will engage with subjects through one online chat per week, post lesson (approximately 15 minute time blocks; duration will vary per subject). The total amount of person-to-person contact time, with a trainer, is an estimated 90 minutes throughout the 6 week program; contact time may vary per subject. The trainer will use motivational interviewing to clarify concepts within each week's lesson. In addition, the trainer will be responsible for making referrals and follow ups, when needed.
Masters level social work education trains people to use evidence-based knowledge derived from research, practice evaluation and theories of human development and behavior and social systems to analyze complex situations between individuals and their environment, in addition to facilitating individual, organizational, social and cultural changes.
Peer Role:
During the 6 weeks of Vets Prevail a peer, a DBSA certified veteran, will engage with subject through one online chat per week, pre lesson (approximately 15 minute time blocks: duration will vary per subject). The total amount of person-to-person contact time, with a peer, is an estimated 60 minutes throughout the 6 week program; contact time my vary per subject. The purpose of the peer engagement is to motivate the subject to complete the activities they schedule for themselves during the week and to apply the lessons from each session into their lives.
DBSA training trains people to use their experiences to work with others. Training features a nationally-developed recovery philosophy curriculum to enhance wellness and treatment strategies, through peer delivery services.
Internet based component:
The current intervention will have four major sections. The first section will relate stress in the context of depressive symptoms with direct tactics that can be immediately implemented to reduce symptoms and guide users towards their individual goals. The second section will demonstrate how to recognize treatment obstacles and organizing implementation of the tactics from section one. The third section addresses overcoming treatment obstacles along with reinforcing reduction of symptoms and goal-directed action. The fourth section provides instruction and application of personal problem-solving, taking goal-directed action to full implementation. The intervention concludes with a review, a reinforcement of personally-relevant treatment applications, and an evaluation of techniques. The internet component will also require active engagement of the individual with interactive activities to improve learning/skill building along with other activities designed to identify how they would manage specific behavioral symptoms (skill development). The internet component will consist of 6 individual sessions, with approximately one week between sessions. The electronic chat with the peer will occur directly before the subjects view this content, and the chat with the trainer occurs immediately afterwards so the trainer can answer any questions about the content the subject might have.
- Being tested
- Vets Prevail
- Keywords
- depression, post traumatic stress syndrome, functional status, veteran, military, stigma, mental health self-efficacy
- Medical subject headings
- Depression, Stress Disorders, Post-Traumatic, Combat Disorders, Social Stigma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Vets PrevailBehavioural
Also called Warriors Prevail
The intervention has two primary components that are both delivered over the Internet:
The first component is a structured series of brief peer-to-peer instant messaging "Chats" structured around ensuring effective motivation, engagement, and completion. This component was modeled after Motivational Interviewing (MI) techniques. The peer-to-peer contact was provided by a master's level social worker, as well as by trained and certified combat veterans who completed the Vet-to-Vet counseling certificate program offered by the Depression and Bipolar Support Alliance (DBSA).
The second component consists of six 30-minute "e-Learning Lessons" using standard Cognitive Behavioral Therapy (CBT) approaches to reducing depressive and anxiety symptoms and strengthening coping skills.
| Study group | Role | What they receive |
|---|---|---|
| Vets Prevail | Experimental | N=50. Participants were recent veterans (deployed after September 11, 2001) of operations in Iraq and Afghanistan who were experiencing depression/distress symptoms at the time of screening (CES-D > 8) but who were not considered to be inappropriate for a health promotion intervention (CES-D > 35 indicating severe depressed mood or exhibiting self-harm risk). Receives: Behavioral: Vets Prevail |
What is being measured
The primary outcome is the main question the study is designed to answer.
Center for Epidemiologic Studies Depression Scale 10 (CES-D 10)
The Center for Epidemiologic Studies Depression Scale (CES-D) is one of the most common screening tests for helping an individual to determine his or her depression quotient. The quick self-test measures depressive feelings and behaviours during the past week.
Measured: baseline, 4 weeks, 8 weeks, 12 weeks
Secondary outcomes (2)
Post Traumatic Stress Disorder Checklist-Military (PCL-M)
The PTSD Checklist-Military (PCL-M) is a 17-item self-report measure of PTSD symptoms that requires respondents to rate the severity of each symptom during the past 30 days on a five-point ordinal scale. A total PCL-M score was created by summing the item ratings.
