AN12--534-26-4-6727-0013 / BIOMEDICAL INFORMATICS CENTER (BMIC) - NEW BASE plus ONE / (VA-26-00063517)

STATEMENT OF WORK Title: WEB-BASED TRAINING DEVELOPMENT 1. Background Post traumatic stress disorder (PTSD) and substance use disorders /(SUD) are two of the most common and debilitating mental health disorders among service members and Veterans, and they often co-occur. Approximately 30-60% of individuals with PTSD also meet criteria for SUD. The need to advance knowledge and promote increased access to and availability of effective treatments for co-occurring PTSD/SUD is a national health care priority. The Clinical Practice Guidelines (CPG) put forth by the Department of Veterans Affairs (VA) and the Department of Defense (DoD) recommend trauma-focused, integrated treatment in which both PTSD and SUD are addressed. However, few providers have been trained in this approach. The proposed project is designed to directly address this critical gap in provider education and training to improve the healthcare of Veterans with PTSD/SUD. Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE) is a 12-session, individual, manualized, trauma-focused treatment that integrates two theory-driven and empirically supported interventions: Prolonged Exposure (PE) for PTSD and Relapse Prevention (RP) for alcohol and drug use disorders. Randomized controlled trials demonstrate the efficacy of COPE in significantly reducing PTSD, substance use, and associated features (e.g., depression, trauma-related guilt) among Veterans and civilians. Moreover, most Veterans with PTSD/SUD prefer an integrated treatment approach7. Despite the strong evidence base supporting the efficacy of COPE, few VA providers have been trained in COPE. Recent data show that 96% of PTSD/SUD Specialists in the VA healthcare system (N=130) are interested in obtaining COPE training, and 99.1% would use a web-based COPE provider training if available. Given the significant financial and emotional burden that PTSD/SUD places on Veterans, their families, and the VA healthcare system, novel efforts to effectively and efficiently train providers to treat co-occurring PTSD/SUD are warranted. This proposal will (1) develop an innovative, web-based training for providers (COPEWeb) to strengthen providers’ capacity to deliver COPE to Veterans with co-occurring PTSD/SUD, and (2) compare the effects of the COPEWeb training versus in-person training on (a) knowledge acquisition, (b) provider satisfaction, and (c) fidelity (behavior). The proposed web-based training will address limitations of conventional in-person workshops (e.g., time, travel costs) and extend training to providers working in rural VA-affiliated community-based outpatient clinics (CBOCs) where opportunities may be less accessible. The COPEWeb content will be based on the 12 sessions of the COPE intervention (plus three additional support modules) that contain the following efficacious components: introduction to content, psychoeducation about the interrelationship between PTSD and SUD, in vivo and imaginal exposure, and relapse prevention skills (e.g., managing cravings, drink refusal skills), telehealth considerations. Each module of COPEWeb will include: (a) video introductions to the technique, (b) an overview of the module's learning objectives, (c) a description of each technique and step-by-step instructions for how to implement them, including sample scripts for introducing the techniques to patients, (d) multiple video demonstrations of the techniques being properly implemented (including telehealth implementation), (e) example homework assignments, (f) discussion of common clinical challenges that may arise in practice, (g) directions for including family members in relevant therapeutic activities, and (h) graded pre- and post-tests to assess prior knowledge and information learned from the module (i) digital and graphic design enhancements, (j) interactive learning activities and (j) additional training recordings with audio and video. Technology tools (e.g., VA- and DoD-developed PE Coach app) will be integrated into the training. The website will function across operating systems, web browsers, and devices (e.g., computers, tablets) to be deployable in any setting (e.g., home, office). Text-based material will be minimized, and video demonstrations and interactive features will ensure the site is highly engaging. 2. Objectives a. Develop a web-based provider training platform (i.e., COPEWeb). The following modules will be included in the platform: b. Test and validate COPEWeb c. Add digital and graphic enhancements, interactive learning activities and additional filming and voiceover recordings. d. Provide real-time support during the ongoing use of COPEWeb during the comparison trial (i.e., randomized controlled trial of COPEWeb compared to in-person COPE training) 3. Scope Develop and support COPEWeb, as detailed within the above-mentioned objectives. COPEWeb will need to be fully operational by January 1, 2027. Real-time support of COPEWeb will be needed for two years. 4. Statement of Required Deliverables Web-based application Design\storyboard UI/UX Develop\Update functionality and workflows. Required features of the dashboard system: Login page Home page Modules pages Resources pages FAQs page “Meet the team” page Create interactive content and activities. Create digital and graphic design elements to support learning Create interactive learning activities Create training modules with video and audio. Application programmed in a ‘VA approved’ language. Application security following approved guidelines and policies Develop SQL database on the backend of the application. 5. Tasks a. Phase 1 i. Identify the BMIC staff – developer, system administrator, database administrator, analyst ii. Set up initial application, private github repository iii. Identify deployment strategy b. Phase 2 i. Deploy development, testing and production versions of applicati…