A complementary and integrative health group-based program pilot demonstrates positive health outcomes with female Veterans

Haun, Jolie; Paykel, Jacquelyn; Alman, Amy C.; Patel, Nitin; Melillo, Christine

doi:10.1016/j.explore.2019.08.001

Cited by 13 publications

(6 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… During the study period, is the intervention administered (or exposure occurred) as intended? Clare et al 2019 [ 39 ] Yes Yes Yes Yes No No Yes 60 Geller et al 2015 [ 48 ] Yes Yes Not Assessable Yes No No Yes 40 Harpole et al 2003 [ 49 ] Yes Yes Not Assessable Yes No Not Assessable Yes 40 Haun et al 2020 [ 50 ] Yes Yes No Yes No Yes Yes 60 Mehl-Madrona et al 2016 [ 51 ] Yes Yes Yes Yes No Not Assessable Yes 60 Meriwether, Vellenga, Ravichandran, et al 2022 [ 53 ] Yes Yes Yes Yes No Yes No 60 Taube et al 2021 [ 64 ] …”

Section: Resultsmentioning

confidence: 99%

Determinants of implementation for group medical visits for patients with chronic pain: a systematic review

Roth,

Tiedt,

Brintz

et al. 2024

Implement Sci Commun

View full text Add to dashboard Cite

Background Despite the critical need for comprehensive and effective chronic pain care, delivery of such care remains challenging. Group medical visits (GMVs) offer an innovative and efficient model for providing comprehensive care for patients with chronic pain. The purpose of this systematic review was to identify barriers and facilitators (determinants) to implementing GMVs for adult patients with chronic pain. Methods The review included peer-reviewed studies reporting findings on implementation of GMVs for chronic pain, inclusive of all study designs. Pubmed, EMBASE, Web of Science, and Cochrane Library were searched. Studies of individual appointments or group therapy were excluded. The Mixed Methods Appraisal Tool was used to determine risk of bias. Data related to implementation determinants were extracted independently by two reviewers. Data synthesis was guided by the updated Consolidated Framework for Implementation Research. Results Thirty-three articles reporting on 25 studies met criteria for inclusion and included qualitative observational (n = 8), randomized controlled trial (n = 6), quantitative non-randomized (n = 9), quantitative descriptive (n = 3), and mixed methods designs (n = 7). The studies included in this review included a total of 2364 participants. Quality ratings were mixed, with qualitative articles receiving the highest quality ratings. Common multi-level determinants included the relative advantage of GMVs for chronic pain over other available models, the capability and motivation of clinicians, the cost of GMVs to patients and the health system, the need and opportunity of patients, the availability of resources and relational connections supporting recruitment and referral to GMVs within the clinic setting, and financing and policies within the outer setting. Conclusions Multi-level factors determine the implementation of GMVs for chronic pain. Future research is needed to investigate these determinants more thoroughly and to develop and test implementation strategies addressing these determinants to promote the scale-up of GMVs for patients with chronic pain. Trial registration This systematic review was registered with PROSPERO 2021 CRD42021231310.

show abstract

Section: Resultsmentioning

confidence: 99%

Determinants of implementation for group medical visits for patients with chronic pain: a systematic review

Roth,

Tiedt,

Brintz

et al. 2024

Implement Sci Commun

View full text Add to dashboard Cite

show abstract

“…The organizational priority of Whole Health (the motivation and readiness of VA employees) and the desire for access to Whole Health by veterans supported implementation of Whole Health within the VA. Resources and leadership endorsement facilitated implementation; however, due to the largescale national implementation, limited resources present barriers. Recent works have demonstrated wide range benefit of Whole Health organization to, most importantly, the individual veteran (Elwy et al, 2020;Goldberg et al, 2019;Haun et al, 2020;Herman et al, 2019;Taylor, Herman, et al, 2019). To support implementation of Whole Health to improve veterans' lives requires cultural transformation, further employee training and knowledge translation, and optimization of veteran engagement and outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Whole Health model implementation began in 2018 with the announcement of 18 design sites and 18 flagship sites. Design sites implemented specific elements of Whole (Elwy et al, 2020;Haun et al, 2020). This project aimed to evaluate implementation of the Whole Health approach through a descriptive and observational evaluation of both design and flagship facilities during FY 2018.…”

