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CDA 13-264 – HSR Study

CDA 13-264
Integration of Peer Support Across the PTSD Continuum of Care
Natalie E Hundt, PhD
Michael E. DeBakey VA Medical Center, Houston, TX
Houston, TX
Funding Period: October 2015 - September 2020
Evidence-based psychotherapies (EBP) for PTSD, such as Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT), are effective, but only a minority of Veterans complete these treatments. Additionally, up to 60% of Veterans continue to meet diagnostic criteria for PTSD after completion, and even those who no longer meet criteria may have remaining psychosocial needs as they rebuild their lives. Peer support programs have the potential to improve patient outcomes by facilitating treatment initiation, engagement, and aftercare. In peer programs, Veterans recovering from PTSD provide emotional support, empathy, and information based upon their own lived experience with PTSD. Guided by social learning theory, peers can model healthy coping behaviors like confronting trauma directly, engaging in therapy, and rebuilding a fulfilling life during the process of recovery. Peer support is well-established for other disorders and is a priority within the VA. It supports treatment initiation, improves functioning and quality of life, reduces utilization of mental health services, and is highly acceptable to Veterans. Despite the recent expansion of peer programs, more research is needed to examine the most effective ways to integrate peers with existing PTSD care to support evidence based treatments.

The goal of this CDA is to refine and pilot test a peer support program for PTSD, with separate components for initiation/engagement of EBP and aftercare.

In Aim 1, through an iterative formative evaluation with stakeholders (Veterans, peer providers, PTSD providers, and national leaders), and based upon the prior needs assessment, we will refine a peer support program that addresses treatment initiation and engagement. In Aim 2, we will conduct an open feasibility pilot for the peer support initiation/ engagement groups to further refine this program, and then test effectiveness in a pilot randomized trial. Primary outcomes will be EBP attitudes, initiation and completion of EBP. These pilot data will support an IIR submission for a Hybrid Type I Effectiveness/Implementation trial in year 3. In Aim 3, we will conduct a formative evaluation to explore stakeholders' opinions of a proposed aftercare peer program for Veterans who complete EBP. In Aim 4, we will pilot feasibility of the peer program as aftercare in two peer support groups and collect qualitative data to guide revisions. Primary outcomes will be functioning and quality of life. In year 5, we will submit an HSR&D Pilot to conduct a pilot randomized trial of peer support as aftercare.

Not yet available.

This research has provided more information about patient and provider related barriers to the full implementation of PE and CPT in the VA.

External Links for this Project

NIH Reporter

Grant Number: IK2HX001515-01A2

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None at this time.

DRA: Mental, Cognitive and Behavioral Disorders
DRE: Treatment - Efficacy/Effectiveness Clinical Trial
Keywords: PTSD
MeSH Terms: none

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