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2019 HSR&D/QUERI National Conference Abstract

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4081 — A pilot study of Whole Health Coaching among military Veterans with suicidal ideation

Lead/Presenter: Lauren Denneson,  COIN - Portland
All Authors: Denneson LM (VA HSR&D Center to Improve Veteran Involvement in Care, Portland, Oregon), Ono, S (VA HSR&D Center to Improve Veteran Involvement in Care, Portland, Oregon), ; Pfeiffer, PN (VA Center for Clinical Management Research, Ann Arbor, Michigan); Dobscha, SK (VA HSR&D Center to Improve Veteran Involvement in Care, Portland, Oregon)

Objectives:
Whole Health Coaching (WHC) is being rolled out across VA. Health coaches help people build lives they wish to live by achieving goals consistent with their strengths and values. No prior studies have examined the use of coaching among patients at risk for suicide. The main purpose of this pilot study was to examine the feasibility and acceptability of WHC among post-9/11 Veterans with suicidal ideation.

Methods:
In this mixed-methods, single-arm feasibility and acceptability pilot trial, we enrolled 22 post-9/11 era Veterans with suicidal ideation to participate in eight weekly coaching sessions. WHC consists of four steps: 1) Articulate mission and purpose in life, 2) Self-assessment over eight life domains, 3) Articulate goals and action steps, and 4) Evaluate action, re-assess, and re-plan as needed. To examine feasibility and acceptability, we tracked enrollment and intervention completion rates, administered a client satisfaction questionnaire, and conducted qualitative interviews with participants to gather feedback on their experiences with coaching. Participants also completed surveys at baseline, 4, 8, and 16 weeks assessing health outcomes; primary outcome measures were psychological well-being and suicidal ideation severity.

Results:
We achieved a 52% enrollment rate, and 86% of participants completed the intervention. At post-intervention (8 weeks), participants reported high satisfaction (mean score = 30), and large increases in psychological well-being (t[12] = 2.89, p = .01, d = 0.80). We also observed large reductions in depression symptoms (t[12] = -2.50, p = .03, d = 0.69), perceived stress (t[12] = -3.27, p = .01, d = 0.91), anxiety (t[12] = -2.36, p = .04, d = 0.65), and PTSD symptoms (t[12] = -3.85, p < .01, d = 1.07). No meaningful change in suicidal ideation severity was observed (t[12] = -1.47, p = .17, d = 0.41). In qualitative interviews, participants felt WHC helped them achieve their goals, facilitated confidence in addressing other concerns in their lives, that coaching is different from other care they receive, and coaching helped them gain/regain clarity regarding their sense of self or identity.

Implications:
This feasibility and acceptability pilot trial found that Veterans with suicidal ideation are very interested in participating in WHC and find it beneficial.

Impacts:
WHC is appealing to Veterans with suicidal ideation and shows promise as a strengths-based approach to enhance current suicide prevention efforts.