RESEARCH

3MDR Cheat Sheet

https://sys.threemdr.himarc.ca/cheat-sheet

- Data collection timeline, survey links, etc.

Research Ethics Protocol

Study Title: Multi-modal, Motion-assisted, Memory Desensitization and Reconsolidation (3MDR) virtual reality-based treatment for individuals with post-traumatic stress disorder and associated conditions: A randomized waitlist control study
Principal Investigator: Dr. Suzette Brémault-Phillips, Professor, Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 8205 - 114 ST NW Edmonton, AB T6G 2G4
Ethics Board: University of Alberta Health Research Ethics Board (HREB)
Protocol #: Pro00084466


Participant ID Codes

- Each 3MDR patient participating in the study must have a unique participant ID code.
- The participant ID code includes a clinic site code, then a hyphen, then a capital "P" (for patient), then a three digit number - example: EOSIC-P001 refers to patient 001 at the EOSIC site (Edmonton Operational Stress Injury Clinic).


- Site codes:

TEST - For testing purposes (data will be ignored)

AHE - Alberta Hospital Edmonton

CDT - University of Calgary Downtown Campus

CGH - Canmore General Hospital

COSIC - Carewest Operational Stress Injury Clinic (Calgary)

EOSIC - Edmonton Operational Stress Injury Clinic

GPRH - Grande Prairie Regional Hospital

LCRH - Lethbridge Chinook Regional Hospital

MCH - Misericordia Hospital

NLRHC - Northern Lights Regional Health Centre (Fort McMurray)

RDAMH - Red Deer Addictions and Mental Health

SCHC - Sheldon Chumir Health Centre (Calgary)

UA - University of Alberta (Corbett Hall)


- Each site assigns participant numbers to its own patients. No need to coordinate with other sites.

- A participant always keeps their ID code throughout the study (even if they cross over from being a waitlist control to a patient).

- A specific participant ID code should only be assigned to one person. If a participant leaves the study without any data being collected, their ID code should not be re-assigned to a new person.

Inclusion / Exclusion Criteria

(Note: Criteria below are from the research ethics protocol. Individual clinics may have additional criteria.)

- From one or more of the following groups:
regular and reserve Canadian Armed Forces service members and veterans,
public safety personnel (PSP - e.g., paramedics, police, firefighters, and correction officers),
healthcare professionals (HCP),
essential service providers (ESP),
adult family members of the aforementioned groups, or
members of the general public affected by trauma;

- With one or more of the following concerns present for at least 3 months:
(a) diagnosis of PTSD;
(b) indication of PTSD based on a score ≥ 30 on the Clinician-Administered PTSD Scale (CAPS-5) on either worst or past month;
(c) a post-traumatic stress injury (PTSI), operational stress injury, or other associated mental health condition;
(d) trauma associated with service provision during the COVID-19 pandemic;
(e) military sexual trauma; and/or
(f) moral injury;

- Age 18 or more years;

- English speaking and capable of giving informed consent in English;

- Agree to be screened by a research team member for study eligibility;

- Be able to participate in 3MDR at one of the 3MDR study sites for 2 hours, once a week for 10 to 14 consecutive weeks and engage in follow-up sessions;

- Be under the care of a healthcare provider or team (primary / lead service provider) for physical and mental health needs during the course of 3MDR and following receipt of the intervention;

- If the individual's 3MDR therapist is not their regular mental healthcare provider, the primary / lead service provider would need to endorse the individual's potential participation in the 3MDR study by signing the 3MDR Referral Form ;

- Able to tolerate strong emotions;

- Be able to process trauma, learn new things, and reconsolidate memories;

- Be able to walk on a treadmill for 1 hour (or if the individual uses a wheelchair, be able to maintain a regular wheelchair pace for 60 minutes on a wheelchair trainer unit, which is equivalent to a treadmill for a wheelchair user);

- If undergoing pharmacotherapy, participants must be stable on their current psychotropic medication for a period of 4 weeks before entering the trial and agree to not increase dosages or add any new medications during the course of the trial;

- If undergoing psychotherapeutic intervention, participants must be stable on a consistent treatment regime and agree not to enter into new interventions during receipt of the 3MDR intervention;

- If using substances (e.g., alcohol or cannabis), use must be stable and not interfere with effectively engaging in trauma therapy.


