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NCT05805657

Implementing and Sustaining a Sleep Treatment to Improve Community Mental Health Part 2: Train-the-Trainer

Completed NA Results posted Last updated 23 October 2025
What this trial tests

NA trial testing Standard Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) in Sleep Disorder in 196 participants. Completed in 8 May 2024.

Timeline
14 December 2020
Primary endpoint
8 May 2024
8 May 2024

Quick facts

Lead sponsorUniversity of California, Berkeley
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingsingle
Primary purposehealth services research
Enrollment196
Start date14 December 2020
Primary completion8 May 2024
Estimated completion8 May 2024
Sites9 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

University of California, Berkeley

Who can join

18 and older, any sex, with Sleep Disorder or Circadian Dysregulation. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Patient-level Outcome: Patient-Reported Outcomes Measurement Information System - Sleep DisturbanceMeasurement Information System - Sleep Disturbance Primary · Baseline, mid-treatment (2/4 weeks post-baseline), post-treatment (4/8 weeks post-baseline - the UC-DT post-assessment follows the same timeframe post-usual care and delayed treatment) for Adapted/Standard TranS-C, respectively, and 6-month follow-up.

Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance Scale. The 8-item short version scale assesses perceived sleep problems (e.g., sleep quality, perception of sleep difficulties) over a 7-day period. Items are rated on a 5-point scale ranging from 1 (not at all) to 5 (very much). Raw scores are summed to produce a single score, resulting in a range from 8 to 40. Raw scores are converted to t-scores using treatment manuals. T-scores range from 30.5 to 77.5. A T-score of 50 indicates the population mean with a standard deviation of 10. Higher scores indicate wors

Baseline
GroupValue95% CI
Standard TranS-C (Immediate)66.67± 6.44
Adapted TranS-C (Immediate)62.21± 7.73
Standard TranS-C (UC-DT)60.54± 5.63
Adapted TranS-C (UC-DT)62.24± 7.34
Immediate TranS-C62.71± 7.69
UC-DT62.05± 7.14
Standard TranS-C63.81± 6.66
Adapted TranS-C62.23± 7.52
TranS-C62.40± 7.42
Mid-treatment
GroupValue95% CI
Standard TranS-C (Immediate)49.55± 2.33
Adapted TranS-C (Immediate)53.81± 9.58
Immediate TranS-C53.60± 9.39
Standard TranS-C50.08± 2.65
Adapted TranS-C55.10± 9.27
TranS-C54.80± 9.08
Post-treatment
GroupValue95% CI
Standard TranS-C (Immediate)51.05± 15.23
Adapted TranS-C (Immediate)55.06± 10.76
Standard TranS-C (UC-DT)61.48± 10.37
Adapted TranS-C (UC-DT)61.04± 8.52
Immediate TranS-C54.74± 11.04
UC-DT61.08± 8.59
Standard TranS-C54.21± 12.22
Adapted TranS-C55.21± 11.18
TranS-C55.12± 11.19
6-month follow-up
GroupValue95% CI
Standard TranS-C (Immediate)52.35± 5.83
Adapted TranS-C (Immediate)52.48± 10.34
Immediate TranS-C52.47± 10.07
Standard TranS-C54.86± 6.74
Adapted TranS-C53.54± 10.05
TranS-C53.63± 9.84
Provider-level Outcome: Acceptability Intervention Measure Primary · Baseline, mid-treatment (2 weeks post-baseline for Adapted TranS-C and 4 weeks post-baseline for Standard TranS- C), post-treatment (4 weeks post-baseline for Adapted TranS-C and 8 weeks post-baseline for Standard TranS-C).

Assesses provider perceptions of the acceptability of the treatment intervention using a self-report questionnaire. The 4-item scale is rated on a 5-point scale from 1 (completely disagree) to 5 (completely agree). A total score is calculated by averaging all four items. Total scores range from 1 to 5, with higher scores indicating greater perceptions of acceptability.

Baseline
GroupValue95% CI
Standard TranS-C - Providers4.90± 0.22
Adapted TranS-C - Providers4.74± 0.41
TranS-C - Providers4.76± 0.39
Mid-treatment
GroupValue95% CI
Standard TranS-C - Providers5.00± 0.00
Adapted TranS-C - Providers4.64± 0.44
TranS-C - Providers4.65± 0.44
Post-treatment
GroupValue95% CI
Standard TranS-C - Providers5.00± 0.00
Adapted TranS-C - Providers4.54± 0.58
TranS-C - Providers4.56± 0.57
Patient-level Outcome: Patient-Reported Outcomes Measurement Information System - Sleep Related Impairment Secondary · Baseline, mid-treatment (2/4 weeks post-baseline), post-treatment (4/8 weeks post-baseline - the UC-DT post-assessment follows the same timeframe post-usual care and delayed treatment) for Adapted/Standard TranS-C, respectively, and 6-month follow-up.

Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Impairment Scale. The 8-item short version scale assesses perceived sleep problems during waking hours (e.g., alertness, sleepiness, tiredness) over a 7-day period. Items are rated on a 5-point scale ranging from 1 (not at all) to 5 (very much). Raw scores are summed to produce a single score, resulting in a range from 8 to 40. Raw scores are converted to t-scores using treatment manuals. T-scores range from 30.1 to 80.1. A T-score of 50 indicates the population mean with a standard deviation of 10. Higher scores indicate

Baseline
GroupValue95% CI
Standard TranS-C (Immediate)63.12± 10.63
Adapted TranS-C (Immediate)60.30± 8.57
Standard TranS-C (UC-DT)59.24± 10.79
Adapted TranS-C (UC-DT)60.09± 8.58
Immediate TranS-C60.59± 8.76
UC-DT59.98± 8.79
Standard TranS-C61.18± 10.54
Adapted TranS-C60.20± 8.54
TranS-C60.31± 8.75
Mid-treatment
GroupValue95% CI
Standard TranS-C (Immediate)60.20± 5.80
Adapted TranS-C (Immediate)55.67± 10.66
Immediate TranS-C55.89± 10.47
Standard TranS-C55.83± 8.82
Adapted TranS-C56.76± 10.45
TranS-C56.70± 10.30
Post-treatment
GroupValue95% CI
Standard TranS-C (Immediate)48.65± 12.87
Adapted TranS-C (Immediate)52.80± 11.90
Standard TranS-C (UC-DT)59.66± 6.61
Adapted TranS-C (UC-DT)57.71± 8.58
Immediate TranS-C52.46± 11.90
UC-DT57.88± 8.39
Standard TranS-C52.74± 10.56
Adapted TranS-C53.54± 11.14
TranS-C53.48± 11.03
6-month follow-up
GroupValue95% CI
Standard TranS-C (Immediate)50.75± 9.05
Adapted TranS-C (Immediate)53.82± 11.29
Immediate TranS-C53.62± 11.12
Standard TranS-C54.27± 9.82
Adapted TranS-C54.71± 10.90
TranS-C54.68± 10.79
Patient-level Outcome: Composite Sleep Health Score Secondary · Baseline, mid-treatment (2/4 weeks post-baseline), post-treatment (4/8 weeks post-baseline - the UC-DT post-assessment follows the same timeframe post-usual care and delayed treatment) for Adapted/Standard TranS-C, respectively, and 6-month follow-up.

Composite Sleep Health Score is defined as the sum of scores on 6 sleep health dimensions: Regularity (Midpoint sleep fluctuation across a 7-day sleep diary \< 1 hour), Satisfaction (Sleep quality question on PROMIS-Sleep Disturbance (PROMIS = Patient-Reported Outcomes Measurement Information System)), Alertness (Daytime sleepiness question on PROMIS-Sleep Related Impairment (PROMIS = Patient-Reported Outcomes Measurement Information System)), Timing (Mean midpoint sleep across the 7 day sleep diary between 2 and 4 AM), Efficiency (Average sleep efficiency based on the 7 day sleep diary ≥ 85%)

Baseline
GroupValue95% CI
Standard TranS-C (Immediate)3.00± 1.10
Adapted TranS-C (Immediate)2.25± 1.29
Standard TranS-C (UC-DT)2.29± 1.50
Adapted TranS-C (UC-DT)2.45± 1.47
Immediate TranS-C2.31± 1.28
UC-DT2.43± 1.46
Standard TranS-C2.62± 1.33
Adapted TranS-C2.33± 1.37
TranS-C2.36± 1.36
Mid-treatment
GroupValue95% CI
Standard TranS-C (Immediate)3.50± 2.12
Adapted TranS-C (Immediate)3.28± 1.54
Immediate TranS-C3.29± 1.54
Standard TranS-C3.50± 1.73
Adapted TranS-C3.05± 1.54
TranS-C3.08± 1.55
Post-treatment
GroupValue95% CI
Standard TranS-C (Immediate)3.33± 2.52
Adapted TranS-C (Immediate)3.07± 1.59
Standard TranS-C (UC-DT)3.00± 1.41
Adapted TranS-C (UC-DT)2.66± 1.45
Immediate TranS-C3.09± 1.63
UC-DT2.69± 1.44
Standard TranS-C2.50± 2.07
Adapted TranS-C3.07± 1.52
TranS-C3.03± 1.56
6-month follow-up
GroupValue95% CI
Standard TranS-C (Immediate)4.00± 1.41
Adapted TranS-C (Immediate)2.94± 1.62
Immediate TranS-C3.02± 1.62
Standard TranS-C3.57± 1.62
Adapted TranS-C2.90± 1.52
TranS-C2.95± 1.53
Patient-level Outcome: Sheehan Disability Scale Secondary · Baseline, post-treatment (4/8 weeks post-baseline - the UC-DT post-assessment follows the same timeframe post-usual care and delayed treatment) for Adapted/Standard TranS-C, respectively, and 6-month follow-up.

