Web-administered STAIR for Patients on Behavioral Health Waitlists (webSTAIR)

Boston Medical Center (BMC)

Status: Active, not recruiting

Conditions: Post Traumatic Stress Disorder

Treatments: Behavioral: CHW coaching; Behavioral: webSTAIR

Study type: Interventional

Funder types: Other

Identifiers

NCT06431022

H-44467

Details and patient eligibility

About

Posttraumatic stress disorder (PTSD) is a significant public health challenge with population prevalence rates in the US between 6.1 to 9.2%. There are large racial and socioeconomic inequities in access to PTSD treatment, as up to half (30-50%) of patients in safety net clinical settings meet criteria for PTSD, yet only 13% receive any behavioral health treatment. Workforce shortages are one major barrier to accessing care. Additional barriers to care can include heightened mental health stigma and mistrust of health services.

Digital mental health interventions (DMHIs) may be suitable within the continuum of care for PTSD in hospital settings, given their potential for rapid-access, scalability, and the high acceptability of DMHI among individuals with high stigma and social needs. Among the available DMHIs for PTSD, the investigators have selected web-administered Skills Training in Affective and Interpersonal Regulation (webSTAIR), based on emerging scientific evidence and a close collaboration with Boston Medical Center (BMC) users (patients and providers) in a previous pilot study in primary care.

The aim of this randomized study is to implement webSTAIR at BMC in the Recovery from Stress and Trauma through Outpatient Care, Research, and Education (RESTORE) Center's subspecialty clinic.

Enrollment: 70 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Client on the RESTORE Center waitlist at Boston Medical Center
• Over 18 years of age
• Able to receive therapy in English or Spanish (per participant report)
• Exposure to trauma (as indicated by the Life Events Checklist for the DSM-5 [LEC-5])
• Probable PTSD (as indicated by the PTSD Checklist for the DSM-5 [PCL-5] based on PCL score of 33+).
• Reasonable to access to technology (e.g., phone, computer, internet access).

Exclusion criteria

• Patient declines to be in the study.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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70 participants in 2 patient groups

Self-directed webSTAIR

Experimental group

Description:

Participants on the Research, and Education Center (RESTORE) waitlist randomized to this arm will receive the self-managed web-administered Skills Training in Affective and Interpersonal Regulation (webSTAIR).

Treatment:

Behavioral: webSTAIR

webSTAIR with coaching from a Community Health Worker (CHW)

Active Comparator group

Description:

Participants on the RESTORE waitlist randomized to this arm will receive the web-administered Skills Training in Affective and Interpersonal Regulation (webSTAIR) with coaching support from a CHW.

Treatment:

Behavioral: webSTAIR

Behavioral: CHW coaching