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: 10689653
• 负责人: Rebecca Kaufman Sripada
• 金额: $ 74.07万
• 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/10689653
• 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; Health Resources; Healthcare Systems; Hybrids; Infrastructure; Intervention; Interview; Lead; Maps; Measures; Mediating; Mediator; Mental Health; Michigan; Military Personnel; Mission; Modeling; National Institute of Mental Health; Occupations; Patients; Performance at work; Population; Post-Traumatic Stress Disorders; Primary 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; brief intervention; burnout; clinical practice; clinically significant; community setting; compare effectiveness; coronavirus disease; cost effective; cost effectiveness; current pandemic; design; disability; effective intervention; effectiveness evaluation; effectiveness research; effectiveness testing; effectiveness/implementation study; effectiveness/implementation trial; experience; functional improvement; future implementation; health care service organization; implementation barriers; implementation efforts; implementation facilitators; implementation strategy; improved; 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 在新冠肺炎疫情前线的医护人员正经历着前所未有的水平 应激和创伤暴露导致极高的创伤后应激障碍发生率(27%-57%) (创伤后应激障碍)。尽管员工援助计划(EAP)已扩展其服务范围以支持医疗保健 在大流行期间，工作人员缺乏为创伤后应激障碍提供耗时的一线治疗的能力。至 为了解决这个问题，研究小组将标准的一线12次治疗改为简短的4-6次 会议形式(长期初级保健暴露；PE-PC)并展示了其在兵役中的效力 会员。鉴于前线医护人员的创伤后应激障碍日益高涨，有迫切需要测试 有效性，并随后通过利用现有资源为该人群实施PE-PC 医疗保健系统EAP。长期目标是解决与新冠肺炎相关的创伤后应激障碍症状 医护人员和其他弱势群体。本应用程序的总体目标是演示 PE-PC在医疗系统中实施的有效性及障碍和促进者 EAPS。中心假说是PE-PC将减少新冠肺炎相关的创伤后应激障碍症状并改善 功能，与EAP照常治疗(TAU)相比。其理由是，有效地对待新冠肺炎- EAP环境中的相关创伤后应激障碍是一种可扩展且经济高效的方式，可以减少医护人员的痛苦和 并将为医疗保健组织及其患者积累下游福利。要完成 该项目的目标是测试EAP咨询师通过远程医疗提供的PE-PC的有效性， 与密歇根州东南部四个医疗系统中患有创伤后应激障碍的360名医护人员的EAP TAU进行比较。这 混合类型1有效性-实施试验将测试PE-PC的有效性，并收集以下数据 通过流程评估和实施映射来实施。具体目标是：具体目标 1：比较PE-PC和EAP TAU在6周(后)减轻PTSD症状方面的有效性 治疗)、3个月和6个月的随访。具体目标2：比较PE-PC和EAP TAU的有效性 在6周、3个月和6个月的随访中，减少职业倦怠，提高工作绩效和功能。 探索性目标1：确认机制并确定关键的调解人/主持人。探索性目标2：行为 成本效益分析。探索性目标3：通过开展过程为未来的实施做准备 评估和实施映射。这一战略将产生一个实施战略，目标是 解决特定于EAP的实施障碍。这个项目意义重大，因为它将对该领域做出贡献 为患有新冠肺炎相关创伤后应激障碍的一线医务人员提供点护理干预，从而改善 这一弱势群体以及对未来突发公共卫生事件的防备不断加强。这项建议是 创新是因为它将改变有效的创伤后应激障碍治疗的交付，而不是传统的 专业护理环境，在一线社区环境中使用远程医疗选项进行简短治疗。