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CDA 08-004 – HSR&D Study

 
CDA 08-004
Implementing Evidence-Based Mental Health Practices in Primary Care
Michael A Cucciare PhD
Central Arkansas Veterans Healthcare System Eugene J. Towbin Healthcare Center, Little Rock, AR
No. Little Rock, AR
Funding Period: September 2009 - August 2014

BACKGROUND/RATIONALE:
The integration of evidence-based mental health practices into VA primary care is a top priority for VHA reflected in the initiative to implement brief alcohol counseling into VA primary care as a National Performance Measure. This initiative is in response to the large percentage of Veterans screening positive for alcohol misuse nationwide (22%). One of the main goals of this study is to further support this initiative by testing methods for treating alcohol misuse in Veterans presenting to a VA primary care clinic.

OBJECTIVE(S):
The primary objective of this study is to compare the relative effectiveness of a computerized motivational intervention plus treatment-as-usual to treatment-as-usual alone on Veteran alcohol consumption. VA administrative data will be used in conjunction with outcome data to determine the impact of SUD-related health care utilization on response to treatment for alcohol misuse delivered in VA primary care. The impact of brief alcohol interventions on VA health care utilization will also be examined.

METHODS:
Veterans screening positive on the AUDIT-C were randomly assigned to one of two conditions - computerized motivational intervention plus treatment-as-usual (TAU) or TAU alone. Participants completed an assessment battery at baseline, three-month, and six- month post-treatment. Primary outcomes include percentage of heavy drinking days, average number of drinks per day, total number of drinking days, and alcohol-related problems.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
The findings from this study may lead to many important benefits for improving mental health care for Veterans presenting to VA primary care. Some of these benefits include: (a) helping to identify low-cost evidence-based practices for treating alcohol misuse in VA primary care; (b) specifying Veterans characteristics associated with a beneficial response to such interventions; and (c) the impact of brief alcohol interventions of VA health care utilization.


External Links for this Project

Dimensions for VA

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
    Search Dimensions for this project

PUBLICATIONS:

