# Enhancing Access to Insomnia Care (EASI Care): Implementing Brief Behavioral Treatment for Insomnia in Primary Care Mental Health Integration Clinics

> **NIH VA I01** · VETERANS HEALTH ADMINISTRATION · 2024 · —

## Abstract

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...

## Key facts

- **NIH application ID:** 10248294
- **Project number:** 5I01HX003096-02
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** ADAM DANIEL BRAMOWETH
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2020-09-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10248294

## Citation

> US National Institutes of Health, RePORTER application 10248294, Enhancing Access to Insomnia Care (EASI Care): Implementing Brief Behavioral Treatment for Insomnia in Primary Care Mental Health Integration Clinics (5I01HX003096-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10248294. Licensed CC0.

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