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رادار التجارب AI
حالة التجربة السريرية NCT06947538 (STEPPS) لـ اضطراب ما بعد الصدمة هي لم يبدأ التجنيد بعد. اطلعوا على جميع التفاصيل في عرض البطاقة الخاص برادار التجارب السريرية وأدوات اكتشاف الذكاء الاصطناعي. أو يمكنكم طرح أي سؤال هنا.
تجربة واحدة تطابق معايير الفلتر
عرض البطاقة
العودة إلى البحث

Stepped Care for Posttraumatic Stress Disorder Study (STEPPS)

لم يبدأ التجنيد بعد
تفاصيل التجربة السريرية متاحة بشكل أساسي باللغة الإنجليزية. ومع ذلك، يمكن لـ 'رادار التجارب AI' أن يساعدك؛ ما عليك سوى النقر على 'وصف الدراسة' لعرض ومناقشة معلومات التجربة باللغة التي اخترتها.
التجربة السريرية NCT06947538 (STEPPS) هي دراسة تدخُّلية لـاضطراب ما بعد الصدمة وهي لم يبدأ التجنيد بعد. من المقرر أن يبدأ التسجيل في ١٣ شعبان ١٤٤٧ هـ لتجنيد ٤٢٨ مشاركًا. يقودها Boston Medical Center، ومن المتوقع اكتمالها بحلول ١٩ محرم ١٤٥١ هـ. تم تحديث البيانات الأخيرة من ClinicalTrials.gov في ١٥ ربيع الآخر ١٤٤٧ هـ.
الملخص
Less than 20% of people with PTSD receive any treatment. This study extends a program of research by the investigator focused on developing adaptive (stepped) interventions for PTSD. The adaptive intervention sequences a digital mental health intervention (DMHI) and brief trauma- and skills-focused treatments for PTSD. The selected treatments are brief and scalable and less burdensome to systems of care. These treatments are: web-administered Skills Training in Affective and Interpersonal Regulation (webSTAIR), Brief STAIR, and Written Exposure Therapy (WET).
وصف مفصل

This study uses a Sequential, Multiple Assignment, Randomized Trial (SMART) design. All participants enrolled will receive access to webSTAIR at baseline ("initial treatment").

Nonresponders at 4 weeks are randomized to either continue webSTAIR or webSTAIR plus community health worker coaching ("stage 1 treatments").

Nonresponders at 8 weeks are re-randomized to clinician-administered treatments, either Brief STAIR or WET ("stage 2 treatments").

Nonresponse is defined as less than a 15-point decrease in PTSD symptom severity, as measured by the PTSD Checklist for DSM-5 (PCL-5).

The objectives of this study are to:

  • examine the main effects of stage 1 treatments, stage 2 treatments, and embedded
  • adaptive interventions on PTSD symptom severity.
  • confirm mechanisms of change established in the extant PTSD literature
  • identify patient-level moderators of change in PTSD symptoms severity at 18 weeks
العنوان الرسمي

Adaptive Interventions to Improve Posttraumatic Stress Disorder (PTSD) Treatment Access, Engagement, and Effectiveness in Routine Care

