ArticleJournal of general internal medicine2026
Delivery of Behavioral Insomnia Care in VA Primary Care Mental Health Integration Clinics: Sustainment Outcomes of a Hybrid Type 3 Trial.
Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04350866 (Enhancing Access to Insomnia), which is not on this map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Enhancing Access to Insomnia (EASI) Care: Implementing Brief Behavioral Treatment for Insomnia in Primary Care Mental Health Integration Clinics
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Authors and funding
7 authors.
Funding
Abstract
backgroundInsomnia is a common disorder associated with significant negative health and functional consequences. Behavioral interventions, such as cognitive behavioral therapy for insomnia (CBT-I), are recommended and supported by training efforts, but access to care remains challenging for many.
objectiveEvaluate change in the delivery of a brief behavioral treatment for insomnia (BBTI) following the withdrawal of implementation strategy support in Department of Veterans Affairs (VA) Primary Care Mental Health Integration (PCMHI) clinics.
designA pre-post analysis of the withdrawal of implementation strategy support during the sustainment phase of a stepped wedge hybrid type 3 trial.
participantsVeterans in Primary Care and PCMHI clinics at four VA Medical Centers.
interventionsImplementation, and withdrawal, of strategies and support to improve BBTI delivery in VA PCMHI clinics. MAIN MEASURES: Delivery of BBTI, CBT-I, and total behavioral insomnia care in PCMHI clinics and prescriptions for sleep medications in Primary Care clinics. KEY
resultsAcross all four study sites, from phase 3 (implementation) to phase 4 (sustainment), delivery of BBTI in PCMHI increased 12.5% among Veterans with insomnia (20.2-32.7%, OR 1.9, p < 0.001) when implementation strategy support was withdrawn. Total behavioral insomnia care (BBTI + CBT-I) also increased (25.5-37.9%, OR 1.8, p < 0.001), although CBT-I delivery was stable during this time period (p = 0.8). Prescription sleep medications in Primary Care also reduced by 0.8% (n = 2158; OR 0.9, p < 0.001).
conclusionsAcross four VAMCs, BBTI training plus implementation strategy support increased the delivery of BBTI, and total behavioral insomnia care (BBTI + CBT-I), including the sustainment phase when implementation support was withdrawn. Increased access to behavioral insomnia care, notably through BBTI implementation, was also associated with decreased prescriptions of sleep medications. BBTI training and implementation support in PCMHI clinics help increase access to behavioral insomnia care and support the VA/DOD Clinical Practice Guidelines for insomnia disorder.
trial registrationClinicalTrials.gov: NCT04350866 (registered 04/14/2020).
Identifiers
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Registered trials
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