Implementing Cognitive Behavioral Therapy for Insomnia With Older Veterans: Function QUERI 3.0 (QUE 25-008)
VA Office of Research and Development
Summary
Implementing Cognitive Behavioral Therapy for Insomnia with Older Veterans (SWELL): Function QUERI 3.0 aims to compare implementation approaches while also gathering information on clinical effectiveness of the EBP in its new context. The overall goal is to implement, evaluate, and sustain SWELL in 20 VA facilities using a type III effectiveness-implementation hybrid study framework and parallel cluster randomized trial (CRT) design.
Description
Background/Purpose. As many as two-thirds of older Veterans meet criteria for chronic insomnia disorder, defined as three or more months of subjective complaints related to difficulty falling or staying asleep or waking too early and/or poor nighttime sleep associated with daytime impairment. Left untreated, chronic insomnia can negatively impact quality-of-life and contribute to accelerated cognitive and functional decline. CBTI is the recommended first-line treatment for chronic insomnia; however, despite several VA initiatives focused on the scale-up of CBTI, fewer than 5% of older Veteran…
Eligibility
- Age range
- 60+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: Site Inclusion Criteria: * Facility is part of the U.S. Department of Veterans Affairs (VA) health system. * Primary care clinic providing care to older Veterans * Clinic is located 25 miles from the nearest other VA clinic participating in the program * Identified site champion (e.g., clinician or staff member) who is willing to assume required program responsibilities for implementation. Patient Inclusion Criteria: * meet diagnostic criteria for chronic insomnia disorder (with or without documented diagnosis) * absence of a CBTI contraindication oi.e., comorbid condit…
Interventions
- OtherImplementation Strategy: Foundational Arm
The Foundational Arm includes the following activities: Toolkit, kickoff call, SharePoint, TEAMS channel, office hours calls, site specific data reports, and education and training.
- OtherImplementation Strategy: REACH arm
The REACH Arm includes everything in the Foundational Arm, plus additional components: targeted data reports and external facilitation.
Location
- Durham VA Medical Center, Durham, NCDurham, North Carolina