الحالات الطبية
اضطراب ما بعد الصدمة
معرّفات دراسة أخرى
NCT معرّف
NCT06947538
تاريخ البدء (فعلي)
2026-02
آخر تحديث مُنشور
2025-10-07
تاريخ الاكتمال (المقدر)
2029-06
عدد المشاركين المخطط لهم
٤٢٨
نوع الدراسة
تدخُّلية
المرحلة
غ/م
الحالة
لم يبدأ التجنيد بعد
الكلمات الرئيسية
Stepped Care
Skills training in affective and interpersonal regulation (STAIR)
Digital Mental Health Intervention
Written Exposure Therapy (WET)
Adaptive Interventions
الغرض الأساسي
العلاج
طريقة توزيع المشاركين
عشوائي
نموذج التدخل
تصميم تسلسلي
التعمية
لا شيء (مفتوحة)
مجموعات/التدخلات
مجموعة المشاركين/مجموعةتَدَخُّل/علاج
مقارن نشطwebSTAIR, webSTAIR to WET
First, offer skills-focused digital mental health intervention (DMHI); then switch to clinician-administered trauma-focused behavioral treatment for nonresponders and continue skills-focused DMHI for responders.
Webstair
WebSTAIR consists of 10 online modules that provide psychoeducation on trauma and emotions and teach skills to improve coping with emotions and strengthen interpersonal relationships. Modules are completed at the participants' own pace and utilize interactive exercises, and audio and video components to aid in delivery.
Clinician Administered WET
WET is a brief, high intensity, exposure-based treatment delivered by mental health clinicians consisting of six 30-minute individual sessions that cover treatment rationale, psychoeducation about PTSD, and directing participants to write in session about their traumatic experience using scripted instructions.
مقارن نشطwebSTAIR+coaching, webSTAIR+coaching to WET
First, offer skills-focused DMHI plus community health worker (CHW) coaching; then add clinician-administered trauma-focused behavioral treatment for nonresponders and continue skills-focused DMHI plus CHW coaching for responders.
Webstair Plus Coaching
WebSTAIR with up to five 30-min coaching sessions with a CHW will focus on guiding participants through the program, discussing exercises that are valuable or problematic, and reviewing module content.
Clinician Administered WET
WET is a brief, high intensity, exposure-based treatment delivered by mental health clinicians consisting of six 30-minute individual sessions that cover treatment rationale, psychoeducation about PTSD, and directing participants to write in session about their traumatic experience using scripted instructions.
مقارن نشطwebSTAIR, webSTAIR to Brief STAIR
First, offer skills-focused DMHI; then add clinician-administered skills-focused behavioral treatment for nonresponders and continue skills-focused DMHI for responders.
Webstair
WebSTAIR consists of 10 online modules that provide psychoeducation on trauma and emotions and teach skills to improve coping with emotions and strengthen interpersonal relationships. Modules are completed at the participants' own pace and utilize interactive exercises, and audio and video components to aid in delivery.
Clinician Administered Brief STAIR
Brief STAIR is a brief, low intensity, therapy that utilizes psychoeducation, coping skills training, and does not include recounting of the trauma memory, making it highly tolerable. It will be delivered by mental health clinicians in five to six 30-minute individual sessions.
مقارن نشطwebSTAIR+coaching, websTAIR+coaching to Brief STAIR
First, offer skills-focused DMHI plus CHW coaching; then add clinician-administered skills-focused behavioral treatment for nonresponders and continue skills-focused DMHI plus CHW coaching for responders.
Webstair Plus Coaching
WebSTAIR with up to five 30-min coaching sessions with a CHW will focus on guiding participants through the program, discussing exercises that are valuable or problematic, and reviewing module content.
Clinician Administered Brief STAIR
Brief STAIR is a brief, low intensity, therapy that utilizes psychoeducation, coping skills training, and does not include recounting of the trauma memory, making it highly tolerable. It will be delivered by mental health clinicians in five to six 30-minute individual sessions.
النتيجة الرئيسية
مقياس النتيجةوصف القياسالإطار الزمني
PTSD symptom severity
This outcome will be assessed by the PTSD Checklist for the DSM-5 (PCL-5), a 20-item self-report measure that evaluates the degree to which individuals have been bothered by PTSD symptoms in the past month tied to their most distressing event. Total scores ranging from 0 to 80, and a score of 31-33 or higher suggests probable PTSD and potential benefit from treatment.
baseline, 4 weeks, 8 weeks, 18 weeks, 30 weeks
Treatment retention
as the proportion (%) of participant who complete 60% of interventions in the treatment windows.
4 weeks, 8 weeks, 18 weeks
Treatment acceptability
This outcome will be assessed with the Client Satisfaction Questionnaire 8 \[CSQ-8\], a 8-item instruction where scores are summed across items once. Items 2, 4, 5, and 8 are reverse scored. Total scores range from 8 to 32, with the higher number indicating greater satisfaction.
4 weeks, 8 weeks, 18 weeks, 30 weeks
النتيجة الثانوية
مقياس النتيجةوصف القياسالإطار الزمني
Trauma coping
This outcome will be assessed with the Trauma Coping Self-Efficacy Scale (TCSE, a 9-item instrument with items rated on a 7-point scale (1=not at all capable to 7=totally capable) and a total score calculated by averaging the item responses, Higher scores suggest better trauma coping.
baseline, 4 weeks, 8 weeks, 18 weeks, 30 weeks
Treatment expectancy
This outcome will be assessed with the Treatment Expectancy Questionnaire (TEQ), is a multidimensional scale measuring participants' expectations of medical and psychological treatments, scored by adding up scores on each item to yield a total score, with higher scores indicating stronger expectations.
baseline, 4 weeks, 8 weeks, 18 weeks, 30 weeks
Mental health stigma
This outcome will be assessed with the Consumer Experiences of Stigma Questionnaire (CESQ), using a 5-point Likert scale (never to very often) for each item, with higher scores indicating greater stigma experienced.
baseline, 4 weeks, 8 weeks, 18 weeks, 30 weeks
Medical mistrust
This outcome will be assessed with the Group-Based Medical Mistrust Scale (GBMMS), a 12-item measure that assesses suspicion of mainstream health care systems and health care professionals and the treatment provided to individuals. The response key is a Likert-type scale ranging from 1 (strongly disagree) to 5 (strongly agree) and the score range is 12 to 60. Higher scores suggest more medical distrust.
baseline, 4 weeks, 8 weeks, 18 weeks, 30 weeks
Posttraumatic cognitions
This outcome will be assessed with the 9-item brief version of the posttraumatic cognitions inventory (PTCI-9). It is scored by averaging the responses to its nine items (a Likert-type scale from 1 to 7) to get a total score ranging from 1 to 7. Higher scores reflect greater endorsement of negative posttraumatic cognitions.
baseline, 4 weeks, 8 weeks, 18 weeks, 30 weeks
Pathological fear extinction
This outcome will be assessed with the subjective units of distress (SUDs), a simple self-assessment tool used to quantify the intensity of distress or anxiety an individual feels at a particular moment. Scores can range from 0 to 10 with a score of 0 indicating complete calmness, while 10 signifies the highest level of distress imaginable.
baseline, 4 weeks, 8 weeks, 18 weeks, 30 weeks
معايير الأهلية

