Pub Date : 2021-12-02DOI: 10.1080/21635781.2021.2007186
L. VanTil, M. MacLean, J. Coulthard, R. Murray, S. Lourenso, J. Camarda, T. Lea
Abstract Both the Canadian Armed Forces and Veterans Affairs Canada identified the need for a brief standardized tool to screen military members and veterans for the risk of a difficult adjustment to civilian life, frailty, suicide and homelessness. Data from Life After Service Studies (n = 8,101) were used to build logistic regression models of difficult adjustment to civilian life. The resulting brief risk screener was piloted in 2018 (n = 246). The modeling considered 28 risk indicators, used 17 of these to build the models, and maintained 8 questions for a brief risk screener. Optimal cutoff was found with a threshold of 3+ for difficult adjustment to civilian life, with 39% sensitivity (95% CI: 37.9 to 41.1) and 94% specificity (95% CI: 93.1 to 94.6). A longer 10 item questionnaire was implemented. Pilot participants who were help-seeking veteran clients had frequency by risk level of 42% low, 40% moderate, and 18% high. Pilot participants who were serving military members had frequency by risk level of 79% low, 13% moderate, and 8% high. In 2019, Canadian government implemented a new standardized risk screening tool to improve the effectiveness of services and referrals.
{"title":"Risk Screening of Veterans Throughout the Life Course","authors":"L. VanTil, M. MacLean, J. Coulthard, R. Murray, S. Lourenso, J. Camarda, T. Lea","doi":"10.1080/21635781.2021.2007186","DOIUrl":"https://doi.org/10.1080/21635781.2021.2007186","url":null,"abstract":"Abstract Both the Canadian Armed Forces and Veterans Affairs Canada identified the need for a brief standardized tool to screen military members and veterans for the risk of a difficult adjustment to civilian life, frailty, suicide and homelessness. Data from Life After Service Studies (n = 8,101) were used to build logistic regression models of difficult adjustment to civilian life. The resulting brief risk screener was piloted in 2018 (n = 246). The modeling considered 28 risk indicators, used 17 of these to build the models, and maintained 8 questions for a brief risk screener. Optimal cutoff was found with a threshold of 3+ for difficult adjustment to civilian life, with 39% sensitivity (95% CI: 37.9 to 41.1) and 94% specificity (95% CI: 93.1 to 94.6). A longer 10 item questionnaire was implemented. Pilot participants who were help-seeking veteran clients had frequency by risk level of 42% low, 40% moderate, and 18% high. Pilot participants who were serving military members had frequency by risk level of 79% low, 13% moderate, and 8% high. In 2019, Canadian government implemented a new standardized risk screening tool to improve the effectiveness of services and referrals.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"10 1","pages":"17 - 26"},"PeriodicalIF":0.0,"publicationDate":"2021-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60240766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-02DOI: 10.1080/21635781.2021.2004958
C. Frank, Jennifer Born
ABSTRACT Military health care providers (HCPs) under-access health services. Measures aimed at assessing barriers to care are either limited in scope, do not address barriers to physical healthcare, or are not grounded in theory. The current study developed and validated a measure of barriers to care based on an existing theoretical framework. Forty focus groups were conducted with 182 Canadian Armed Forces (CAF) HCPs across Canada focusing on barriers to accessing care. Focus group content was used to develop 52 unique barrier items. The Barriers to Care scale was completed by 1033 CAF HCPs. The sample was randomly split so that both an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) could be conducted. The identified factors were correlated with intent to access care to assess concurrent validity. Results of the EFA and CFA (CFI = .84; TLI = .84; SRMR = .08; RMSEA = .07) suggested an eight-factor model. The alphas of the eight subscales were excellent (> .85). All subscales significantly and negatively correlated with intent to access care. The findings suggest a promising first step toward creating a theory-based, valid, and reliable measure for assessing barriers to care.