Journal Articles

  1. Cucciare MA, Coleman EA, Timko C. A conceptual model to facilitate transitions from primary care to specialty substance use disorder care: a review of the literature. Primary health care research & development. 2015 Sep 1; 16(5):492-505. [view]
  2. Cucciare MA, Weingardt KR, Ghaus S, Boden MT, Frayne SM. A randomized controlled trial of a web-delivered brief alcohol intervention in Veterans Affairs primary care. Journal of studies on alcohol and drugs. 2013 May 1; 74(3):428-36. [view]
  3. Cucciare MA, Ghaus S. A Web-based intervention for alcohol misuse in VA primary care. Psychiatric services (Washington, D.C.). 2012 Mar 1; 63(3):292. [view]
  4. Hoggatt KJ, Jamison AL, Lehavot K, Cucciare MA, Timko C, Simpson TL. Alcohol and drug misuse, abuse, and dependence in women veterans. Epidemiologic Reviews. 2015 Jan 21; 37:23-37. [view]
  5. Cucciare MA, Blonigan D, Sox-Harris A. Associations between Alcohol-Related Concerns, Normative Perceptions of Peer Alcohol Use, and Veterans' Drinking Behavior over Six-Months. Journal of substance abuse. 2013 Dec 17; doi: 10.3109/14659891.2013.868935. [view]
  6. Cucciare MA, Blonigen DM, Sox-Harris A. Associations between alcohol-related concerns, normative perceptions of peer alcohol use, and Veterans’ drinking behavior over six months. Journal of Substance Use. 2015 Apr 1; 20(2):128-135. [view]
  7. Cucciare MA, Sadler AG, Mengeling MA, Torner JC, Curran GM, Han X, Booth BM. Associations between deployment, military rank, and binge drinking in active duty and Reserve/National Guard US servicewomen. Drug and Alcohol Dependence. 2015 Aug 1; 153:37-42. [view]
  8. Cucciare MA, Han X, Curran GM, Booth BM. Associations Between Religiosity, Perceived Social Support, and Stimulant Use in an Untreated Rural Sample in the U.S.A. Substance use & misuse. 2016 Jun 6; 51(7):823-34. [view]
  9. Cucciare MA, Boden MT, Weingardt KR. Brief alcohol counseling improves mental health functioning in veterans with alcohol misuse: results from a randomized trial. Journal of affective disorders. 2013 May 1; 147(1-3):312-7. [view]
  10. Halvorson MA, Ghaus S, Cucciare MA. Care utilization and patient characteristics of veterans who misuse alcohol. Journal of addictive diseases. 2014 Jan 1; 33(4):332-9. [view]
  11. Cucciare MA, Darrow M, Weingardt KR. Characterizing binge drinking among U.S. military Veterans receiving a brief alcohol intervention. Addictive Behaviors. 2011 Apr 1; 36(4):362-7. [view]
  12. Oser M, Cucciare M, McKellar J, Weingardt K. Correlates of hazardous drinking among Veterans with and without hepatitis C. Journal of behavioral medicine. 2012 Dec 1; 35(6):634-41. [view]
  13. Holland JM, Thompson LW, Cucciare MA, Tsuda A, Okamura H, Spiegel D, Rasgon NL, Gallagher-Thompson D. Cortisol outcomes among Caucasian and Latina/Hispanic women caring for a family member with dementia: A preliminary examination of psychosocial predictors and effect of a psychoeducational intervention. Stress and health : journal of the International Society for the Investigation of Stress. 2011 Jan 5; 27:doi: 10.1002/smi.1375. [view]
  14. Cucciare MA, Weingardt KR, Greene CJ, Hoffman J. Current trends in using Internet and mobile technology to support the treatment of substance use disorders. Current drug abuse reviews. 2012 Sep 1; 5(3):172-7. [view]
  15. Leykin Y, Cucciare MA, Weingardt KR. Differential effects of online training on job-related burnout among substance abuse counselors. Journal of substance abuse. 2011 Apr 1; 16(2):1-9. [view]
  16. Aldridge-Gerry A, Cucciare MA, Ghaus S, Ketroser N. Do normative perceptions of drinking relate to alcohol use in U.S. Military veterans presenting to primary care? Addictive Behaviors. 2012 Jul 1; 37(7):776-82. [view]
  17. Cucciare MA, Coleman EA, Saitz R, Timko C. Enhancing transitions from addiction treatment to primary care. Journal of addictive diseases. 2014 Oct 9; 33(4):340-53. [view]
  18. Gray HL, Jimenez DE, Cucciare MA, Tong HQ, Gallagher-Thompson D. Ethnic differences in beliefs regarding Alzheimer disease among dementia family caregivers. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2009 Nov 1; 17(11):925-33. [view]
