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Delivering Written Exposure Therapy for PTSD in Underserved Primary Care Settings

Award Number: R01MH123585
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/13/2021
PERIOD OF PERFORMANCE END DATE: 06/30/2027

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Delivering Written Exposure Therapy for PTSD in Underserved Primary Care Settings - PROJECT SUMMARY Posttraumatic stress disorder (PTSD) results in substantial costs to society is highly prevalent among adults. Importantly, the prevalence PTSD within primary care settings is even higher than the general population as primary care is the setting to which individuals with PTSD most often present. Evidence-based psychotherapies (EBPs) for PTSD are available but dissemination within real world settings is fraught with challenges because these therapies require 10-15, lengthy treatment sessions and extensive therapist training to implement, and these treatments are not feasible within primary care settings given the limited time resources. Consequently, there are multiple barriers to accessing EBPs for PTSD. Efforts to integrate mental health services within primary care for PTSD though collaborative care management (CoCM) interventions are rapidly expanding and have been shown to be effective in the treatment of depression and anxiety. However, the evidence for PTSD is limited due to the time intensive nature of the PTSD therapy approaches that have been examined. An efficient PTSD treatment approach is needed to address the treatment needs of individuals with PTSD presenting to primary care. Written exposure therapy (WET) is a brief EBP that provides an alternative to more intensive EBPs. Recent studies of WET have yielded positive outcomes and have shown it to be non-inferior when directly compared to more time intensive PTSD EBPs, but WET has not yet been examined within the primary care environment. The primary aims of the proposed study are to evaluate the effectiveness and implementation of delivering WET into CoCM to improve the management of PTSD among underserved primary care patients in Federally Qualified Health Centers (FQHCs). The pragmatic cluster- randomized study will use a hybrid effectiveness-implementation design. Twelve FQHCs will be randomized to either CoCM plus WET (CoCM+WET) or CoCM alone and 60 patients within each FQHC will be screened for eligibility. We will use the RE-AIM framework (for Reach, Efficacy/Effectiveness, Adoption, Implementation, & Maintenance) to evaluate the effectiveness and implementation process of the CoCM+WET intervention using mixed methods. To examine effectiveness and potential mediators and moderators of the intervention, we will administer assessments at baseline, 3- and 6-month follow-up. To assess implementation, we will use clinic process data and clinic staff interviews pre- and post-intervention. This study has the potential to substantially impact practice and public health by validating the effectiveness and feasibility of delivering a brief trauma- focused EBP embedded within CoCM in primary care to improve PTSD outcomes for underserved patients.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $0 )
2026	2025	THE RAND CORPORATION	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Mental Health Research Grants	000	5	4/1/2026	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2025 ( Subtotal = $967,012 )
2025	2025	THE RAND CORPORATION	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Mental Health Research Grants	000	5	7/28/2025	NON-COMPETING CONTINUATION	$967,012
														Subtotal = $967,012

Issue Date FY: 2024 ( Subtotal = $1,310,805 )
2024	2024	THE RAND CORPORATION	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Mental Health Research Grants	000	4	6/20/2024	NON-COMPETING CONTINUATION	$1,310,805
														Subtotal = $1,310,805

Issue Date FY: 2023 ( Subtotal = $1,331,734 )
2023	2023	THE RAND CORPORATION	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Mental Health Research Grants	000	3	7/21/2023	NON-COMPETING CONTINUATION	$1,331,734
														Subtotal = $1,331,734

Issue Date FY: 2022 ( Subtotal = $1,280,800 )
2022	2022	RAND CORPORATION, THE	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Mental Health Research Grants	000	2	7/1/2022	NON-COMPETING CONTINUATION	$1,280,800
														Subtotal = $1,280,800

Issue Date FY: 2021 ( Subtotal = $1,034,438 )
2021	2021	RAND CORPORATION, THE	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Mental Health Research Grants	000	1	9/10/2021	NEW	$1,034,438
														Subtotal = $1,034,438

Grand Total All Awards = $5,924,789

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Delivering Written Exposure Therapy for PTSD in Underserved Primary Care Settings

Award Number: R01MH123585

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/13/2021

PERIOD OF PERFORMANCE END DATE: 06/30/2027

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