The Sheehan Disability Scale (SDS) assesses impairment in work/school, social, and family life. Items are rated on a scale from 0 (not at all) to 10 (extremely). Items are summed to produce a single score. Scores range from 0 to 30, with higher scores indicating higher functional impairment.

Baseline
GroupValue95% CI
Standard TranS-C (Immediate)15.25± 6.63
Adapted TranS-C (Immediate)12.49± 7.72
Standard TranS-C (UC-DT)11.75± 10.07
Adapted TranS-C (UC-DT)11.88± 7.04
Immediate TranS-C12.77± 7.62
UC-DT11.86± 7.38
Standard TranS-C13.50± 8.43
Adapted TranS-C12.21± 7.40
TranS-C12.36± 7.50
Post-treatment
GroupValue95% CI
Standard TranS-C (Immediate)6.50± 6.35
Adapted TranS-C (Immediate)7.98± 7.06
Standard TranS-C (UC-DT)10.80± 7.66
Adapted TranS-C (UC-DT)11.10± 7.51
Immediate TranS-C7.86± 6.95
UC-DT11.07± 7.46
Standard TranS-C8.86± 7.73
Adapted TranS-C8.36± 6.47
TranS-C8.40± 6.54
6-month follow-up
GroupValue95% CI
Standard TranS-C (Immediate)9.75± 8.26
Adapted TranS-C (Immediate)8.51± 7.06
Immediate TranS-C8.59± 7.07
Standard TranS-C9.71± 8.46
Adapted TranS-C8.70± 7.05
TranS-C8.77± 7.11
Patient-level Outcome: The Diagnostic and Statistical Manual of Mental Disorders Cross-Cutting Symptom Measure Secondary · Baseline, post-treatment (4/8 weeks post-baseline - the UC-DT post-assessment follows the same timeframe post-usual care and delayed treatment) for Adapted/Standard TranS-C, respectively, and 6-month follow-up.

The Diagnostic and Statistical Manual of Mental Disorders Cross-Cutting Symptom Measure (DSM-5) assesses psychiatric symptoms across 13 mental health domains. Participants rate on a 5-point scale how often they were bothered by each symptom on a scale from 0 (not at all) to 4 (nearly every day). Scores range from 0 to 52, with higher scores indicating more severe symptoms.

Baseline
GroupValue95% CI
Standard TranS-C (Immediate)25.38± 8.93
Adapted TranS-C (Immediate)23.48± 8.70
Standard TranS-C (UC-DT)18.75± 5.18
Adapted TranS-C (UC-DT)23.25± 9.48
Immediate TranS-C22.69± 9.15
UC-DT23.68± 8.69
Standard TranS-C22.06± 7.84
Adapted TranS-C23.37± 9.03
TranS-C23.23± 8.89
Post-treatment
GroupValue95% CI
Standard TranS-C (Immediate)14.00± 10.68
Adapted TranS-C (Immediate)17.91± 9.61
Standard TranS-C (UC-DT)20.60± 5.32
Adapted TranS-C (UC-DT)20.67± 8.74
Immediate TranS-C17.59± 9.64
UC-DT20.67± 8.46
Standard TranS-C16.14± 8.07
Adapted TranS-C18.00± 9.34
TranS-C17.84± 9.20
6-month follow-up
GroupValue95% CI
Standard TranS-C (Immediate)14.25± 8.30
Adapted TranS-C (Immediate)18.47± 10.16
Immediate TranS-C18.19± 10.04
Standard TranS-C17.29± 7.20
Adapted TranS-C18.24± 9.51
TranS-C18.18± 9.34
Provider-level Outcome: Intervention Appropriateness Measure Secondary · Baseline, mid-treatment (2 weeks post-baseline for Adapted TranS-C and 4 weeks post-baseline for Standard TranS- C), post-treatment (4 weeks post-baseline for Adapted TranS-C and 8 weeks post-baseline for Standard TranS-C).

