TY - JOUR
AU - R. L. Shepardson
AU - R. B. Weisberg
AU - M. Wade
AU - S. A. Maisto
AU - J. S. Funderburk
A1 - 
AB - BACKGROUND: 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. METHODS: 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. RESULTS: 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. LIMITATIONS: 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. CONCLUSIONS: This brief modular anxiety intervention, which was designed with implementation in mind, may help to address the anxiety treatment gap in primary care.
AD - Center for Integrated Healthcare, Syracuse VA Medical Center. USA; Department of Psychology, Syracuse University. USA. Electronic address: Robyn.Shepardson@va.gov.; VA, Boston Healthcare System. USA; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine. USA; Department of Family Medicine, Alpert Medical School, Brown University. USA.; Center for Integrated Healthcare, Syracuse VA Medical Center. USA.; Center for Integrated Healthcare, Syracuse VA Medical Center. USA; Department of Psychology, Syracuse University. USA.; Center for Integrated Healthcare, Syracuse VA Medical Center. USA; Department of Psychology, Syracuse University. USA; Department of Psychiatry, University of Rochester. USA.
AN - 38810782
BT - J Affect Disord
C5 - Healthcare Disparities
DA - Sep 15
DO - 10.1016/j.jad.2024.05.107
DP - NLM
ET - 20240527
JF - J Affect Disord
LA - eng
N2 - BACKGROUND: 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. METHODS: 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. RESULTS: 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. LIMITATIONS: 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. CONCLUSIONS: This brief modular anxiety intervention, which was designed with implementation in mind, may help to address the anxiety treatment gap in primary care.
PY - 2024
SN - 0165-0327
SP - 497
EP - 507+
ST - Brief modular anxiety intervention for primary care: Hybrid I pilot randomized controlled trial of feasibility, acceptability, effectiveness, and implementation potential
T1 - Brief modular anxiety intervention for primary care: Hybrid I pilot randomized controlled trial of feasibility, acceptability, effectiveness, and implementation potential
T2 - J Affect Disord
TI - Brief modular anxiety intervention for primary care: Hybrid I pilot randomized controlled trial of feasibility, acceptability, effectiveness, and implementation potential
U1 - Healthcare Disparities
U3 - 10.1016/j.jad.2024.05.107
VL - 361
VO - 0165-0327
Y1 - 2024
ER -