Veteran participation in the integrative health and wellness program: Impact on self-reported mental and physical health outcomes.

Abstract

Complementary and integrative health (CIH) services are being used more widely across the nation, including in both military and veteran hospital settings. Literature suggests that a variety of CIH services show promise in treating a wide range of physical and mental health disorders. Notably, the Department of Veterans Affairs is implementing CIH services within the context of a health care transformation, changing from disease based health care to a personalized, proactive, patient-centered approach where the veteran, not the disease, is at the center of care. This study examines self-reported physical and mental health outcomes associated with participation in the Integrative Health and Wellness Program, a comprehensive CIH program at the Washington DC VA Medical Center and one of the first wellbeing programs of its kind within the VA system. Using a prospective cohort design, veterans enrolled in the Integrative Health and Wellness Program filled out self-report measures of physical and mental health throughout program participation, including at enrollment, 12 weeks, and 6 months. Analyses revealed that veterans reported significant improvements in their most salient symptoms of concern (primarily pain or mental health symptoms), physical quality of life, wellbeing, and ability to participate in valued activities at follow-up assessments. These results illustrate the potential of CIH services, provided within a comprehensive clinic focused on wellbeing not disease, to improve self-reported health, wellbeing, and quality of life in a veteran population. Additionally, data support recent VA initiatives to increase the range of CIH services available and the continued growth of wellbeing programs within VA settings. (PsycINFO Database Record

Examining the Impact of a Peer-Led Group Program for Veteran Engagement and Well-Being

“…It is possible that this reduction in stress occurred through use of the program's recommended mindful awareness practices, as studies show that such practices are effective for stress management. 27,28 Veterans also reported improvements on the PROMIS-10, suggesting that TCMLH not only prepares patients to engage in their health care but may also have direct impacts on quality of life.…”

Achieving Whole Health: A Preliminary Study of TCMLH, a Group-Based Program Promoting Self-Care and Empowerment Among Veterans

“…Veterans also reported reductions in perceived stress following the program. Findings from similar program evaluations suggest that learned skills related to mindful awareness practices may foster this outcome by providing veterans with an effective coping tool (Hull et al, 2019; B. W. Smith et al, 2008).…”

“…Using the TCMLH manual, facilitators guide participants through conversations about their health using the circle of health (Figure 1; OPCC and CT, 2020) and Personal Health Inventory (PHI; Supplemental Appendix A; OPCC and CT, 2019) as self-assessment tools to (a) highlight how the body, mind, environment, and relationships are interrelated and affect veterans’ well-being and (b) identify areas of self-care where veterans are motivated to make changes. Each time they meet, the groups engage in facilitated self-care practices, including mindful awareness (Carlson et al, 2013; Hull et al, 2019; Siegel, 2009). In addition, veterans develop “S.M.A.R.T.” (specific, measurable, action-oriented, realistic, and timed) goals and action steps that address personal barriers and utilize accountability partners to achieve success (Lawn & Schoo, 2010).…”

“…The TCMLH group program builds on evidence suggesting the following elements can help individuals with chronic conditions achieve better health: (a) integrated, person-driven care (Hibbard & Greene, 2013; Jackson et al, 2013; Rosenthal et al, 2016); (b) shared decision making (Coulter et al,1999; Q. W. Smith et al, 2013); (c) effective goal setting (Lawn & Schoo, 2010); (d) mindful awareness (Carlson et al, 2013; Hull et al, 2019; Siegel, 2009); and (e) peer support and group-based health education programming (Chang et al, 2009; Davidson et al, 2012; DeCoster & George, 2005; Eisen et al, 2012; Epstein & Street, 2011; Lorig et al, 1999; Parchman et al, 2010). TCMLH’s development also relied heavily on the theoretical underpinnings of peer support for health promotion, which emphasizes three attributes of successful peer-based interventions: emotional, informational, and appraisal support (Dennis, 2003).…”

Engagement, experience, and satisfaction with peer-delivered whole health coaching for veterans with PTSD: A mixed methods process evaluation.

“…The Whole Health initiative is focused on making VA healthcare personalized, proactive, and patient-driven and targets all the elements of an individual’s health and wellness (e.g., community, professional care, and self-care; Krejci et al, 2014). Early research on Whole Health suggests positive benefits, but to our knowledge, no articles have yet evaluated peer-delivered Whole Health Coaching (Denneson et al, 2019; Hull et al, 2019; Mori et al, 2019). In fact, the reviews cited previously suggest a need for more rigorous evaluation of peer-delivered Whole Health Coaching, including the need to disentangle the unique contributions of the peers and interventions (Cabassa et al, 2017).…”