Assesses provider perceptions of the appropriateness of the treatment intervention using a self-report questionnaire. The 4-item scale is rated on a 5-point scale from 1 (completely disagree) to 5 (completely agree). A total score is calculated by averaging all four items. Total scores range from 1 to 5, with higher scores indicating greater perceptions of appropriateness.

Baseline
GroupValue95% CI
Standard TranS-C - Providers5.00± 0.00
Adapted TranS-C - Providers4.79± 0.35
TranS-C Providers4.82± 0.33
Mid-treatment
GroupValue95% CI
Standard TranS-C - Providers4.83± 0.29
Adapted TranS-C - Providers4.56± 0.52
TranS-C Providers4.58± 0.51
Post-treatment
GroupValue95% CI
Standard TranS-C - Providers4.75± 0.50
Adapted TranS-C - Providers4.39± 0.67
TranS-C Providers4.41± 0.67
Provider-level Outcome: Feasibility of Intervention Measure Secondary · Baseline, mid-treatment (2 weeks post-baseline for Adapted TranS-C and 4 weeks post-baseline for Standard TranS-C), post-treatment (4 weeks post-baseline for Adapted TranS-C and 8 weeks post-baseline for Standard TranS-C).

Assesses provider perceptions of the feasibility of the treatment intervention using a self-report questionnaire. The 4- item scale is rated on a 5-point scale from 1 (completely disagree) to 5 (completely agree). A total score is calculated by averaging all four items. Total scores range from 1 to 5, with higher scores indicating greater perceptions of feasibility.

Baseline
GroupValue95% CI
Standard TranS-C - Providers4.95± 0.11
Adapted TranS-C - Providers4.59± 0.57
TranS-C - Providers4.64± 0.54
Mid-treatment
GroupValue95% CI
Standard TranS-C - Providers4.83± 0.29
Adapted TranS-C - Providers4.60± 0.54
TranS-C - Providers4.61± 0.53
Post-treatment
GroupValue95% CI
Standard TranS-C - Providers4.44± 0.72
Adapted TranS-C - Providers4.42± 0.65
TranS-C - Providers4.43± 0.65

Sponsor's own description

The train-the-trainer (TTT) approach is a promising method of sustaining training efforts in community mental health centers (CMHCs). This study will test the implementation and effectiveness outcomes of a sleep treatment delivered by CMHC providers who are trained and supervised within CMHCs via TTT. The investigators will test two versions of the sleep treatment, a "Standard" version and an "Adapted" version that has been adapted using theory, data and stakeholder inputs to improve the fit for SMI patients treated in community mental health centers.

Publications & conference data

6 peer-reviewed publications reference this trial (live from Europe PMC):

  1. The Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) for serious mental illness in community mental health part 2: study protocol for a hybrid type 2 effectiveness-implementation cluster-randomized trial using train-the-trainer.
    Callaway CA, Sarfan LD, Agnew ER, Dong L, et al · · 2023 · cited 14× · PMID 37550730 · DOI 10.1186/s13063-023-07523-6
  2. A randomized trial of adapted versus standard versions the transdiagnostic intervention for sleep and circadian dysfunction (TSC) implemented via facilitation and delivered by community mental health providers using train-the-trainer.
    Harvey AG, Agnew ER, Esteva Hache R, Callaway CA, et al · · 2025 · cited 1× · PMID 41318500 · DOI 10.1186/s13012-025-01467-y
  3. Patient outcomes and session dose in a randomized controlled trial of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction: Influential factors and methodological considerations.
    Milner AE, Sarfan LD, Diaz M, Esteva Hache R, et al · · 2026 · PMID 41734718 · DOI 10.1016/j.brat.2026.104987
  4. The Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TSC) in Community Mental Health: Evaluating Self-Reported Psychiatric Disorders as a Predictor of Symptoms and Treatment Outcome
    Horwitz TB, Sarfan LD, Milner AE, Varghese J, et al · · 2025 · DOI 10.21203/rs.3.rs-7189279/v1
  5. A randomized trial of Adapted versus Standard versions the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TSC) implemented via facilitation and delivered by community mental health providers using train-the-trainer
    Harvey A, Agnew ER, Hache RE, Callaway CA, et al · · 2025 · DOI 10.21203/rs.3.rs-6414484/v1
  6. The Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) for serious mental illness in community mental health part 2: Study protocol for a hybrid type 2 effectiveness-implementation cluster-randomized trial using train-the-trainer
    Callaway CA, Sarfan LD, Agnew ER, Dong L, et al · · 2023 · DOI 10.21203/rs.3.rs-2943787/v1

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