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CDA 09-020 – HSR Study

 
CDA 09-020
Dissemination & Implementation of Exposure Treatments for PTSD
Shannon M. Kehle-Forbes, PhD
Minneapolis VA Health Care System, Minneapolis, MN
Minneapolis, MN
Funding Period: July 2011 - June 2015
BACKGROUND/RATIONALE:
Evidence-based psychotherapies (EBPs) for PTSD have been shown to be efficacious in reducing symptoms of PTSD among Veterans. The Veterans Health Administration (VHA) implemented several initiatives designed to increase the adoption of EBPs for PTSD. Early data suggest that significant barriers still exist and few Veterans receive these treatments.

OBJECTIVE(S):
The overall objective of my CDA was to examine factors related to the dissemination and implementation of EBPs for PTSD. Within that objective I pursued three inter-related lines of research: 1) Veteran factors impacting the implementation of EBPs for PTSD; 2) system-level barriers and facilitators to accessing EBPs for PTSD, and 3) Veterans' adherence to EBPs for PTSD. The specifics of the first line of research are detailed in this abstract because they most closely aligned with the projects proposed in my funded CDA application. The primary aims of this line of research were to (1) Identify facilitator and barriers to the implementation of EBPs for PTSD and (2) Develop and pilot an intervention designed to enhance the implementation of EBPs for PTSD.

METHODS:
Aim 1 was completed in two phases. First, we conducted key informant interviews with five of the eight evidence-based coordinators within VISN 23. The key informant interviews with the evidence-based psychotherapy coordinators suggested that little attention had been paid to Veteran-facing implementation interventions, which resulted in limited Veteran demand for EBPs. Therefore, we sought to develop a Veteran-facing social marketing campaign designed to increase demand for EBPs for PTSD. The second phase of Aim 1 involved semi-structured interviews with 31 Veterans with full or subthreshold PTSD (intervention target population) at the Minneapolis VA Medical Center. The interviews focused on Veterans' knowledge of EBPs for PTSD, how they prefer to receive information regarding PTSD treatment, their attitudes towards EBPS for PTSD, and perceived barriers and facilitators to participating in the treatments. Following the analysis of the Veterans interviews, we created draft versions of the intervention materials (Aim 2). We then invited the 31 Veterans who completed the semi-structured interviews back to participate in focus groups to refine and pilot test the materials. Thirteen Veterans attended one of three focus groups. Finally, three experts in the treatment of PTSD completed key informant interviews to further refine the intervention. Details regarding the findings from the Veteran interviews and focus groups can be found in the abstract for RRP 12-512, which funded the study.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
PTSD is one of the most commonly occurring and debilitating health conditions following deployment to a combat zone. By facilitating the implementation of EBPs for PTSD, this research has the potential to increase the number of Veterans receiving effective PTSD treatments, thereby improving Veterans health and functioning.


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PUBLICATIONS:

None at this time.


DRA: Military and Environmental Exposures, Mental, Cognitive and Behavioral Disorders
DRE: Treatment - Comparative Effectiveness
Keywords: none
MeSH Terms: none

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