  19. Finney JW, Amundson EO, Bi X, Cucciare MA, Eisen SA, Finlay AK, Halvorson MA, Hayashi K, Owens DK, Maisel NC, Timko C, Weitlauf JC, Cronkite RC. Evaluating the Productivity of VA, NIH, and AHRQ Health Services Research Career Development Awardees. Academic Medicine. 2016 Apr 1; 91(4):563-9. [view]
  20. Cucciare MA, Gray H, Azar A, Jimenez D, Gallagher-Thompson D. Exploring the relationship between physical health, depressive symptoms, and depression diagnoses in Hispanic dementia caregivers. Aging & mental health. 2010 Apr 1; 14(3):274-82. [view]
  21. Cucciare MA, Lewis ET, Hoggatt KJ, Bean-Mayberry B, Timko C, Durazo EM, Jamison AL, Frayne SM. Factors Affecting Women's Disclosure of Alcohol Misuse in Primary Care: A Qualitative Study with U.S. Military Veterans. Women's health issues : official publication of the Jacobs Institute of Women's Health. 2016 Mar 1; 26(2):232-9. [view]
  22. Cucciare MA, Weingardt KR, Humphreys K. How Internet technology can improve the quality of care for substance use disorders. Current drug abuse reviews. 2009 Sep 1; 2(3):256-62. [view]
  23. Midboe AM, Cucciare MA, Trafton JA, Ketroser N, Chardos J. Implementing motivational interviewing in primary care: the role of provider characteristics. Translational behavioral medicine. 2011 Oct 28; 1(4):588-594. [view]
  24. Timko C, Below M, Schultz NR, Brief D, Cucciare MA. Patient and program factors that bridge the detoxification-treatment gap: a structured evidence review. Journal of substance abuse treatment. 2015 May 1; 52:31-9. [view]
  25. Schultz NR, Martinez R, Cucciare MA, Timko C. Patient, Program, and System Barriers and Facilitators to Detoxification Services in the U.S. Veterans Health Administration: A Qualitative Study of Provider Perspectives. Substance use & misuse. 2016 Aug 23; 51(10):1330-41. [view]
  26. Cucciare MA, Weingardt K, Garcia D, Ghaus S. Posttraumatic stress disorder and illicit drug use in Veterans presenting to primary care with alcohol misuse. Addiction research & theory. 2015 Aug 1; 23(4):287-293. [view]
  27. Mason AE, Boden MT, Cucciare MA. Prospective associations among approach coping, alcohol misuse and psychiatric symptoms among veterans receiving a brief alcohol intervention. Journal of substance abuse treatment. 2014 May 1; 46(5):553-60. [view]
  28. Abraham TH, Lewis ET, Cucciare MA. Providers' Perspectives on Barriers and Facilitators to Connecting Women Veterans to Alcohol-Related Care From Primary Care. Military medicine. 2017 Sep 1; 182(9):e1888-e1894. [view]
  29. Kendra MS, Weingardt KR, Cucciare MA, Timko C. Satisfaction with substance use treatment and 12-step groups predicts outcomes. Addictive Behaviors. 2015 Jan 1; 40:27-32. [view]
  30. Cucciare MA, Ghaus S, Weingardt KR, Frayne SM. Sexual assault and substance use in male veterans receiving a brief alcohol intervention. Journal of studies on alcohol and drugs. 2011 Sep 1; 72(5):693-700. [view]
  31. Cucciare MA, Simpson T, Hoggatt KJ, Gifford E, Timko C. Substance use among women veterans: epidemiology to evidence-based treatment. Journal of addictive diseases. 2013 Jan 1; 32(2):119-39. [view]
  32. Cucciare MA, Ketroser N, Wilbourne P, Midboe AM, Cronkite R, Berg-Smith SM, Chardos J. Teaching motivational interviewing to primary care staff in the Veterans Health Administration. Journal of general internal medicine. 2012 Aug 1; 27(8):953-61. [view]
  33. Halvorson MA, Finlay AK, Cronkite RC, Bi X, Hayashi K, Maisel NC, Amundson EO, Weitlauf JC, Litt IF, Owens DK, Timko C, Cucciare MA, Finney JW. Ten-Year Publication Trajectories of Health Services Research Career Development Award Recipients: Collaboration, Awardee Characteristics, and Productivity Correlates. Evaluation & the health professions. 2016 Mar 1; 39(1):49-64. [view]
  34. Jimenez DE, Gray HL, Cucciare M, Kumbhani S, Gallagher-Thompson D. Using the Revised Acculturation Rating Scale for Mexican Americans (ARSMA-II) with Older Adults. Hispanic health care international : the official journal of the National Association of Hispanic Nurses. 2010 Mar 1; 8(1):14-22. [view]
  35. Lewis ET, Cucciare MA, Trafton JA. What do patients do with unused opioid medications? The Clinical Journal of Pain. 2014 Aug 1; 30(8):654-62. [view]
Journal Other