{"title":"Development and Validation of the Barriers to Care Scale: Assessing Access to Care among Canadian Armed Forces Health Care Providers","authors":"C. Frank, Jennifer Born","doi":"10.1080/21635781.2021.2004958","DOIUrl":"https://doi.org/10.1080/21635781.2021.2004958","url":null,"abstract":"ABSTRACT Military health care providers (HCPs) under-access health services. Measures aimed at assessing barriers to care are either limited in scope, do not address barriers to physical healthcare, or are not grounded in theory. The current study developed and validated a measure of barriers to care based on an existing theoretical framework. Forty focus groups were conducted with 182 Canadian Armed Forces (CAF) HCPs across Canada focusing on barriers to accessing care. Focus group content was used to develop 52 unique barrier items. The Barriers to Care scale was completed by 1033 CAF HCPs. The sample was randomly split so that both an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) could be conducted. The identified factors were correlated with intent to access care to assess concurrent validity. Results of the EFA and CFA (CFI = .84; TLI = .84; SRMR = .08; RMSEA = .07) suggested an eight-factor model. The alphas of the eight subscales were excellent (> .85). All subscales significantly and negatively correlated with intent to access care. The findings suggest a promising first step toward creating a theory-based, valid, and reliable measure for assessing barriers to care.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"10 1","pages":"287 - 300"},"PeriodicalIF":0.0,"publicationDate":"2021-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41750852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-29DOI: 10.1080/21635781.2021.2007185
J. Coulthard, M. Therrien
Abstract Research has shown that physical fitness can benefit individuals with an injury or illness, enhancing their psycho-social health and well-being. The Soldier On program supports Canadian Armed Forces personnel and veterans in overcoming their physical and mental health injuries through promotion of physical activity and sport. Using a qualitative research design, a key question was investigated: are there optimal time points during which ill/injured military members and veterans have higher levels of readiness that would facilitate maximum benefit from program involvement? Semi-structured, in-person interviews were conducted with participants (n = 75) at Soldier On events across Canada. Results suggest there may be critical points following the onset of a significant injury/illness where event participation has the potential to enhance the positive impacts. For service members, this was identified to be following the official medical release decision and duration leading up to their transition out of the military. For veterans, it was found to be only after there was sufficient time post-release to allow for the full reintegration into civilian life. Findings suggest that when considering enrollment of military members and veterans into physical and sport therapy programs, it is important to tailor programs to these critical time periods for each individual.
{"title":"Building Connections through Sport and Physical Activity for Ill and Injured Military Members and Veterans: Determining the Optimal Time for Program Involvement","authors":"J. Coulthard, M. Therrien","doi":"10.1080/21635781.2021.2007185","DOIUrl":"https://doi.org/10.1080/21635781.2021.2007185","url":null,"abstract":"Abstract Research has shown that physical fitness can benefit individuals with an injury or illness, enhancing their psycho-social health and well-being. The Soldier On program supports Canadian Armed Forces personnel and veterans in overcoming their physical and mental health injuries through promotion of physical activity and sport. Using a qualitative research design, a key question was investigated: are there optimal time points during which ill/injured military members and veterans have higher levels of readiness that would facilitate maximum benefit from program involvement? Semi-structured, in-person interviews were conducted with participants (n = 75) at Soldier On events across Canada. Results suggest there may be critical points following the onset of a significant injury/illness where event participation has the potential to enhance the positive impacts. For service members, this was identified to be following the official medical release decision and duration leading up to their transition out of the military. For veterans, it was found to be only after there was sufficient time post-release to allow for the full reintegration into civilian life. Findings suggest that when considering enrollment of military members and veterans into physical and sport therapy programs, it is important to tailor programs to these critical time periods for each individual.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"10 1","pages":"60 - 69"},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42330550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-22DOI: 10.1080/21635781.2021.2004267
D. Cosio
Abstract Pain education programming is considered one avenue of treatment for comorbid chronic pain and mental health disorders. The purpose of the current single group, longitudinal ex post facto study was to determine whether participation in a pain education program would decrease symptoms on psychiatric and functional disability domains using emerging screening measures. A sample of 90 Veterans participated in a pain education program at a Midwestern VA Medical Center between November 1, 2013 and October 31, 2014. The Pain Education School program is a comprehensive program that is open to all Veterans and introduces them to different modalities that deal with chronic pain available in the VA hospital. All participants completed pre- and post-education screening measures. Paired-samples t-tests were conducted to evaluate the impact of the pain education program on Veterans’ scores on these measures. The current study found a significant difference in depression (p=.005; d=.18), mobility (p=.000; d=.47), social participation (p=.001; d=.30), and total functional disability scores (p=.001; d=.30) upon completion of the program. The current study serves as a model of how to use emerging screening measures and education programming to enhance clinical practice and decision-making to better address Veterans’ needs.
