Treatment Options for People with Posttraumatic Stress Disorder, Evidence Updates - Dissemination

Background: Healthcare providers need additional, up-to-date, evidence-based approaches for addressing posttraumatic stress disorder (PTSD), especially after two years of the COVID Pandemic.

Proposed Solution to the Problem: Rochester Regional Health was approved for a PCORI-funded Dissemination Award focused on the PCORI Evidence Updates on Treatment Options for People with Posttraumatic Stress Disorder. Rochester Regional Health is an integrated network of eight hospitals, outpatient healthcare services, specialty services, and community services located in Western New York, the Finger Lakes, and Northern New York.

This dissemination award will focus on sharing up-to-date information on PTSD with three target audiences:

1. Primary care physicians and behavioral health providers
2. Non-clinical staff that would benefit from learning about PTSD
3. Patients of Rochester Regional Health

Objectives: Rochester Regional Health will provide workshops custom-tailored to these three target populations over the course of the two-year award with a goal of training over 600 individuals. Key learnings from the workshops include understanding PTSD as a treatable condition and evidence-based treatment options available for PTSD. Workshop attendees will receive a toolkit packed with relevant information on PTSD, treatment options, and local resources. Short-term outcomes of this work include improving physicians comfort level in discussing PTSD with their patients and improving knowledge base on evidence-based treatment options for behavioral health clinicians. Long-term outcomes of this work include decreasing stigma related to PTSD and empowering individuals with PTSD to seek out evidence-based treatment that supports recovery and wellness.

Activities:

• Formation of an advisory board comprised of 50% patients and 50% staff. Advisory board members will be key stakeholders and will meet monthly.
• Creation of a provider training and toolkit on PTSD and provision of regularly occurring workshops to disseminate the training and toolkit
• Creation of a non-provider employee training and toolkit on PTSD and provision of regularly occurring workshops to disseminate training and toolkit
• Creation of a patient training and toolkit on PTSD and provision of regularly occurring workshops to disseminate the training and toolkit
• Creation and provision of a train-the-trainer workshop so that dissemination can continue after the conclusion of the two-year award

Projected Outcomes and Outputs:

Short-term outcomes during the project period: Treating providers, Rochester Regional Health (RRH) employees, and patients will have an increased understanding of PTSD as a treatable condition, and an increased understanding of evidence-based treatment options for PTSD. Treating providers, RRH employees, and patients will have the tools and motivations to implement/participate in evidence-based treatment options for PTSD. Over the course of the two-year award, the following outcomes will be achieved:

• Outcome 1:  300 RRH treating providers will attend workshops that disseminate the PCORI Evidence Updates for Clinicians—Treatment Options for People with Posttraumatic Stress Disorder. All will receive the Clinicians Toolkit.
• Outcome 2:  100 RRH employees that are not treating providers will attend workshops that disseminate the PCORI Evidence Updates for Clinicians and Healthcare Consumers—Treatment Options for People with Posttraumatic Stress Disorder. All will receive a blended toolkit of information from the Clinician and Healthcare Consumer Evidence Updates—this recognizes that training attendees may be interested in content from both a professional and personal experience.
• Outcome 3:  200 RRH patients will attend workshops that disseminate the PCORI Evidence Updates for Healthcare Consumers—Treatment Options for People with Posttraumatic Stress Disorder. All will receive the Healthcare Consumer toolkit.

Medium-term outcomes (0-2 years post-project period): Increased awareness of PTSD as a treatable condition and increased understanding of evidence-based treatment options will improve the knowledge base for providers, RRH employees, and patients. This awareness and knowledge base will destigmatize PTSD and create a culture shift that empowers individual wellness.

Long-term outcomes (3+ years post-project period): As a result of this culture shift, more individuals with PTSD will engage in treatment and move towards wellness.

Patient and Stakeholder Engagement Plan: Stakeholders for this project include RRH providers (primary care physicians, PAs, and NPs) and behavioral health staff; RRH non-provider employees (nurses, leadership, administrative staff, support staff, and service staff); and RRH patients (both primary care and behavioral health). The Advisory Board on the previous dissemination award (which included staff and patients) provided feedback and recommendations on this PTSD dissemination award including the LOI and full project application. Many Advisory Board members have asked to continue serving on the new Advisory Board for the new PTSD award. The project team will also aim to recruit new board members that may have a special interest in PTSD. Recruitment efforts will include:

• Reaching out to behavioral health staff at four mental health clinics to identify staff members that would like to join the Advisory Board.
• Reaching out to behavioral health staff at four mental health clinics to identify patients that would like to join the Advisory Board.
• Reaching out to Collaborative Care Therapists in Primary Care settings to identify staff members that would like to join the Advisory Board.
• Reaching out to Collaborative Care Therapists in Primary Care settings to identify staff members that would like to join the Advisory Board.
• Reaching out to primary care physicians, PAs, and NPs to identify if they would like to join the Advisory Board.
• Recruiting from the Participant Advisory Board at Healthy Moms.

Stakeholders will be involved in monthly Advisory Board meetings.

Stakeholders (patients and staff) will benefit from this project in many ways:

• They will be actively engaged in the design of the toolkits and training curriculum. This empowers stakeholders to be a part of the process and serve as an ambassador for disseminating this work.
• Stakeholders can actively participate in the workshops and receive the toolkit.
• Stakeholders will benefit from the educational content including understanding PTSD as a treatable condition and understanding evidence-based treatment options. This will result in stakeholders experiencing decreased stigma and being an active participant in changing the culture around PTSD and mental health.

This award initiative embodies core PCORI principles including an Advisory Board that is comprised of 50% RRH staff and 50% patients and a train-the-trainer program that promotes the work continuing beyond the PCORI-funded award period.

Project Collaborators: Rochester Regional Health is the only organization participating in this dissemination award.