1. Brief modular anxiety intervention for primary care: Hybrid I pilot randomized controlled trial of feasibility, acceptability, effectiveness, and implementation potential.
- Author
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Shepardson, Robyn L., Weisberg, Risa B., Wade, Michael, Maisto, Stephen A., and Funderburk, Jennifer S.
- Subjects
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MENTAL health services , *PRIMARY care , *RANDOMIZED controlled trials , *THERAPEUTIC alliance , *ANXIETY , *ANXIETY treatment - Abstract
Anxiety is highly prevalent, but undertreated, in primary care. Brief, non-pharmacological interventions are needed. Modular Anxiety Skills Training (MAST), a cognitive-behavioral anxiety intervention, was developed for primary care and tailored for a Veteran sample (MAST-V). The purpose of this mixed methods pilot study was to evaluate MAST-V's feasibility, acceptability, and implementation potential, and preliminarily examine its effectiveness compared to Primary Care Behavioral Health (PCBH) usual care. This hybrid I randomized controlled trial (conducted 2019–2021) assigned 35 primary care patients (M age = 47, 17 % female, 27 % racial/ethnic minority) with clinically significant anxiety symptoms to receive MAST-V or PCBH usual care. Participants completed validated measures of anxiety symptoms and functional impairment at 0, 4, 8, 12, and 16 weeks. Participants attended more sessions in MAST-V than usual care. After necessary adjustments to reduce session duration, MAST-V will likely fit within PCBH practice parameters. Participants in both conditions valued treatment, but treatment satisfaction, credibility, and therapeutic alliance were higher for MAST-V. Study therapists achieved high treatment fidelity and rated MAST-V as highly feasible, acceptable, and appropriate for PCBH. They identified ways to address potential barriers to implementation. MAST-V was more effective than usual care in reducing anxiety symptoms and impairment. This was a small pilot study at a single site using study therapists. Results should be considered preliminary until replicated in a full-scale clinical trial. This brief modular anxiety intervention, which was designed with implementation in mind, may help to address the anxiety treatment gap in primary care. • Brief nonpharmacological anxiety interventions feasible in primary care are needed. • We conducted a pilot RCT of a modular cognitive-behavioral anxiety intervention. • The intervention was feasible and highly acceptable for patients and therapists. • Clinical outcomes improved more than with usual care (primarily supportive therapy). • The intervention's potential for implementation in routine primary care is high. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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