{"title":"Improving Pain Care Using Psychosocial Screening and Patient Education among Veterans","authors":"D. Cosio","doi":"10.1080/21635781.2021.2004267","DOIUrl":"https://doi.org/10.1080/21635781.2021.2004267","url":null,"abstract":"Abstract Pain education programming is considered one avenue of treatment for comorbid chronic pain and mental health disorders. The purpose of the current single group, longitudinal ex post facto study was to determine whether participation in a pain education program would decrease symptoms on psychiatric and functional disability domains using emerging screening measures. A sample of 90 Veterans participated in a pain education program at a Midwestern VA Medical Center between November 1, 2013 and October 31, 2014. The Pain Education School program is a comprehensive program that is open to all Veterans and introduces them to different modalities that deal with chronic pain available in the VA hospital. All participants completed pre- and post-education screening measures. Paired-samples t-tests were conducted to evaluate the impact of the pain education program on Veterans’ scores on these measures. The current study found a significant difference in depression (p=.005; d=.18), mobility (p=.000; d=.47), social participation (p=.001; d=.30), and total functional disability scores (p=.001; d=.30) upon completion of the program. The current study serves as a model of how to use emerging screening measures and education programming to enhance clinical practice and decision-making to better address Veterans’ needs.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"10 1","pages":"275 - 286"},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45693771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-13DOI: 10.1080/21635781.2021.2000904
Elisa V. Borah, Valerie C. Rosen, Jessica Fink, Christopher M Paine
Abstract Military cultural competence that supports military-informed care (MIC) of veterans and service members is a necessity for healthcare systems to effectively care for 22 million veterans who receive healthcare outside of the Department of Veterans Affairs (VA). This study evaluated a 2-hour military informed care training with 77 healthcare providers that was developed based on input from veteran patients. Changes in knowledge, attitudes and skills were assessed with the Assessment of Military Cultural Competence (AMCC). Trainees showed improvements in knowledge (t(73) =17.19, p < .000), attitudes and skills. Respondents’ attitudes improved regarding whether the respondent’s cultural background influences their delivery of care, t(75) = −3.24, p = .002, whether a patient’s military or cultural background can impact their perception of care, F(1, 147) = 5.26, p =.023, whether the respondent’s cultural beliefs can be at odds with other cultures or the military, F(1, 148) = 11.66, p =.001, and whether the military is a culture, t (76) = −3.70, p<.000. Trainees’ skills improved in two of four areas, including looking up unfamiliar cultural phrases or military terms F(1, 150) = 4.13, p = .044, and screening for diseases/disorders based on prevalence within a culture or within the military, F(1, 150)=18.22, p < .001.
支持退伍军人和服务人员的军事知情护理(MIC)的军事文化能力是医疗保健系统有效照顾2200万退伍军人事务部(VA)以外接受医疗保健的退伍军人的必要条件。本研究评估了77名医疗保健提供者进行的2小时军事知情护理培训，该培训是基于退伍军人患者的输入而开发的。采用军事文化能力评估(AMCC)评估知识、态度和技能的变化。学员在知识(t(73) =17.19, p < .000)、态度和技能方面均有改善。受访者对文化背景是否影响其护理服务的态度有所改善，t(75) = - 3.24, p =。002，患者的军事或文化背景是否会影响他们对护理的感知，F(1,147) = 5.26, p =。023，被调查者的文化信仰是否会与其他文化或军队不一致，F(1,148) = 11.66, p =。001，军队是否是一种文化，t (76) = - 3.70, p<.000。受训者的技能在四个领域中的两个领域有所提高，包括查找不熟悉的文化短语或军事术语F(1,150) = 4.13, p =。044，以及基于文化或军队中患病率的疾病/障碍筛查，F(1,150)=18.22, p < .001。
{"title":"Evaluation of a Military Informed Care Training with Private Sector Healthcare Providers","authors":"Elisa V. Borah, Valerie C. Rosen, Jessica Fink, Christopher M Paine","doi":"10.1080/21635781.2021.2000904","DOIUrl":"https://doi.org/10.1080/21635781.2021.2000904","url":null,"abstract":"Abstract Military cultural competence that supports military-informed care (MIC) of veterans and service members is a necessity for healthcare systems to effectively care for 22 million veterans who receive healthcare outside of the Department of Veterans Affairs (VA). This study evaluated a 2-hour military informed care training with 77 healthcare providers that was developed based on input from veteran patients. Changes in knowledge, attitudes and skills were assessed with the Assessment of Military Cultural Competence (AMCC). Trainees showed improvements in knowledge (t(73) =17.19, p < .000), attitudes and skills. Respondents’ attitudes improved regarding whether the respondent’s cultural background influences their delivery of care, t(75) = −3.24, p = .002, whether a patient’s military or cultural background can impact their perception of care, F(1, 147) = 5.26, p =.023, whether the respondent’s cultural beliefs can be at odds with other cultures or the military, F(1, 148) = 11.66, p =.001, and whether the military is a culture, t (76) = −3.70, p<.000. Trainees’ skills improved in two of four areas, including looking up unfamiliar cultural phrases or military terms F(1, 150) = 4.13, p = .044, and screening for diseases/disorders based on prevalence within a culture or within the military, F(1, 150)=18.22, p < .001.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"10 1","pages":"249 - 260"},"PeriodicalIF":0.0,"publicationDate":"2021-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47023212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-05DOI: 10.1080/21635781.2021.2000905
