Supporting equitable engagement and retention of women patients in a trauma-informed virtual mental health intervention: Acceptability and needed adaptations.

Abstract

Objective: This study examines barriers and facilitators to participation in webSTAIR, a telemental health program providing virtual coaching sessions for veterans with posttraumatic stress disorder (PTSD) and depression symptoms, among women veterans from racial and ethnic minority groups.

Method: Using qualitative interviews (n = 26), we compared women veterans from racial and ethnic minority groups who completed (completers; n = 16) and did not complete (noncompleters; n = 11) webSTAIR at rural-serving facilities in the Veterans Health Administration (VA). Interview data were analyzed using rapid qualitative analysis. Chi-square and t tests assessed differences between completers and noncompleters by sociodemographic characteristics and baseline PTSD and depression symptomatology.

Results: There were no statistically significant sociodemographic differences at baseline between completers and noncompleters; completers reported significantly higher baseline PTSD and depression symptomatology. Noncompleters were more likely to describe feeling angry, depressed, and unable to control their environments during participation in the program as barriers to webSTAIR completion. Completers, despite higher symptomatology, cited internal motivation and support from concurrent mental health services as facilitators. Both groups made recommendations for how VA can better support women veterans from racial and ethnic minority groups, including providing space for peer support and community building, addressing stigma associated with seeking mental health services and fostering mental health provider diversity and retention.

Conclusions and implications for practice: Although previous research has identified racial and ethnic disparities in PTSD treatment retention, mechanisms to improve retention have been unclear. Women veterans from racial and ethnic minority groups should be collaboratively engaged in the design and implementation of telemental health programs for PTSD to improve equitable retention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).