Reducing COVID-related PTSD symptoms in Frontline Healthcare Workers through Trauma-Focused Treatment in Employee Assistance Programs

通过员工援助计划中的创伤重点治疗，减少一线医护人员与新冠肺炎相关的创伤后应激障碍 (PTSD) 症状

• 批准号: 10246656
• 负责人: Rebecca Kaufman Sripada
• 金额: $ 77.94万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10246656
• 关键词: Absenteeism; Address; Adherence; Aftercare; Age; Area; COVID-19; COVID-19 pandemic; COVID-19 treatment; Caring; Cognition; Community Practice; Consolidated Framework for Implementation Research; Cost Effectiveness Analysis; Data; Distress; Effectiveness; Effectiveness of Interventions; Employee; Employee Assistance Program (Health Care); Ensure; Ethnic Origin; Evidence based treatment; Future; Goals; Health; Health Personnel; Healthcare Systems; Hybrids; Individual; Infrastructure; Intervention; Interview; Lead; Measures; Mediating; Mediator of activation protein; Mental Health; Michigan; Military Personnel; Mission; Modeling; National Institute of Mental Health; Occupations; Patients; Performance at work; Population; Post-Traumatic Stress Disorders; Primary Health Care; Procedures; Process; Professional counselor; Public Health; Quality of life; Quality-Adjusted Life Years; Race; Readiness; Resources; Severities; Stress; Structure; Symptoms; Testing; Therapeutic Effect; Time; Training; Trauma; Veterans Health Administration; Vulnerable Populations; active duty; adverse outcome; anxious; base; brief intervention; burnout; clinical practice; clinically significant; community setting; compare effectiveness; coronavirus disease; cost effective; cost effectiveness; design; disability; effectiveness evaluation; effectiveness implementation study; effectiveness implementation trial; effectiveness research; effectiveness testing; experience; future implementation; health care service organization; implementation barriers; implementation efforts; implementation facilitators; implementation strategy; improved; improved functioning; innovation; medical specialties; military service; pandemic disease; point of care; practice setting; process evaluation; programs; public health emergency; reduce symptoms; service member; sex; telehealth; trauma exposure; treatment as usual

Project Summary/Abstract Healthcare workers on the frontlines of the COVID-19 pandemic are experiencing unprecedented levels of stress and trauma exposure, resulting in exceptionally high rates (27-57%) of posttraumatic stress disorder (PTSD). Although Employee Assistance Programs (EAPs) have expanded their offerings to support healthcare workers during the pandemic, they lack the capacity to provide time-intensive first-line treatments for PTSD. To address this problem, the study team has adapted a standard first-line 12-session treatment into a brief, 4-6 session format (Prolonged Exposure for Primary Care; PE-PC) and demonstrated its efficacy in military service members. Given the rising tide of PTSD in frontline healthcare workers, there is an urgent need to test the effectiveness and subsequently implement PE-PC for this population by leveraging the existing resource of the healthcare system EAP. The long-term goal is to address COVID-19-related PTSD symptoms among healthcare workers and other vulnerable populations. The overall objective of this application is to demonstrate the effectiveness and identify barriers and facilitators to the implementation of PE-PC in healthcare system EAPs. The central hypothesis is that PE-PC will reduce COVID-19-related PTSD symptoms and improve functioning, compared to EAP Treatment as Usual (TAU). The rationale is that effectively treating COVID-19- related PTSD in the EAP setting is a scalable and cost-effective way to reduce healthcare worker distress and disability and will accrue downstream benefits to the healthcare organization and its patients. To accomplish the objective, this project will test the effectiveness of PE-PC, delivered by EAP counselors via telehealth, versus EAP TAU in 360 healthcare workers with PTSD at four southeast Michigan healthcare systems. This Hybrid Type 1 effectiveness-implementation trial will test the effectiveness of PE-PC and gather data regarding implementation through process evaluation and implementation mapping. The specific aims are: Specific Aim 1: Compare the effectiveness of PE-PC versus EAP TAU in reducing PTSD symptoms at 6-week (post- treatment), 3-, and 6-month follow-ups. Specific Aim 2: Compare the effectiveness of PE-PC versus EAP TAU in reducing burnout and improving job performance and functioning at 6-week, 3-, and 6-month follow-ups. Exploratory Aim 1: Confirm the mechanism and identify key mediators/moderators. Exploratory Aim 2: Conduct cost-effectiveness analysis. Exploratory Aim 3: Prepare for future implementation by conducting process evaluation and implementation mapping. This strategy will yield an implementation strategy that is targeted to address EAP-specific implementation barriers. This project is significant because it will contribute to the field a point-of-care intervention for frontline HCWs with COVID-19 related PTSD, thus improving clinical practice for this vulnerable population and increasing preparedness for future public health emergencies. This proposal is innovative because it will it will shift delivery of efficacious PTSD treatment from lengthy care in a traditional specialty care setting to brief treatment with a telehealth option in a frontline community setting.

项目摘要/摘要 COVID-19大流行前线的医护人员正在经历前所未有的水平 压力和创伤暴露，导致创伤后应激障碍的率异常高（27-57％） （PTSD）。尽管员工援助计划（EAP）扩大了他们的产品以支持医疗保健 在大流行期间，工人缺乏为PTSD提供时间密集型一线治疗的能力。到 解决这个问题，研究团队已将标准的一线12课程改编为简短的4-6 会议格式（长时间接触初级保健； PE-PC），并证明了其在兵役中的功效 成员。鉴于PTSD在前线医疗保健工人中的潮流中升，迫切需要测试 有效性并随后通过利用现有的资源来为该人群实施PE-PC 医疗保健系统EAP。长期目标是解决与COVID-19与COVID相关的PTSD症状 医护人员和其他脆弱人群。该应用程序的总体目的是证明 在医疗保健系统中实施PE-PC的有效性并确定障碍和促进者 EAPS。中心假设是，PE-PC将减少与19次相关的PTSD症状并改善相关的PTSD症状 与EAP像往常一样（TAU）相比，功能。理由是有效治疗Covid-19-- EAP环境中相关的PTSD是一种可扩展且具有成本效益的方法，可减少医疗保健工作者的困扰和 残疾，将为医疗组织及其患者带来下游益处。完成 该项目的目标将测试由EAP顾问通过远程医疗提供的PE-PC的有效性， 在密歇根州东南部四个医疗保健系统中，与PTSD的360名医疗保健工人相比，与EAP TAU相比。这 Hybrid 1型有效性实施试验将测试PE-PC的有效性，并收集有关有关的数据 通过流程评估和实施映射实施。具体目的是：特定目标 1：比较PE-PC与EAP TAU在6周减少PTSD症状方面的有效性（后 治疗），3个月和6个月的随访。特定目标2：比较PE-PC与EAP TAU的有效性 在减少倦怠和改善工作绩效并在6周，3个月和6个月的随访中起作用。 探索目的1：确认机制并确定关键的介体/主持人。探索目标2：行为 成本效益分析。探索目标3：通过进行过程为将来实施做准备 评估和实施映射。该策略将产生针对的实施策略 解决特定于EAP的实施障碍。该项目很重要，因为它将为该领域做出贡献 与COVID-19相关的PTSD的前线HCWS的即时护理干预措施，从而改善了临床实践 这个脆弱的人口和日益增加了对未来公共卫生紧急情况的准备。该提议是 创新性，因为它将在传统的漫长护理中转移有效的PTSD治疗的能力 专业护理设置可在一线社区环境中使用远程医疗选项进行简要治疗。