L. Morgan, D. Aldington
Abstract Veterans with chronic pain may face complex additional challenges, notably the potentially high rate of comorbid post-traumatic stress disorder. Linked to this is the developing concept of moral injury, essentially feelings of guilt and shame associated with transgressing one’s moral beliefs. Work has begun to explore moral injury in the context of psychological trauma, however it has not to date been considered in relation to chronic pain. As the moral injury concept is still developing, this paper explores what is known about the roles of guilt and shame in psychological trauma and chronic pain, and aims to set this in a military context, to begin to understand clinical implications and to make recommendations for further research. A search of the literature reveals that guilt and shame in psychological trauma and chronic pain are not well understood, and research has predominantly focused on these as consequences, rather than as potential contributory elements. Literature is currently separated, focusing either on PTSD or on chronic pain, and we suggest a more integrated approach is required.
{"title":"Chronic Pain, PTSD and Moral Injury in Military Veterans: Suffering and the Compromised Self","authors":"L. Morgan, D. Aldington","doi":"10.1080/21635781.2021.2000905","DOIUrl":"https://doi.org/10.1080/21635781.2021.2000905","url":null,"abstract":"Abstract Veterans with chronic pain may face complex additional challenges, notably the potentially high rate of comorbid post-traumatic stress disorder. Linked to this is the developing concept of moral injury, essentially feelings of guilt and shame associated with transgressing one’s moral beliefs. Work has begun to explore moral injury in the context of psychological trauma, however it has not to date been considered in relation to chronic pain. As the moral injury concept is still developing, this paper explores what is known about the roles of guilt and shame in psychological trauma and chronic pain, and aims to set this in a military context, to begin to understand clinical implications and to make recommendations for further research. A search of the literature reveals that guilt and shame in psychological trauma and chronic pain are not well understood, and research has predominantly focused on these as consequences, rather than as potential contributory elements. Literature is currently separated, focusing either on PTSD or on chronic pain, and we suggest a more integrated approach is required.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"10 1","pages":"267 - 274"},"PeriodicalIF":0.0,"publicationDate":"2021-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43174129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-28DOI: 10.1080/21635781.2021.1995546
K. Godfrey, K. Walsh, D. Albright, K. H. Thomas
Abstract This study sought to explore the association between employment status, self-reported impact of service on mental health, and the current mental health levels reported by women veterans. Our team drew from data from the Service Women’s Action Network’s (SWAN) 2017 needs assessment survey, this study includes 1,294 current or former women U.S. Armed Forces service members throughout the 50 states and the District of Columbia. We explored demographic characteristics by calculating frequencies. A logistic regression analysis was utilized to explore research questions. For women veterans, ongoing poor mental health days per month was significantly predicted by the impact they self-reported their military service had on their mental health (OR = 8.744). Unemployment was significantly predicted by 10 or more poor mental health days in the last 30 days (OR = 2.246) and also by the impact service women’s military service had on their mental health (OR = 2.130). The findings show the negative impact that service women’s military time in service can have on their mental health. Moreover, findings suggest that this negative impact on mental health can carry beyond their time in the military, negatively impacting employment status. Understanding this can allow service providers to intervene and provide appropriate mental health care and programs to service women before the negative impacts of military service on mental health lead to other negative psychosocial impacts.