Measured: baseline, week 4, week 8, week 12
12-Item Short Form Health Survey (SF-12)
The SF-12 is a generic measure and does not target a specific age or disease group. It is a shorter, valid alternative to the SF-36. The SF-12 is weighted and summed to provide separate scales for an individuals phisical and mental health called the Physical Composite Score (PCS) and Mental Composite Score (MCS).
Measured: baseline, week 4, week 8, week 12
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Nov 2010 (estimated)
- Study startSep 2009
- Primary completionFeb 2010
- Study completionJun 2010
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for DepressionStudies 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 1
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 50 participants (actual)
Sponsor and investigators
- Lead sponsor
- Prevail Health Solutions, LLC
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Rise Consulting, LLC, McCormick Foundation
- Investigators
- Benjamin VanVoorhees, MD, MPH, Principal investigator, Rise Consulting, LLCBrock K Hokenson, MBA, Study director, Prevail Health Solutions
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01231711
- Sponsor's protocol ID
- 24633-1
- Status last verified
- Oct 2010
- First submitted
- 28 Oct 2010
- Last updated
- 1 Nov 2010
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 1 Nov 2010. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Improving Quality-of-life and Depressive Symptoms for OEF/OIF Combat Veterans: Assessing the Benefits of Interactive, Internet-based Psychotherapy and Peer-to-peer Support
- ClinicalTrials.gov ID
- NCT01231711
- Acronym / sponsor ID
- 24633-1
- Keywords
- depression, post traumatic stress syndrome, functional status, veteran, military, stigma, mental health self-efficacy
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 50 participants (actual)
- Lead sponsor
- Prevail Health Solutions, LLCIndustry (pharma, biotech, devices)
- Collaborators
- Rise Consulting, LLC, McCormick Foundation
- Study start
- Sep 2009
- Primary completion
- Feb 2010 (actual)
- Study completion
- Jun 2010 (actual)
- First posted
- 1 Nov 2010 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Background: Current military involvement in Afghanistan (Operation Enduring Freedom - OEF) and Iraq (Operation Iraqi Freedom - OIF) has created unforeseen burdens on the mental health and well-being of US service women and men. Although OEF/OIF service members and veterans are at high risk of developing sub-threshold combat stress and depressive symptoms or full disorders in the post-deployment period, only a small fraction ever receive care. The VETS PREVAIL Intervention, which combines Cognitive-Behavioral-Therapy-based (CBT-based) coping skills training with peer-to-peer support and counseling, was specifically designed to offer the returning OEF/OIF service member or veteran an accessible and confidential first step to care.
Evaluation Study: RISE Consulting, lead by Dr. Benjamin W. Van Voorhees, MD, MPH, was contracted to supervise a pilot study of potential benefit, feasibility and safety of the VETS PREVAIL Intervention. The study would consist of a single group pre/post comparison study of N=50 recent OEF/OIF veterans in the frame work of a phase 1 clinical trial (phase 1). Feasibility (adherence and satisfaction), evidence of clinical benefit would be evaluated through changes in the following clinical self-report measures: i) symptoms of depressed mood (Center for Epidemiologic Studies Depression Scale, CES-D), ii) post traumatic stress disorder (Post Traumatic Stress Disorder Checklist-Military, PCL-M), and iii) functional status (Short Form 12, SF-12), as well as changes in key attitudes toward mental health care seeking (intent to seek treatment, mental health self-efficacy and stigma).
Detailed description
Intervention overview content and design:
The intervention, VETS PREVAIL, will empower the user to gain control over life problems through enhancement of coping strategies, self-care, social support, and a repertoire of problems solving skills in an interactive internet intervention. This intervention will have two components: internet delivery of the intervention and brief person-to-person electronic contact structured around ensuring effective motivation, engagement, and completion. The coaching model for the person-to-person contact will be based on motivational interviewing with masters level social workers , as well as contact with peers who have completed the Vet-to-Vet certificate program offered by the Depression and Bipolar Support Alliance (DBSA). The internet component is focused on combat stress, self-assessment, coping strategies, problem solving, and social support.
Trainer Role:
During the 6 weeks of Vets Prevail a trainer, a masters level social worker, will engage with subjects through one online chat per week, post lesson (approximately 15 minute time blocks; duration will vary per subject). The total amount of person-to-person contact time, with a trainer, is an estimated 90 minutes throughout the 6 week program; contact time may vary per subject. The trainer will use motivational interviewing to clarify concepts within each week's lesson. In addition, the trainer will be responsible for making referrals and follow ups, when needed.
Masters level social work education trains people to use evidence-based knowledge derived from research, practice evaluation and theories of human development and behavior and social systems to analyze complex situations between individuals and their environment, in addition to facilitating individual, organizational, social and cultural changes.