الأعمار المؤهلة للدراسة
بالغ, كبار السن
العمر الأدنى للدراسة
18 Years
الجنس المؤهل
الكل

Assessed at pre-screening

  • Boston Medical Center primary care patient
  • At least 18 years of age
  • Access to computer or mobile device
  • Able to receive treatments in English or Spanish
  • Able to read at 4th grade level

Assessed at baseline

  • Endorsement of Criterion A trauma using the Life Events Checklist for the DSM-5 (LEC-5), assessed at baseline
  • PTSD diagnosis, confirmed by the Clinician-Administered PTSD Scale for the DSM-5 (CAPS-5) assessed at baseline
  • Clinically appropriate for outpatient level of care
  • Stable on psychotropic medication for >4 weeks

Assessed at pre-screening

• Patient is currently engaged in clinician-administered therapy

Assessed at baseline (clinician interview)

  • Patient is not clinically appropriate for outpatient level of care.
  • Acute risk for suicidal thoughts or behaviors, assessed by the Columbia Suicide Severity Rating Scale, administered by research clinician at baseline.
Boston Medical Center logoBoston Medical Center
National Institute of Mental Health (NIMH) logoNational Institute of Mental Health (NIMH)
جهة اتصال مركزية للدراسة
جهة اتصال: Sarah Valentine, PhD, 857 264 1102, [email protected]
1 مواقع الدراسة في 1 بلدان

Massachusetts

Boston Medical Center, Boston, Massachusetts, 02118, United States
Sarah Valentine, PhD, جهة اتصال, 857-264-1102, [email protected]