{"title":"Negative Impact of Military Service on Women Veterans’ Mental Health Can Lead to Long-Term Poor Mental Health and Higher Unemployment Rates","authors":"K. Godfrey, K. Walsh, D. Albright, K. H. Thomas","doi":"10.1080/21635781.2021.1995546","DOIUrl":"https://doi.org/10.1080/21635781.2021.1995546","url":null,"abstract":"Abstract This study sought to explore the association between employment status, self-reported impact of service on mental health, and the current mental health levels reported by women veterans. Our team drew from data from the Service Women’s Action Network’s (SWAN) 2017 needs assessment survey, this study includes 1,294 current or former women U.S. Armed Forces service members throughout the 50 states and the District of Columbia. We explored demographic characteristics by calculating frequencies. A logistic regression analysis was utilized to explore research questions. For women veterans, ongoing poor mental health days per month was significantly predicted by the impact they self-reported their military service had on their mental health (OR = 8.744). Unemployment was significantly predicted by 10 or more poor mental health days in the last 30 days (OR = 2.246) and also by the impact service women’s military service had on their mental health (OR = 2.130). The findings show the negative impact that service women’s military time in service can have on their mental health. Moreover, findings suggest that this negative impact on mental health can carry beyond their time in the military, negatively impacting employment status. Understanding this can allow service providers to intervene and provide appropriate mental health care and programs to service women before the negative impacts of military service on mental health lead to other negative psychosocial impacts.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"10 1","pages":"243 - 248"},"PeriodicalIF":0.0,"publicationDate":"2021-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44778032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-28DOI: 10.1080/21635781.2021.1990813
Sam Cacace, E. Smith, Sarah L. Desmarais, Elizabeth A. Alders
Abstract Military service members (MSM) and veterans make up nearly 10% of the U.S. population. They face unique challenges and require unique assistance related to community services and resources. However, little has been done to determine the specific needs within this population, particularly with regard to “locale” or “geographically-specific” military population needs. This study used a mixed-methods approach to investigate geographically-specific needs in the MSM and veteran populations residing in one southeastern state, collecting both qualitative focus group data and secondary quantitative data. The qualitative data was gathered from focus groups (15 veterans and leaders from military-service organizations) and the quantitative data was gathered from client requests from a regional network of military and veteran-serving organizations (N = 4,328). Thematic analysis of focus group transcripts shows, from the organizational side, a lack of availability, understanding, education, and advertising of resources. The client call data showed that MSM and veterans who live in higher population locales were more likely to experience longer wait times to achieve needs resolution when compared to the smaller locale group (β = 0.0000606, t(4,226) = 14.49, p < .0001, R2 = 0.047). Follow-up investigations should examine the importance of regional differences in professional branding and information dissemination practices maintained by organizations serving the MSM and veteran populations in this locale, with the goal of finding how to communicate more effectively and efficiently with their target audience(s). These future efforts should include comparing data with other regions and national data sets to further understand locale specific needs.
{"title":"Locale Matters: Regional Needs of U.S. Military Service Members and Veterans","authors":"Sam Cacace, E. Smith, Sarah L. Desmarais, Elizabeth A. Alders","doi":"10.1080/21635781.2021.1990813","DOIUrl":"https://doi.org/10.1080/21635781.2021.1990813","url":null,"abstract":"Abstract Military service members (MSM) and veterans make up nearly 10% of the U.S. population. They face unique challenges and require unique assistance related to community services and resources. However, little has been done to determine the specific needs within this population, particularly with regard to “locale” or “geographically-specific” military population needs. This study used a mixed-methods approach to investigate geographically-specific needs in the MSM and veteran populations residing in one southeastern state, collecting both qualitative focus group data and secondary quantitative data. The qualitative data was gathered from focus groups (15 veterans and leaders from military-service organizations) and the quantitative data was gathered from client requests from a regional network of military and veteran-serving organizations (N = 4,328). Thematic analysis of focus group transcripts shows, from the organizational side, a lack of availability, understanding, education, and advertising of resources. The client call data showed that MSM and veterans who live in higher population locales were more likely to experience longer wait times to achieve needs resolution when compared to the smaller locale group (β = 0.0000606, t(4,226) = 14.49, p < .0001, R2 = 0.047). Follow-up investigations should examine the importance of regional differences in professional branding and information dissemination practices maintained by organizations serving the MSM and veteran populations in this locale, with the goal of finding how to communicate more effectively and efficiently with their target audience(s). These future efforts should include comparing data with other regions and national data sets to further understand locale specific needs.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"10 1","pages":"221 - 234"},"PeriodicalIF":0.0,"publicationDate":"2021-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44660226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-23DOI: 10.1080/21635781.2021.1994490