Information and Consent Form

- Form is filled online. Link is at the top of the 3MDR Cheat Sheet.
- A participant must sign the consent form before any data is collected or 3MDR therapy administered.
- Participant must have the chance to ask questions. For questions a clinician is not comfortable answering, please forward to the research team.

Surveys

- Surveys are filled in online at various points during 3MDR.
- Surveys schedule and links are in the 3MDR Cheat Sheet.
- Each survey starts with an Admin form to be filled out by the clinician, prior to handing over to the participant.
- Alternately, a custom survey link can be sent to the participant, including prefilling the Admin form data.

Privacy Risk with Microsoft Edge and Google Chrome

- By default, the Microsoft Edge and Google Chrome web browsers enable a participant to see previous participants' answers on the consent form or surveys, including names, emails, etc. This is a problem with those web browsers, not the survey website. This problem also affects all web-based forms, not just this study's web forms.
- Clear browser cache to remove old, saved form data.
- Possible fixes:
- Disable autofilling of form data. (This is our recommended fix.)
- For MS Edge, see this link (last checked June 11, 2024).
- For Google Chrome, see this link (last checked June 11, 2024).
- Run browser in incognito mode to prevent saving new form answers (but will still show any previously-saved form answers, so first clear cache).
- Use another browser (eg: Firefox).

Verbal Clinical Summary at End of Session

- At the end of each recorded session (preparatory session, treadmill session, reconsolidation session, etc.), we ask that the clinician speak into the camera and give a brief clinical summary of the session, before turning off video recording in OBS Studio.
- Please include:
- How did the client present at the start, when they first arrived?
- What did you work on during the session - eg: which index trauma or trauma theme?
- How did the session go (both treadmill portion if applicable and reconsolidation)?
- What worked well and what did not?
- If something in the session did not go well, what was it and why?
- Did the client have external life circumstances that affected the session (eg: death in the family)?
- Was there something about 3MDR itself that caused an issue?
- How did the client present at the end, just before leaving?
- What is the plan for the next 3MDR session, including any changes for next session (eg: new pictures)?

LEC-5 Interview (optional)

- Timeline and links for web-based LEC-5 Interview are in the 3MDR Cheat Sheet.
- The LEC-5 Interview and the LEC-5 self report questionnaire both identify the client's past traumatic experiences, including the worst traumatic event (i.e. index trauma). Both ask similar questions, one in interview form and the other in self report questionnaire form.
- The LEC-5 Interview is optional. Before doing the CAPS-5 Interview, the client will typically have done the baseline survey, which includes the LEC-5 self report questionnaire. If the clinician wants additional details, they may also opt to do the LEC-5 Interview with the client.
- The CAPS-5 Interview is designed to be done after the LEC-5 self report questionnaire and/or the LEC-5 Interview. If the LEC-5 Interview is used, it should be administered just before the first CAPS-5 Interview. (The LEC-5 Interview is not needed at later time points, unless the patient experiences a new, substantial trauma during the course of 3MDR therapy.)

CAPS-5 Interview

- Timeline and links for web-based CAPS-5 Brief Version are in the 3MDR Cheat Sheet.
- Clinician may also want a copy of the full CAPS-5 for reference during an interview.

3MDR Exit Form

- Link is at the bottom of the 3MDR Cheat Sheet.
- Please fill this out when a client finishes the 10-14 week 3MDR program or otherwise leaves the study.

Video Recording

- We ask that video recording be done for all 3MDR sessions.
- For technical details of video recording, see here .