Background: Chronic insomnia, one of the most common health problems among Veterans, significantly impacts health, function, and quality of life. Cognitive Behavioral Therapy for Insomnia (CBTI) is the first line treatment; however, despite efforts to train hundreds of VA clinicians to deliver CBTI, there are still significant barriers to providing adequate access to insomnia care. Up to 44% of Veterans seen in Primary Care report insomnia, making it an optimal clinical setting for improving access to insomnia care. Furthermore, Brief Behavioral Treatment for Insomnia (BBTI), adapted from CBTI as a briefer, more flexible treatment, is easily delivered by Primary Care Mental Health Integration (PCMHI) clinicians and can greatly improve access to care for Veterans with insomnia. Yet, simply training PCMHI clinicians to deliver BBTI is not enough. Implementation strategies are needed for successful uptake, adoption, and sustainable delivery of care. Significance/Impact: BBTI is effective, developed for non-specialty care settings, and easier to deliver than CBTI. If delivered sustainably within Primary Care, BBTI can help increase access to evidence-based insomnia care and overcome barriers related to accessing CBTI. The proposed study has potential to significantly impact, and improve, how insomnia care is delivered in VA. It is responsive to VA ORD priorities of expanding access to high quality clinical trials and increasing the real-world impact of VA research. Also, it targets HSR&D research, and ORD clinical, priority areas (access to care, mental health, primary care practice, virtual care/telehealth) using a cross-cutting health services research methodology, implementation science. Innovativeness: The study design is rigorous, pragmatic, and features innovative methods, notably a stepped- wedge, hybrid implementation-effectiveness design. This study is unique—a search of VA ORD and NIH funded studies found there are no studies testing implementation strategies to improve the delivery of BBTI in Primary Care. Focusing on implementation outcomes and treatment effectiveness will help produce results that can improve access to care for a prevalent disorder and more rapidly translate results into practice and policy. Specific Aims: Aim 1 will compare the impact of PCMHI clinicians trained to deliver BBTI vs. the impact of BBTI training plus 12-months of access to an implementation strategy bundle (BBTI+IS). BBTI+IS vs. BBTI training alone is expected to result in more Veterans with access to insomnia care in the Primary Care setting. Aim 2 will identify specific strategies that promote successful implementation of BBTI in PCMHI through the use of qualitative interviews and surveys with clinical stakeholders at each study site. Methodology: This stepped-wedge, hybrid III implementation-effectiveness trial involves four VA Medical Centers/Health Care Systems: Baltimore, Durham, Minneapolis, and Philadelphia. The stepped-wedge design allows for fewe...