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Does format matter? A naturalistic study of digital and provider-led cognitive behavioral therapy for insomnia implemented in a healthcare system.

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Title: Does format matter? A naturalistic study of digital and provider-led cognitive behavioral therapy for insomnia implemented in a healthcare system.
Authors: Reed, Alexandra C. (AUTHOR), Rogers, Daniel G. (AUTHOR), Berlin, Gregory S. (AUTHOR), Burrone, Laura (AUTHOR), Dante, Greg (AUTHOR), DeViva, Jason (AUTHOR), McCarthy, Elissa (AUTHOR), Niculete, Maria E. (AUTHOR), Santoro, Gia (AUTHOR), Hermes, Eric D. A. (AUTHOR)
Source: Behavioral Sleep Medicine. Nov/Dec2024, Vol. 22 Issue 6, p883-893. 11p.
Subjects: Cognitive therapy, Digital technology, Veterans' health, Insomnia, Treatment effectiveness
Abstract: Objectives: Cognitive Behavioral Therapy for Insomnia (CBTi) is a first-line treatment for a prevalent and impairing disorder. Digital CBTi programs increase access to internet-based self-directed care. However, the clinical effect of offering different forms of CBTi in a healthcare setting is not clearly understood. This study examines treatment engagement and clinical outcomes for individuals referred to either digital or provider-led CBTi. Methods: Over two years, providers at a Veterans Health Administration (VHA) facility referred patients to digital CBTi with telephone coaching support or traditional provider-led CBTi. Characteristics of those referred, proportions engaging in and completing treatment, as well as insomnia severity were compared among those referred to each format. Results: Providers referred 139 individuals to digital CBTi, 340 to provider-led CBTi, and 14 to both formats. Individuals referred to digital CBTi were older with less severe insomnia. Despite lower levels of program engagement and completion in the digital CBTi cohort, measures of insomnia symptom change were similar between the groups. Conclusions: This is the first study to evaluate both digital and provider-led evidence-based treatments for insomnia disorder simultaneously deployed in a healthcare setting. While engagement in digital CBTi lagged that for provider-led CBTi, offering both formats may expand access to different groups, while fostering similar outcomes. [ABSTRACT FROM AUTHOR]
Copyright of Behavioral Sleep Medicine is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Does format matter? A naturalistic study of digital and provider-led cognitive behavioral therapy for insomnia implemented in a healthcare system.
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  Data: <searchLink fieldCode="AR" term="%22Reed%2C+Alexandra+C%2E%22">Reed, Alexandra C.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rogers%2C+Daniel+G%2E%22">Rogers, Daniel G.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Berlin%2C+Gregory+S%2E%22">Berlin, Gregory S.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Burrone%2C+Laura%22">Burrone, Laura</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Dante%2C+Greg%22">Dante, Greg</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22DeViva%2C+Jason%22">DeViva, Jason</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22McCarthy%2C+Elissa%22">McCarthy, Elissa</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Niculete%2C+Maria+E%2E%22">Niculete, Maria E.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Santoro%2C+Gia%22">Santoro, Gia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hermes%2C+Eric+D%2E+A%2E%22">Hermes, Eric D. A.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Behavioral+Sleep+Medicine%22">Behavioral Sleep Medicine</searchLink>. Nov/Dec2024, Vol. 22 Issue 6, p883-893. 11p.
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  Data: <searchLink fieldCode="DE" term="%22Cognitive+therapy%22">Cognitive therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Digital+technology%22">Digital technology</searchLink><br /><searchLink fieldCode="DE" term="%22Veterans'+health%22">Veterans' health</searchLink><br /><searchLink fieldCode="DE" term="%22Insomnia%22">Insomnia</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink>
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  Label: Abstract
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  Data: Objectives: Cognitive Behavioral Therapy for Insomnia (CBTi) is a first-line treatment for a prevalent and impairing disorder. Digital CBTi programs increase access to internet-based self-directed care. However, the clinical effect of offering different forms of CBTi in a healthcare setting is not clearly understood. This study examines treatment engagement and clinical outcomes for individuals referred to either digital or provider-led CBTi. Methods: Over two years, providers at a Veterans Health Administration (VHA) facility referred patients to digital CBTi with telephone coaching support or traditional provider-led CBTi. Characteristics of those referred, proportions engaging in and completing treatment, as well as insomnia severity were compared among those referred to each format. Results: Providers referred 139 individuals to digital CBTi, 340 to provider-led CBTi, and 14 to both formats. Individuals referred to digital CBTi were older with less severe insomnia. Despite lower levels of program engagement and completion in the digital CBTi cohort, measures of insomnia symptom change were similar between the groups. Conclusions: This is the first study to evaluate both digital and provider-led evidence-based treatments for insomnia disorder simultaneously deployed in a healthcare setting. While engagement in digital CBTi lagged that for provider-led CBTi, offering both formats may expand access to different groups, while fostering similar outcomes. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Behavioral Sleep Medicine is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1080/15402002.2024.2385822
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              Text: Nov/Dec2024
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