BACKGROUND/RATIONALE:
Over 10,000 men and women have been deployed from Puerto Rico (PR) to serve in the wars in Iraq and Afghanistan. No known investigative team has developed education interventions for this special subgroup of OEF/OIF veterans and their families. Because culture has a far-reaching effect on how one interprets experiences, processes new information, and learns to adapt, it is critical that Spanish-language OEF/OIF education materials are developed, promoted, disseminated and evaluated to meet the needs of the PR population

OBJECTIVE(S):
(1) Conduct a marketing and promotional campaign to increase awareness and acceptance of our printed Spanish-language post-deployment education materials or Fact Sheets.
2) Disseminate our post-deployment education materials to veterans and family members at VA, military and veteran service organizations in San Juan, PR
3) Disseminate our education materials via the VA Caribbean Healthcare System website
4) Evaluate our dissemination project
5) Develop a plan for adapting and disseminating our materials to the larger, Hispanic American OEF/OIF population and the English-speaking OEF/OIF population.


METHODS:
The education materials were packaged into an attractive, tabulated booklet, which included photos and graphics of Puerto Rico and Puerto Rican veterans and family members. We used a community-based participatory research approach to engage VA and veteran-service organization partners. We promoted our booklet with email banners and through newsletters. We disseminated the booklet with the help of our partners, champions, and providers at a "Welcome Home" event in San Juan and through other events and meetings. We used the Re-AIM framework to guide the evaluation of our dissemination process. We conducted telephone interviews and on-line surveys with providers. We conducted a focus group with providers and one with veterans. We circulated a postcard survey to all veterans who received our booklets. We developed a web page on the VA Caribbean Healthcare website in which our education materials can be accessed by providers and veterans. We collaborated with leaders throughout VISN8 and the VA to write a proposal for a project in the Virgin Islands and to plan for future educational projects.

FINDINGS/RESULTS:
The booklet was disseminated to 3,400 veterans and family members at the "Welcome Home" event in San Juan. Our partners, champions, and other providers disseminated 10,326 additional booklets to Puerto Rican veterans and family members. The web page on the VA CHS was accessed 263 times. Respondents stated in telephone interviews, postcard surveys, on-line surveys, and focus groups that the booklet had positive outcomes (e.g., increased knowledge, improved family relationships, decreased stress, increased access of VA benefits and services).

IMPACT:
We developed a Spanish-language post-deployment readjustment booklet that was disseminated to about 14,000 veterans and family members living in PR. Individual fact sheets and resources, as well as the entire booklet, can be accessed through a web page on the VA Caribbean Healthcare web site. We learned the best dissemination strategies and evaluation methods for future education projects to improve outcomes of Hispanic American veterans and their families.

---

External Links for this Project

---

PUBLICATIONS:

Conference Presentations

1. Uphold CR, Freytes IM, Midolo JP, del Valle L, Easey KL. Cultural Influence on Community Reintegration of OEF/OIF Veterans in Puerto Rico and the U.S. Virgin Islands. Poster session presented at: VA Nursing Polytrauma Annual Conference; 2010 Oct 19; Arlington, VA. [view]
2. Resende R, Freytes IM, Uphold CR. Through the eyes of a square peg: Unpacking cultural meanings of post-deployment Puerto Rican Veterans and their families through anthropological expertise at the VA. Paper presented at: Society for Applied Anthropology Annual Meeting; 2011 Apr 2; Seattle, WA. [view]

DRA: Military and Environmental Exposures
DRE: Prevention
Keywords: Education (patient), Operation Enduring Freedom, Operation Iraqi Freedom
MeSH Terms: none