Peer Role:
During the 6 weeks of Vets Prevail a peer, a DBSA certified veteran, will engage with subject through one online chat per week, pre lesson (approximately 15 minute time blocks: duration will vary per subject). The total amount of person-to-person contact time, with a peer, is an estimated 60 minutes throughout the 6 week program; contact time my vary per subject. The purpose of the peer engagement is to motivate the subject to complete the activities they schedule for themselves during the week and to apply the lessons from each session into their lives.
DBSA training trains people to use their experiences to work with others. Training features a nationally-developed recovery philosophy curriculum to enhance wellness and treatment strategies, through peer delivery services.
Internet based component:
The current intervention will have four major sections. The first section will relate stress in the context of depressive symptoms with direct tactics that can be immediately implemented to reduce symptoms and guide users towards their individual goals. The second section will demonstrate how to recognize treatment obstacles and organizing implementation of the tactics from section one. The third section addresses overcoming treatment obstacles along with reinforcing reduction of symptoms and goal-directed action. The fourth section provides instruction and application of personal problem-solving, taking goal-directed action to full implementation. The intervention concludes with a review, a reinforcement of personally-relevant treatment applications, and an evaluation of techniques. The internet component will also require active engagement of the individual with interactive activities to improve learning/skill building along with other activities designed to identify how they would manage specific behavioral symptoms (skill development). The internet component will consist of 6 individual sessions, with approximately one week between sessions. The electronic chat with the peer will occur directly before the subjects view this content, and the chat with the trainer occurs immediately afterwards so the trainer can answer any questions about the content the subject might have.
Study design
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Vets Prevail | Experimental | Behavioral: Vets PrevailN=50. Participants were recent veterans (deployed after September 11, 2001) of operations in Iraq and Afghanistan who were experiencing depression/distress symptoms at the time of screening (CES-D > 8) but who were not considered to be inappropriate for a health promotion intervention (CES-D > 35 indicating severe depressed mood or exhibiting self-harm risk). |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- >=18 years of age
- A veteran of the U.S. military having served in the Iraq or Afghanistan theaters in the last 5 years.
- CES-D(20) score >8
- Access to high-speed internet
- Own a cell phone with text message capability
Key exclusion criteria (6 listed)
- psychiatric hospitalizations within past 10 years
- any past suicide attempt
- diagnoses of schizophrenia or bipolar disorder
- CES-D(20) score >36
- discontinued or altered dosage of medication within 10 days prior to enrollment
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 |
|---|---|---|
| Vets PrevailAlso: Warriors PrevailThe intervention has two primary components that are both delivered over the Internet: The first component is a structured series of brief peer-to-peer instant messaging "Chats" structured around ensuring effective motivation, engagement, and completion. This component was modeled after Motivational Interviewing (MI) techniques. The peer-to-peer contact was provided by a master's level social worker, as well as by trained and certified combat veterans who completed the Vet-to-Vet counseling certificate program offered by the Depression and Bipolar Support Alliance (DBSA). The second component consists of six 30-minute "e-Learning Lessons" using standard Cognitive Behavioral Therapy (CBT) approaches to reducing depressive and anxiety symptoms and strengthening coping skills. | Behavioural | Vets Prevail |
Primary outcome
Center for Epidemiologic Studies Depression Scale 10 (CES-D 10)
Time frame: baseline, 4 weeks, 8 weeks, 12 weeks
The Center for Epidemiologic Studies Depression Scale (CES-D) is one of the most common screening tests for helping an individual to determine his or her depression quotient. The quick self-test measures depressive feelings and behaviours during the past week.
2 secondary outcomes
Post Traumatic Stress Disorder Checklist-Military (PCL-M)
Time frame: baseline, week 4, week 8, week 12
12-Item Short Form Health Survey (SF-12)
Time frame: baseline, week 4, week 8, week 12
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Nov 2010.
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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.
Benjamin VanVoorhees, MD, MPH principal investigator
Rise Consulting, LLC
Brock K Hokenson, MBA study director
Prevail Health Solutions
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing Vets Prevail in people with Depression and Post-Traumatic Stress Disorder, run by Prevail Health Solutions, LLC at 1 site 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 6 inclusion and 6 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 1 Nov 2010. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site 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.
What does this phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Center for Epidemiologic Studies Depression Scale 10 (CES-D 10) (time frame: baseline, 4 weeks, 8 weeks, 12 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 1 Nov 2010.