Targeted Assessment and Context-Tailored Implementation of Change Strategies (TACTICS) to increase evidence based psychotherapy in military behavioral health clinics: A cluster-randomized stepped-wedge implementation study

Principal Investigators: Carmen McLean, PhD and Craig Rosen, PhD
Implementation Core Co-Investigators: David Riggs, Katherine Anne Comtois, Elisa Borah, Katherine Dondanville, & Shannon Wiltsey-Stirman

Protocol Paper

A context-tailored implementation approach, TACTICS combines a needs assessment, a rubric for selecting implementation strategies based on local barriers, an implementation toolkit, and external facilitation to support local champions and their implementation teams in enacting changes.

The study is a multi-site, cluster randomized, stepped-wedge trial, with the military treatment facility as the unit of analysis. Eight facilities undergo a provider-training phase, followed by 5 months of TACTICS implementation. The timing of TACTICS at each facility is randomly assigned to begin 9, 14, or 19 months after beginning the provider-training phase. Primary analyses will compare the proportion of PTSD patients receiving PE and patients' mean improvement in PTSD symptoms before and after the onset of TACTICS.

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Recruitment

All sites have been selected.  Data collection is ongoing.

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Implementation Core Team

Kate Comtois, PhD, MPH
University of Washington

Carmen McLean, PhD
Craig Rosen, PhD
Shannon Wiltsey-Stirman, PhD
Andrea Neitzer, MS
National Center for PTSD
Dissemination and Training Division (D&T) Division
VA Palo Alto Health System

David Riggs, PhD
Jeffrey Cook, PhD
Erin Frick, PsyD
Jeffrey Mann, PsyD
Melissa Mistretta, BA
Center for Deployment Psychology

Katherine Dondanville, PsyD
STRONG STAR Training Initiative
University of Texas Health Science Center San Antonio

Elisa Borah,PhD
University of Texas at Austin
School of Social Work

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Funding Agency