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2023 HSR&D/QUERI National Conference Abstract

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1086 — Use of Whole Health and Self-Care among Veterans Experiencing Distress Due to COVID

Lead/Presenter: David Reed ,  COIN - Seattle/Denver
All Authors: Gaj LJ (Center for Healthcare Organization and Implementation Research), Bokhour BG (Center for Healthcare Organization and Implementation Research, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School) Barker A (Center for Healthcare Organization and Implementation Research) Deeney C (Center for Healthcare Organization and Implementation Research) Orner M (Center for Healthcare Organization and Implementation Research) Reed D (Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Health Systems and Population Health, School of Public Health, University of Washington) Zeliadt S (Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Health Systems and Population Health, School of Public Health, University of Washington)

Objectives:
The COVID pandemic has been a dominant external stressor impacting health and well-being. Self-care, such as meditation and yoga, has been emphasized to manage COVID-related distress. The Veterans Health Administration (VHA) offers these and other patient-centered approaches as part of the Whole Health (WH) system of care. As the pandemic began, the VHA was poised to adapt to Veterans’ changing needs by offering self-care and WH activities centered on personal health goals. The goal of this study was to understand how patients experiencing COVID-related distress utilized self-care and WH during the COVID pandemic.

Methods:
We conducted a survey of Veterans who responded to a previous survey on the use and outcomes of WH at 18 VHA medical centers implementing WH. The goal of this new survey was to understand COVID’s impact on Veterans and their use of self-care and WH during the pandemic. Between Jan-May 2021, 5550 Veterans were approached and 3435 (62%) responded. Descriptive statistics assessed how patients negatively impacted by COVID reported use of self-care (meditation, yoga, tai chi/qi gong, or guided imagery) or WH (coach or group) compared to those not impacted.

Results:
Of the 3435 respondents, 35% reported COVID caused them to worry, 28% reported it caused them to feel depressed, and 46% reported it interfered with their enjoyment of life. Among 3211 respondents with reported chronic pain, 27% indicated COVID interfered with pain management. Veterans experiencing COVID-related distress in these four areas were more likely to report participating in WH. Compared to those reporting not being impacted by COVID in these areas, Veterans reporting experiencing worry reported 52% greater WH participation (p < 0.001); feeling depressed, 47% greater participation (p < 0.001), interference with enjoyment in life, 34% greater participation (p = 0.004); and pain management interference, 45% greater participation (p < 0.001). Self-care use was not associated with reporting negative COVID impacts related to worry, feeling depressed, enjoyment of life, or pain management (p > .05).

Implications:
VHA’s WH offerings filled a gap and served as an alternative and important form of care, both virtually and in person, for many Veterans experiencing the negative impacts of the pandemic. Offerings that focused on individuals’ WH and personal health goals were an important resource for those experiencing emotional distress. Interestingly, despite attention given to self-care activities, we did not see higher rates of self-care among patients experiencing COVID-related distress.

Impacts:
These findings suggest VHA’s ability to offer WH services may have been important for Veterans experiencing negative impacts of the pandemic. Providing Veterans the opportunity and support to explore their personal health goals, both in one-on-one and group settings, can be a critical and valued resource for those experiencing mental health-related and other emotional distress. These services may also help those struggling with self-management of chronic pain or other chronic conditions. This tailored and supportive approach to setting and achieving personal health goals is an important tool the healthcare system can provide in support of Veterans experiencing COVID-related and other forms of emotional distress.