J. Pittman, E. Almklov, A. Angkaw, Neal Doran, L. Lindamer, S. Norman, Kathleen M. Grubbs, W. Wolfe, N. Afari
Abstract Background Measurement-based care (MBC) is associated with improved patient outcomes, but is seldom fully implemented. Electronic self-report screening systems may help overcome some obstacles associated with implementing MBC. One such program, eScreening, provides customized and automated self-report mental and physical health screening via mobile tablet for veterans seen in Veterans Health Administration (VHA) settings and by web browser for patients seen remotely by telemedicine. We aimed to describe how electronic health screening systems can support the implementation of measurement-based behavioral healthcare. Methods We collected descriptive data on the use of eScreening, including clinical settings, measures used, and frequency of use; and present a brief case composite example. Results eScreening was used in multiple VHA clinical programs to administer validated symptom severity measures at baseline and regular intervals during treatment. The case composite example describes a Veteran referred to the PTSD clinic where he was treated with Cognitive Processing Therapy. eScreening was used routinely to track mental health symptoms, promote collaborative dialogue, and inform treatment progress. Conclusion Electronic self-report screening systems can support the implementation of MBC by facilitating the process of routine symptom collection/monitoring, informed decision-making, objective evaluation of treatment outcomes, and collaborative care in behavioral healthcare settings.
{"title":"Electronic Screening to Support Measurement Based Care: Examples from the Field","authors":"J. Pittman, E. Almklov, A. Angkaw, Neal Doran, L. Lindamer, S. Norman, Kathleen M. Grubbs, W. Wolfe, N. Afari","doi":"10.1080/21635781.2021.1994490","DOIUrl":"https://doi.org/10.1080/21635781.2021.1994490","url":null,"abstract":"Abstract Background Measurement-based care (MBC) is associated with improved patient outcomes, but is seldom fully implemented. Electronic self-report screening systems may help overcome some obstacles associated with implementing MBC. One such program, eScreening, provides customized and automated self-report mental and physical health screening via mobile tablet for veterans seen in Veterans Health Administration (VHA) settings and by web browser for patients seen remotely by telemedicine. We aimed to describe how electronic health screening systems can support the implementation of measurement-based behavioral healthcare. Methods We collected descriptive data on the use of eScreening, including clinical settings, measures used, and frequency of use; and present a brief case composite example. Results eScreening was used in multiple VHA clinical programs to administer validated symptom severity measures at baseline and regular intervals during treatment. The case composite example describes a Veteran referred to the PTSD clinic where he was treated with Cognitive Processing Therapy. eScreening was used routinely to track mental health symptoms, promote collaborative dialogue, and inform treatment progress. Conclusion Electronic self-report screening systems can support the implementation of MBC by facilitating the process of routine symptom collection/monitoring, informed decision-making, objective evaluation of treatment outcomes, and collaborative care in behavioral healthcare settings.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"10 1","pages":"235 - 242"},"PeriodicalIF":0.0,"publicationDate":"2021-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47722888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-18DOI: 10.1080/21635781.2021.1982085
J. McDaniel, Nathaniel V. Mohatt, Mallory Gary, D. Albright, Kaamel M Nuhu, S. McIntosh, Kombe Kapatamoyo
Abstract E-cigarette use is more prevalent among veterans with mental distress; however, no studies have examined the impact of rurality on the relationship between mental distress and e-cigarette use among veterans. We obtained nationally-representative data on veterans from 2016 to 2018 Behavioral Risk Factor Surveillance System (BRFSS) surveys in order to explore the aforementioned relationship (n = 62,884). Results of generalized linear mixed models, stratified by rural-urban status, indicated that the relationship between mental distress and e-cigarette use was moderated by current traditional cigarette use, especially in highly rural areas. Our 33-state study showed that the rate of e-cigarette use among veterans with 14+ days of mental distress and current cigarette use living in highly urban areas was 8.93% (compared to 0.89% for those with no mental distress and no cigarette use, p < 0.001), while in rural areas, the prevalence of e-cigarette use among veterans with 14+ days of mental distress and current cigarette use was 12.75% (compared to 0.77% for those with no mental distress and no cigarette use, p < 0.001). Behavioral health programs for veterans in rural areas should target those with mental distress and e-cigarette use.
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