Pre‐Implementation Strategies to Adapt and Implement a Veteran Peer Coaching Intervention to Improve Mental Health Treatment Engagement Among Rural Veterans

Koenig, Christopher J.; Abraham, Traci H.; Zamora, Kara; Hill, Coleen; Kelly, P. Adam; Uddo, Madeline; Hamilton, Michelle; Pyne, Jeffrey M.; Seal, Karen H.

doi:10.1111/jrh.12201

Cited by 55 publications

(40 citation statements)

References 48 publications

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“…With a typically shorter turnaround time, qualitative researchers in implementation science have turned toward rapid analysis techniques in which key concepts are identified in advance to structure and focus the inquiry (32, 39). In the rapid analytic approach used by Hamilton (39), main topics (domains) are drawn from interview and focus group guides and a template is developed to summarize transcripts (32, 49). Summaries are analyzed using matrix analysis, and key actionable findings are shared with the implementation team to guide further implementation (e.g., the variable use of implementation strategies) in real time, particularly during phased implementation research such as in a hybrid type II study (20).…”

Section: Procedures For Collecting Qualitative Datamentioning

confidence: 99%

Innovations in Mixed Methods Evaluations

Palinkas

Mendon

Hamilton

2019

Annu. Rev. Public Health

221

128

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Mixed methods research—i.e., research that draws on both qualitative and qualitative methods in varying configurations—is well suited to address the increasing complexity of public health problems and their solutions. This review focuses specifically on innovations in mixed methods evaluations of intervention, program or policy (i.e., practice) effectiveness and implementation. The article begins with an overview of the structure, function and process of different mixed methods designs and then provides illustrations of their use in effectiveness studies, implementation studies, and combined effectiveness-implementation hybrid studies. The article then examines four specific innovations: procedures for transforming (or “quantitizing”) qualitative data, applying rapid assessment and analysis procedures in the context of mixed methods studies, development of measures to assess implementation outcomes, and strategies for conducting both random and purposive sampling particularly in implementation-focused evaluation research. The article concludes with an assessment of challenges to integrating qualitative and quantitative data in evaluation research.

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Section: Procedures For Collecting Qualitative Datamentioning

confidence: 99%

Innovations in Mixed Methods Evaluations

Palinkas

Mendon

Hamilton

2019

Annu. Rev. Public Health

221

128

View full text Add to dashboard Cite

show abstract

“…A significant proportion of veterans who receive care from the VHA are located in rural areas distant from VHA medical centers. 23 Given that communitybased clinics provide more limited mental health services, 24,25 veterans seeking specialty mental healthcare often must travel great distances to access appropriate treatment. Research has shown that greater distance from providers predicts decreased engagement in psychotherapy among veterans with a diagnosed mental health condition.…”

Section: Introductionmentioning

confidence: 99%

“…19,24 Indeed, these are among the most commonly cited reasons for not initiating treatment or for the premature discontinuation of treatment among veterans. 18,25,26 Social barriers may also impede treatment engagement, some of which may be particularly salient to individuals who have experienced a sexual trauma. For instance, veterans have described fears of being judged for seeking therapy and/or for disclosing their trauma, 14,27 as well as a fear that providers and institutions may not believe their report of experiencing MST.…”

Section: Introductionmentioning

confidence: 99%

Comparing PTSD treatment retention among survivors of military sexual trauma utilizing clinical video technology and in-person approaches

et al. 2019

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Introduction Interventions such as Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) have demonstrated efficacy for the treatment of post-traumatic stress disorder (PTSD) following military sexual trauma (MST). However, MST survivors report a number of logistical and social barriers that impede treatment engagement. In an effort to address these barriers, the Veterans Health Administration offers remote delivery of services using clinical video technology (CVT). Evidence suggests PE and CPT can be delivered effectively via CVT. However, it is unclear whether rates of veteran retention in PTSD treatment for MST delivered remotely is comparable to in-person delivery in standard care. Methods Data were drawn from veterans ( N = 171, 18.1% CVT-enrolled) with PTSD following MST who were engaged in either PE or CPT delivered either via CVT or in person. Veterans chose their preferred treatment modality and delivery format in collaboration with providers. Data were analysed to evaluate full completion (FP) of the protocol and completion of a minimally adequate care (MAC) number of sessions. Results FP treatment completion rates did not differ significantly by treatment delivery format. When evaluating receipt of MAC care, CVT utilizers were significantly less likely to complete. Kaplan–Meier analyses of both survival periods detected significant differences in attrition speed, with the CVT group having higher per-session attrition earlier in treatment. Discussion Disengagement from CVT-delivered treatment generally coincided with early imaginal exposures and writing of trauma narratives. CVT providers may have to take special care to develop rapport and problem-solve anticipated barriers to completion to retain survivors in effective trauma-focused interventions.

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“…Practical barriers such as inadequate transportation, shortage of local providers, and constraints due to work, school, or caregiving responsibilities are commonly cited impediments to treatment seeking both among veterans 9,12,13 and the general population. 14,15 A significant proportion of Veteran's Health Administration (VHA) users are located in rural areas distant from VHA medical centres.…”

Section: Introductionmentioning

confidence: 99%

“…14,15 A significant proportion of Veteran's Health Administration (VHA) users are located in rural areas distant from VHA medical centres. 16 Given that community based clinics often provide more limited mental health services, 12,17 veterans seeking mental health care often must travel great distances. Research has shown distance from providers predicts decreased engagement in psychotherapy among veterans with mental health conditions.…”

Section: Introductionmentioning

confidence: 99%

Demographic and psychiatric predictors of engagement in psychotherapy services conducted via clinical video telehealth

2018

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Introduction Military veterans are at high risk for developing mental health problems. Unfortunately, veterans have relatively low rates of engagement in mental health services compared with non-veterans. In order to address barriers to mental health care services, the Veteran’s Health Administration (VHA) has implemented clinical video telehealth (CVT). Although the effectiveness of this technology appears promising, there is limited research evaluating rates of engagement in CVT mental health services or what factors may predict premature attrition from mental health care delivered via this format. Methods The present study aimed to investigate treatment engagement among veterans enrolled in psychotherapy delivered via CVT, as well as to explore the effects of various demographic and clinical characteristics on these outcomes. Participants were 250 veterans with consults placed to the CVT clinic at a large Midwestern VHA. To evaluate characteristics related to therapy retention, demographic and symptom profile information was gathered from a subset of 93 participants who attended at least one CVT psychotherapy appointment. Results Results indicated there were no significant demographic differences between veterans who attended at least one CVT appointment and those who did not attend at least one session. Demographic variables were not related to the number of CVT visits attended. Regarding psychological characteristics, veterans with anxiety disorders attended fewer CVT appointments overall than veterans with mood disorders and attendance at CVT was negatively correlated with anxiety severity. Discussion These findings have potential implications for providers working in CVT clinics as well as for future research in this area.

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Pre‐Implementation Strategies to Adapt and Implement a Veteran Peer Coaching Intervention to Improve Mental Health Treatment Engagement Among Rural Veterans

Cited by 55 publications

References 48 publications

Innovations in Mixed Methods Evaluations

Innovations in Mixed Methods Evaluations

Comparing PTSD treatment retention among survivors of military sexual trauma utilizing clinical video technology and in-person approaches

Demographic and psychiatric predictors of engagement in psychotherapy services conducted via clinical video telehealth

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