Section: Introductionmentioning

confidence: 99%

Evaluating a Whole Health Approach to Enhance Veteran Care: Exploring the Staff Experience

Haun

Melillo

Cotner

et al. 2021

JVS

Self Cite

View full text Add to dashboard Cite

The Whole Health Initiative is a redesign of health care delivery that focuses on admini stering personalized veteran health plans rather than focusing on treating disease. In 2018, Whole Health launched at 36 Veteran Affairs (VA) facilities throughout the country. Flagship sites (N = 18) implemented the full Whole health system and design sites (N = 18) implemented elements of Whole Health. The project purpose was to identify efforts to improve implementation for this national initiative to improve veterans' lives. This evaluation project used a crosssectional design to obtain qualitative semistructured interview data. Rapid analysis using Consolidated Framework for Implementation Research Constructs (CFIR) was used to identify themes. A snowball sample of 45 staff participants from five design sites and one flagship site participated. Participants represented management and providers among other Whole Health staff. Facilities varied in the degree to which Whole Health was implemented. The provision of leadership support and resources, the need to address national policies and procedures and the need for standardized measures used to measure Whole Health outcomes were common experiences. Implementation of Whole Health to improve veterans' lives is a complex endeavor. Providers, clinicians, and leadership are engaged and motivated to implement this new delivery model at their facilities, understanding it changes the focus of their relationships with veterans from one of focusing on problems to one of collaboratively working with veterans to achieve individual health goals. Identified barriers limit implementation and expose issues such as lack of facility resources, hiring and training mechanisms, and leadership endorsement. Whole Health is a priority within the VA and the motivation and readiness of VA staff to move into a more collaborative relationship with the veterans they serve are foundational to success and longevity of the program. Our findings created an opportunity to promote sustainable outcomes for future Whole Health implementation efforts.

show abstract

“…Effectiveness can be measured in many ways (eg, clinical outcomes, organizational outcomes). A recent evaluation of 201 female veteran participants in THRIVE demonstrated the effectiveness of this program at improving self-reported mental health outcomes, such as depression, anxiety, psychological inflexibility, and experiential avoidance, as well as improvements in life satisfaction and work pain interference [ 21 ]. Organizational outcomes such as cost-effectiveness are currently under review.…”

Section: Methodsmentioning

confidence: 99%

Transforming Health and Resiliency Through Integration of Values-based Experiences: Implementation of an Electronic Evidence-based Whole Health Clinical Program

Haun¹,

Paykel²,

Melillo³

2021

JMIR Form Res

Self Cite

View full text Add to dashboard Cite

Background Complementary and integrative health (CIH) is the foundation of the Department of Veterans Affairs (VA) Whole Health System program (WH), including Transforming Health and Resiliency through Integration of Values-based Experiences (THRIVE). The global COVID-19 pandemic prompted an urgent need to provide services such as THRIVE while following guidelines for social distancing. Objective The objective of this paper was to describe the systematic implementation of THRIVE using an electronic delivery model. Methods The study involved an observational clinical program implementation project using the RE-AIM framework to contextualize the implementation strategies and results, and then the implementation of an electronically delivered CIH group medical appointment program (eTHRIVE). Results Clinical staff transitioned to 100% electronic delivery of the THRIVE curriculum using the new eTHRIVE delivery model. The current electronic delivery model, eTHRIVE, has effectively enrolled 10-12 veterans per cohort, with 8 cohorts, totaling 87 veterans to date. eTHRIVE attrition has been 6% (5/87) since initiation. Conclusions The current climate of the VA WH programmatic initiative combined with the public health needs during a global pandemic prompted the move of THRIVE program into an electronic format to broaden scalability and reach.

show abstract

A complementary and integrative health group-based program pilot demonstrates positive health outcomes with female Veterans

Cited by 13 publications

References 29 publications

Determinants of implementation for group medical visits for patients with chronic pain: a systematic review

Determinants of implementation for group medical visits for patients with chronic pain: a systematic review

Evaluating a Whole Health Approach to Enhance Veteran Care: Exploring the Staff Experience

Transforming Health and Resiliency Through Integration of Values-based Experiences: Implementation of an Electronic Evidence-based Whole Health Clinical Program

Contact Info

Product

Resources

About