• Pain Med · Nov 2024

    Screening, brief intervention, and referral to treatment for pain management for veterans separating from military service: study protocol of a hybrid type 2 study testing implementation facilitation versus training-as-usual.

    • John J Sellinger, Marc I Rosen, Christina M Lazar, Kathryn Gilstad-Hayden, James Dziura, Fang-Yong Li, Kristin Mattocks, Adrienne Weede, Michael Sullivan-Tibbs, Liam Rose, Garcia VassalloGabrielaGVA Connecticut Healthcare System, West Haven, CT 06516, United States.Yale University, New Haven, CT 06510, United States., Ajay Manhapra, Amos Turner, Dawne Vogt, Eva N Woodward, Christine W Hartmann, Sally G Haskell, Amir Mohammad, and Steve Martino.
    • VA Connecticut Healthcare System, West Haven, CT 06516, United States.
    • Pain Med. 2024 Nov 1; 25 (Supplement_1): S99S106S99-S106.

    BackgroundVeterans transitioning to civilian life often have chronic pain from service-related musculoskeletal disorders (MSD) with higher risk for substance misuse. Many seek VA (Department of Veterans Affairs) compensation for MSD. Use of Screening, Brief Intervention, and Referral to Treatment for Pain Management (SBIRT-PM) by VA Post-9/11 Military2VA (M2VA) case managers presents an opportunity to engage these veterans in VA pain care and address substance misuse. Implementation facilitation might help case managers use SBIRT-PM and engage veterans in services to improve outcomes.DesignThis study is a 2-cohort multisite cluster-randomized hybrid type 2 effectiveness-implementation trial. Within 2 separate cohorts of 14 VA sites each, sites will be allocated to receive an implementation strategy through the use of a constrained randomization procedure: virtual implementation facilitation or training-as-usual. Sites and M2VA case managers will receive the assigned implementation strategy to support use of SBIRT-PM. Recently discharged veterans (n = 1848) claiming service-connected MSD will be recruited, with case managers blind to veterans' study enrollment. The proportion of participants who receive any SBIRT-PM will be the primary implementation outcome. Veteran participants will complete baseline, 12-week, and 36-week assessments, irrespective of whether case managers conduct SBIRT-PM with them (intent-to-treat). Pain intensity and interference will be the primary clinical outcomes. The study emphasizes pragmatic over explanatory methodological features.SummaryThis pragmatic trial will examine implementation facilitation versus training-as-usual in implementing SBIRT-PM to promote veteran engagement in nonpharmacological pain services. Using innovative methods to train and support VA case managers in SBIRT-PM, study outcomes could have broad implications for case management systems of care across the VA.Published by Oxford University Press on behalf of the American Academy of Pain Medicine.

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