Feasibility and Acceptability of Prolonged Exposure in Primary Care (PE-PC) for Posttraumatic Stress Disorder in Federally Qualified Health Centers: A Pilot Study

• Type of Material: Article
• Authors: Rebecca K Sripada, Veterans Affairs Ann Arbor Health Care System; Heather M Walters, Veterans Affairs Ann Arbor Health Care System; Dara Ganoczy, Veterans Affairs Ann Arbor Health Care System; Kimberly M Avallone, University of Michigan; Jeffrey A Cigrang, Wright State University; Sheila Rauch, Emory University
• Language: English
• Date: 2022-04-20
• Publisher: SPRINGER
• Publication Version: Final Published Version
• Copyright Statement: © This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2022
• Final Published Version (URL): http://dx.doi.org/10.1007/s10488-022-01195-1
• Title of Journal or Parent Work: ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH
• Volume: 49
• Issue: 5
• Start Page: 722
• End Page: 734
• Grant/Funding Information: This work was supported by the Center of Medicare and Medicaid Services through the Michigan Department of Health and Human Services and by the Frances and Kenneth Eisenberg Collaborative Innovation Award, University of Michigan Depression Center, to Dr. Sripada (Project Number MA No. 20200032-00/PN E20202413-00). Dr. Sripada is supported by CDA 15-251, IK2 HX-002095-01 from the United States (U.S.) Department of Veterans Affairs Health Services R&D (HSRD) Service. These funding sources had no involvement in the analysis, interpretation of data, or writing of this report.
• Keywords: VETERANS; ALCOHOL; Health Care Sciences & Services; Health Policy & Services; Federally Qualified Health Center; CHECKLIST; Prolonged exposure; RISK; COGNITIVE PROCESSING THERAPY; Posttraumatic stress disorder; Trauma-focused treatment; Science & Technology; TRIAL; Public, Environmental & Occupational Health; RESILIENCE; Stepped care; PTSD; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Mental Health

Abstract

Posttraumatic stress disorder (PTSD) is a debilitating psychiatric disorder that affects 6% of U.S. adults, yet is treated in only 30% of affected individuals and even fewer low-income individuals. One third of the nation’s low-income individuals are treated in Federally Qualified Health Centers (FQHCs). Most of these facilities lack capacity to provide their patients with first-line, evidence-based treatments for PTSD such as Prolonged Exposure (PE). To address this problem, PE has been adapted for use in a primary care setting and demonstrated efficacy in a brief model for military service members (PE in Primary Care: PE-PC). The effectiveness of this treatment in civilian, low-resource settings such as FQHCs is unknown. This pilot study tested the feasibility and acceptability of PE-PC in 30 Michigan FQHC patients. High rates of therapy participation suggest that the intervention was feasible and acceptable. Semi-structured interview data from 10 patients and 5 FQHC providers indicated that the intervention was helpful and filled a critical need for effective PTSD treatment in the FQHC setting. Interviews also elucidated barriers such as transportation, provider training, and time commitment for patients and providers. These findings set the stage for a full-scale randomized controlled trial to test the effectiveness of PE-PC on PTSD symptoms in this low-resource, high-need setting. Trial registry ClinicalTrials.gov Identifier: NCT03711266. October 18, 2018.