  1. Cucciare MA, Ghaus S, Weingardt KR. A Web-Based Intervention for Reducing Alcohol Use in Veterans Presenting to Primary Care: Preliminary Results from an RCT. Symposia presented at: Research Society on Alcoholism Annual Scientific Meeting. [Abstract]. Alcoholism, clinical and experimental research. 2012 Jun 4; DOI: 10.1111/j.1530-0277.2012.01804.x:page 347a. [view]
  2. Cucciare MA, Weingardt KR. Commentary on Gibson et al. (2011): Brief alcohol interventions in the context of treatment for hepatitis C. Addiction. 2011 Dec 1; 106(12):2193-4. [view]
Books

  1. Cucciare MA. Using Technology to Support Evidence-Based Behavioral Health Practices: A Clinician's Guide. 1 ed. Cucciare MA, Weingardt KR, editors. New York, NY: Routledge; 2009. 291 p. [view]
Book Chapters

  1. Cucciare MA, Weingardt KR. Editors' Introduction: Technology and Behavioral Health. In: Cucciare MA, Weingardt KR, editors. Using Technology to Support Evidence-Based Behavioral Health Practices: A Clinician's Guide. New York, NY: Routledge; 2009. Introduction. 7-10 p. [view]
  2. Weingardt KR. Evaluation. In: Cucciare MA, Weingardt KR, editors. Using Technology to Support Evidence-Based Behavioral Health Practices: A Clinician's Guide. New York, NY: Routledge; 2009. Chapter 12. 247-266 p. [view]
  3. Cucciare MA, Weingardt KR. Implementation. In: Cucciare MA, Weingardt KR, editors. Using Technology to Support Evidence-Based Behavioral Health Practices: A Clinician's Guide. New York, NY: Routledge; 2009. Chapter 11. 225-246 p. [view]
Reports

  1. Halvorson M, Finney JW, Cronkite RC, Amundson EO, Bi X, Cucciare MA, Finlay A, Hayashi K, Macus S, Owens DK, Maisel N, Smith BN, Timko C, Unger-Hu K, Weitlauf JC. Accomplishments of Veterans Health Administration Health Services Research and Development Research Career Scientists. Menlo Park, CA: Center for Health Care Evaluation; 2013 May 1. 10 p. [view]
  2. Finney JW, Cronkite RC, Amundson EO, Bi X, Cucciare M, Finlay A, Halvorson M, Hayashi K, Macus S, Owens D, Maisel N, Smith B, Timko C, Unger-Hu K, Weitlauf J. An Evaluation of the Veterans Health Administration Health Services Research and Development Career Development Award Program. Menlo Park, CA: Center for Health Care Evaluation; 2013 May 1. 52 p. [view]
  3. Finney JW, Cronkite RC, Amundson E, Bi X, Cucciare MA, Finlay A, Halvorson M, Hayashi K, Macus S, Owens DK, Maisel N, Smith BN, Timko C, Unger-Hu K, Weitlauf JC. Evaluation of the VHA Office of Research and Development Career Development Program: Accomplishments of Biomedical/Laboratory, Clinical Sciences, and Rehabilitation Research and Development Services Awardees. Menlo Park, CA: Center for Health Care Evaluation; 2013 May 1. 34 p. [view]
HSR&D or QUERI Publications

  1. Halvorson M, Finney JW, Cronkite RC, Amundson EO, Bi X, Cucciare MA, Finlay A, Hayashi K, Owens D, Maisel N, Timko C, Weitlauf J. Improving the VHA Health Services and Development Career Development Award Program: Interviews with Key Stakeholders. 2014 May 1. [view]
HSR&D or QUERI Articles

  1. Timko C, Cucciare MA, Ilgen M. Facilitating care transitions among patients with substance use disorders. VA HSR&D FORUM: Translating research into quality health care for Veterans. 2014 Aug 1; 6. [view]
Center Products

  1. Cucciare MA. Implementing brief alcohol counseling in primary care: feasibility to evaluation. 2013 Feb 1. [view]
VA Cyberseminars

  1. Asch S, Blonigen D, Cucciare M, Gellad WF, Keyhani S. Transitioning off CDA and Factors Influencing Retention. HSR&D Career Development Awardee Series [Cyberseminar]. HSR&D. 2016 Apr 12. [view]
Conference Presentations

