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Evaluating a community-based training program for evidence-based treatments for PTSD using the RE-AIM framework.

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The STRONG STAR Training Initiative effectively trained community mental health providers in evidence-based treatments (EBTs) for posttraumatic stress disorder (PTSD), significantly reducing patient symptoms and demonstrating sustained implementation.

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Area of Science:

  • Mental Health
  • Psychology
  • Public Health

Background:

  • Community mental health providers often lack adequate training in evidence-based treatments (EBTs) for posttraumatic stress disorder (PTSD).
  • The STRONG STAR Training Initiative (SSTI) model was developed to address this gap by adapting learning collaboratives for community settings.

Purpose of the Study:

  • To evaluate the dissemination and implementation outcomes of the SSTI model using the RE-AIM framework.
  • To assess the effectiveness of EBTs for PTSD delivered by trained community providers.

Main Methods:

  • Utilized the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework for program evaluation.
  • Trained 280 mental health providers across 25 states between January 2018 and January 2020.
  • Tracked EBT initiation and completion rates for 930 patients with PTSD and assessed symptom severity changes.

Main Results:

  • Trained providers initiated EBTs for PTSD in 29% of eligible patients, with 238 patients completing treatment.
  • Completed treatment resulted in significant reductions in PTSD symptom severity (32.51 points) and depression symptom severity (8.73 points).
  • High rates of sustained EBT implementation were observed at 6 months and 1 year post-training for cognitive processing therapy and prolonged exposure.

Conclusions:

  • The SSTI model is an effective national training program for enhancing community provider competence in delivering EBTs for PTSD.
  • Scalable models for EBT dissemination and implementation in community mental health settings are crucial for improving veteran care.
  • Findings support the continued refinement and expansion of training initiatives to broaden access to evidence-based PTSD treatments.