A cluster randomized controlled trial to determine the efficacy of Trauma Risk Management (TRiM) in a military population
Abstract: Trauma Risk Management is a peer-support program that aims to promote help-seeking in the aftermath oftraumatic events. Prior to its implementation, the British military conducted a randomized controlled trialof Trauma Risk Management against standard care in 12 warships; 6 were randomized to use Trauma RiskManagement after collecting baseline measurements. Follow up after 12–18 months found no significant changein psychological health or stigma scores in either group; however, the studied vessels only encountered low numbersof critical incidents. Additionally, measurements of organizational functioning were modestly better in the TraumaRisk Management ships. The authors conclude that within organizations using Trauma Risk Management maybe beneficial and may, in time, lead to a valuable cultural shift.
Abstract: IMPORTANCE: Veterans with occupational performance (e.g., activities of daily living [ADL]) limitations who are receiving inpatient psychiatric care may benefit from outpatient occupational therapy upon discharge, but access disparities have not been investigated. OBJECTIVE: To investigate whether ADL limitations, an indicator of need, are associated with outpatient occupational therapy utilization after inpatient psychiatric hospitalization in the Veterans Health Administration (VHA) and whether this relationship differs by facility characteristics. DESIGN: Secondary analysis of VHA medical record data. Modified Poisson regression was used to model outpatient occupational therapy utilization (yes or no) as a function of ADL limitations, facility characteristics, and sociodemographic and clinical characteristics. Interactions were used to estimate whether the relationship between ADL limitations and outpatient occupational therapy utilization differs across facility characteristics. SETTING: VHA outpatient setting. PARTICIPANTS: Veterans who received VHA inpatient psychiatric care from 2015 to 2020 and lived