The Redesign and Validation of Multimodal Motion-Assisted Memory Desensitization and Reconsolidation Hardware and Software: Mixed Methods, Modified Delphi–Based Validation Study (Preprint)
Abstract
BACKGROUND In recent years, the delivery of evidence-based therapies targeting posttraumatic stress disorder (PTSD) has been the focus of the Departments of Defense in countries such as Canada, the Netherlands, and the United States. More than 66% of military members continue to experience symptoms of PTSD that significantly impact their daily functioning and quality of life after completing evidence-based treatments. Innovative, engaging, and effective treatments for PTSD are needed. Multimodal motion-assisted memory desensitization and reconsolidation (3MDR) is an exposure-based, virtual reality–supported therapy used to treat military members and veterans with treatment-resistant PTSD. Given the demonstrated efficacy of 3MDR in recently published randomized control trials, there is both an interest in and a need to adapt the intervention to other populations affected by trauma and to improve accessibility to the treatment. OBJECTIVE We aimed to further innovate, develop, and validate new and existing hardware and software components of 3MDR to enhance its mobility, accessibility, feasibility, and applicability to other populations affected by trauma, including public safety personnel (PSP), via international collaboration. METHODS This study used a modified Delphi expert consultation method and mixed methods quasi-experimental validation with the purpose of software validation among PSP (first responders, health care providers) participants (N=35). A team of international experts from the Netherlands, the United States, and Canada met on the web on a weekly basis since September 2020 to discuss the adoption of 3MDR in real-world contexts, hardware and software development, and software validation. The evolution of 3MDR hardware and software was undertaken followed by a mixed methods software validation study with triangulation of results to inform the further development of 3MDR. RESULTS This study resulted in the identification, description, and evolution of hardware and software components and the development of new 3MDR software. Within the software validation, PSP participants widely acknowledged that the newly developed 3MDR software would be applicable and feasible for PSP affected by trauma within their professions. The key themes that emerged from the thematic analysis among the PSP included the desire for occupationally tailored environments, individually tailored immersion, and the applicability of 3MDR beyond military populations. CONCLUSIONS Within the modified Delphi consultation and software validation study, support for 3MDR as an intervention was communicated. PSP participants perceived that 3MDR was relevant for populations affected by trauma beyond military members and veterans. The resulting hardware and software evolution addressed the recommendations and themes that arose from PSP participants. 3MDR is a novel, structured, exposure-based, virtual reality–supported therapy that is currently used to treat military members and veterans with PTSD. Going forward, it is necessary to innovate and adapt 3MDR, as well as other trauma interventions, to increase effectiveness, accessibility, cost-effectiveness, and efficacy among other populations affected by trauma.
Authors 16
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Chelsea Jones Aachen
Alberta Health Services · University of Alberta · Leiden University Medical Center
Affiliation as printed
Alberta Health Services, Edmonton, AB, Canada
Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
Leiden University Medical Center, Leiden University, Leiden, Netherlands
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Affiliation as printed
Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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Affiliation as printed
Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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Leidos (United States) · Naval Health Research Center
Affiliation as printed
Department of Warfighter Performance, Naval Health Research Center, San Diego, CA, United States
Leidos Inc, San Diego, CA, United States
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Leidos (United States) · Naval Health Research Center
Affiliation as printed
Department of Warfighter Performance, Naval Health Research Center, San Diego, CA, United States
Leidos Inc, San Diego, CA, United States
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Leidos (United States) · Naval Health Research Center
Affiliation as printed
Department of Warfighter Performance, Naval Health Research Center, San Diego, CA, United States
Leidos Inc, San Diego, CA, United States
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Walter Reed National Military Medical Center
Affiliation as printed
National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States
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Affiliation as printed
Department of Warfighter Performance, Naval Health Research Center, San Diego, CA, United States
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Nancy van Veelen Aachen
Leiden University Medical Center
Affiliation as printed
Leiden University Medical Center, Leiden University, Leiden, Netherlands
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Arq Psychotrauma Expert Group · Amsterdam University Medical Centers
Affiliation as printed
ARQ National Psychotrauma Center, Diemen, Netherlands
Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, Netherlands
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Alberta Health Services · University of Alberta
Affiliation as printed
Alberta Health Services, Edmonton, AB, Canada
Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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Affiliation as printed
Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Uniformed Services University of the Health Sciences · Center for Neuroscience and Regenerative Medicine
Affiliation as printed
Department of Medicine and Center for Neuroscience and Regenerative Medicine, Uniformed Services University, Bethesda, MD, United States
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Affiliation as printed
Department of Warfighter Performance, Naval Health Research Center, San Diego, CA, United States
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Eric H. G. J. M. Vermetten Aachen
Leiden University Medical Center
Affiliation as printed
Leiden University Medical Center, Leiden University, Leiden, Netherlands
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Affiliation as printed
Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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