  1. Halvorson M, Finney JW, Bi X, Maisel N, Hayashi K, Amundson E, Weitlauf JC, Litt I, Owens DK, Goldstein MK, Fine M, Timko C, Asch SM, Cucciare MA, Cronkite RC. A Multivariate Model of Mentoring Relationships and Outcomes in the VA Health Services Research & Development CDA Program. Presented at: AcademyHealth Annual Research Meeting; 2015 Jun 15; Minneapolis, MN. [view]
  2. Seal KH, McCamish N, Abadjian L, Tarasovsky G, Daley A, Ren L, Shi Y, Lui R, Weingardt KR, Cucciare MA. A Randomized Controlled Trial of Motivational Interviewing to Improve Mental Health Treatment Engagement and Outcomes in OEF/OIF Veterans. Poster session presented at: VA HSR&D National Meeting; 2011 Feb 16; National Harbor, MD. [view]
  3. Cucciare MA, Blonigen DM, Durazo E, Weingardt KR. Alcohol-related concerns and normative perceptions of peer drinking predict change in outcomes among Veterans receiving brief alcohol counseling. Poster session presented at: Society of Behavioral Medicine Annual Meeting and Scientific Sessions; 2013 Mar 20; San Francisco, CA. [view]
  4. Cucciare MA, Ketroser N, Wilbourne PL, Weingardt KR, Chardos J. An evaluation of a motivational interviewing training protocol in ambulatory care. Poster session presented at: VA Mental Health Annual Conference; 2011 Aug 23; Baltimore, MD. [view]
  5. Cucciare MA, Frayne SM, Weingardt KR, Kivlahan D. Are brief alcohol interventions in primary care effective? Results from an RCT. Poster session presented at: VA HSR&D / QUERI National Meeting; 2012 Jul 16; National Harbor, MD. [view]
  6. Weingardt KR, Cucciare MA, Bellotti C, Lai WP. Blending web-based training and virtual group supervision to promote the adoption of CBT among community substance abuse counselors. Presented at: Association for Behavioral and Cognitive Therapies Annual Convention; 2008 Nov 15; Orlando, FL. [view]
  7. Cucciare MA. Brief alcohol counseling in VA primary care. Presented at: VA Center for Mental Healthcare and Outcomes Research Meeting; 2013 Mar 1; North Little Rock, AR. [view]
  8. Possemato K, Brief DJ, Cucciare MA, Maisto S. Computer-based treatments for Veterans with substance use and PTSD: Treatment development and testing with randomized clinical trials. Poster session presented at: VA Mental Health Annual Conference; 2011 Aug 23; Baltimore, MD. [view]
  9. Oser ML, Cucciare MA, McKellar JD, Weingardt KR. Correlates of hazardous drinking among Veterans with and without hepatitis C. Presented at: Association for Behavioral and Cognitive Therapies Annual Convention; 2011 Nov 10; Toronto, Canada. [view]
  10. Oser ML, Cucciare MA, McKellar JD, Weingardt KR. Hazardous Alcohol Use among Veterans with Hepatitis C: Alcohol-related Coping, Consequences, and Confidence to Change. Paper presented at: Society of Behavioral Medicine Annual Meeting and Scientific Sessions; 2011 Apr 30; Washington, DC. [view]
  11. Oser ML, Cucciare MA, Trafton JA. Impact of Somatization on the misuse of prescription opioids. Poster session presented at: Society of Behavioral Medicine Annual Meeting and Scientific Sessions; 2010 Apr 8; Seattle, WA. [view]
  12. Cucciare MA, Ghaus S, Ketroser N, Frayne SM, Weingardt KR, Kivlahan D. Implementing a brief alcohol intervention in primary care: Preliminary findings. Poster session presented at: VA HSR&D Career Development Annual Meeting; 2011 Feb 18; National Harbor, MD. [view]
  13. Weingardt KR, Cucciare MA, Wilbourne PL, Baer JA. Lessons learned from implementing a web-based tool for brief alcohol interventions in a large integrated health care system. Presented at: Seattle Implementation Research Conference; 2013 May 16; Seattle, WA. [view]
  14. Jamison A, Cucciare MA, Timko C, Simpson T. Substance misuse, abuse, and dependence in women Veterans: a systematic review of the literature. Paper presented at: VA HSR&D Enhancing Partnerships for Research and Care of Women Veterans Conference; 2014 Jul 31; Arlington, VA. [view]
  15. Cucciare MA, Ghaus S, Weingardt KR. Symposia: Randomized Controlled Trials of Web-based interventions for alcohol and substance use disorders: Results and Future Directions. Presented at: Research Society on Alcoholism Annual Scientific Meeting; 2012 Jun 26; San Francisco, CA. [view]
  16. Halvorson MA, Finlay A, Bi X, Maisel NC, Hayashi K, Amundson EO, Weitlauf JC, Litt IF, Owens DK, Timko C, Cucciare MA, Cronkite RC, Finney JW. Ten-year publication trajectories of Health Services Research Career Development Award recipients. Poster session presented at: AcademyHealth Annual Research Meeting; 2014 Jun 10; San Diego, CA. [view]
  17. Cucciare MA. Toward implementing a web-based brief alcohol intervention in the U.S. Veterans Health Administration. Poster session presented at: VA HSR&D Career Development Annual Meeting; 2010 Feb 1; San Francisco, CA. [view]


DRA: Mental, Cognitive and Behavioral Disorders, Substance Use Disorders, Health Systems
DRE: Treatment - Observational, Treatment - Comparative Effectiveness
Keywords: Alcohol
MeSH Terms: none

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