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CDA 15-257 – HSR&D Study

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CDA 15-257
Patient-centered Strategies to Engage Veterans in Behavioral Health Services
Jessica Yelena Breland PhD MS BA
VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, CA
Funding Period: October 2016 - September 2021

BACKGROUND/RATIONALE:
Almost 80% of Veterans using the Veterans Health Administration (VHA) are overweight or obese, putting millions at risk for costly and debilitating chronic conditions. Weight loss treatments improve health, but there is an implementation gap: VHA offers weight loss treatments to 94% of overweight/obese Veterans, but only 10% use them. Therefore, improving weight loss treatment engagement could prolong millions of lives. Motivational interviewing can improve treatment engagement (i.e., help patients initiate/maintain treatments), but clinicians have limited time to use it. As a result, there is a need for a motivational, self-help tool that can increase Veterans' weight loss treatment engagement without requiring clinicians' time.

OBJECTIVE(S):
Aim 1: Identify patient and organizational predictors of weight loss treatment engagement.
Aim 2: Develop a motivational, self-help tool to increase weight loss treatment engagement.
Aim 3: Pilot-test a motivational, self-help tool to engage Veterans in weight loss treatments.

METHODS:
Aim 1 used interviews with clinicians and national leaders to identify VHA behavioral weight loss treatments, including, but not limited to MOVE! (VHA's primary weight loss treatment). Next, gender stratified administrative database analyses will be used to identify patient and organizational predictors of Veterans' engagement in those treatments. Aim 2 uses Aim 1 results and interviews with VHA clinicians and patients to develop a motivational, self-help tool to increase women and men Veterans' weight loss treatment engagement. Aim 3 will be a pilot test of the tool to assess the feasibility of methods for a subsequent randomized trial of the tool's effects on weight loss treatment engagement.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
The proposed research will help identify Veteran populations most in need of improved weight loss treatment engagement and inform efforts to implement VHA weight management programs. Findings may ultimately lead to increased engagement in effective weight loss treatments that will improve the health of Veterans through weight loss, improved physical health, and improved quality of life. Results may also facilitate understanding of and improvements in engagement and outcomes related to other behavioral health treatments.

PUBLICATIONS:

Journal Articles

  1. Altman M, Huang TTK, Breland JY. Design Thinking in Health Care. Preventing chronic disease. 2018 Sep 27; 15:E117.
  2. Zulman DM, O'Brien CW, Slightam C, Breland JY, Krauth D, Nevedal AL. Engaging High-Need Patients in Intensive Outpatient Programs: A Qualitative Synthesis of Engagement Strategies. Journal of general internal medicine. 2018 Nov 1; 33(11):1937-1944.
  3. O'Brien CW, Breland JY, Slightam C, Nevedal A, Zulman DM. Engaging high-risk patients in intensive care coordination programs: the engagement through CARInG framework. Translational behavioral medicine. 2018 May 23; 8(3):351-356.
  4. Breland JY, Quintiliani LM, Schneider KL, May CN, Pagoto S. Social Media as a Tool to Increase the Impact of Public Health Research. American journal of public health. 2017 Dec 1; 107(12):1890-1891.
  5. Timko C, Ilgen M, Haverfield M, Shelley A, Breland JY. Polysubstance use by psychiatry inpatients with co-occurring mental health and substance use disorders. Drug and Alcohol Dependence. 2017 Nov 1; 180:319-322.
  6. Breland JY, Donalson R, Nevedal A, Dinh JV, Maguen S. Military experience can influence Women's eating habits. Appetite. 2017 Nov 1; 118:161-167.
  7. McAndrew LM, Martin JL, Friedlander M, Shaffer K, Breland JY, Slotkin S, Leventhal H. The Common Sense of Counseling Psychology: Introducing the Common Sense Model of Self-Regulation. Counselling psychology quarterly. 2017 Aug 1; doi.org/10.1080/09515070.2017.1336076.
  8. Breland JY, Donalson R, Li Y, Hebenstreit CL, Goldstein LA, Maguen S. Military sexual trauma is associated with eating disorders, while combat exposure is not. Psychological trauma : theory, research, practice and policy. 2018 May 1; 10(3):276-281.
  9. Breland JY, Phibbs CS, Hoggatt KJ, Washington DL, Lee J, Haskell S, Uchendu US, Saechao FS, Zephyrin LC, Frayne SM. The Obesity Epidemic in the Veterans Health Administration: Prevalence Among Key Populations of Women and Men Veterans. Journal of general internal medicine. 2017 Apr 1; 32(Suppl 1):11-17.
  10. Breland JY, Donalson R, Dinh JV, Maguen S. Trauma exposure and disordered eating: A qualitative study. Women & health. 2018 Feb 1; 58(2):160-174.


DRA: Cardiovascular Disease, Diabetes and Related Disorders, Other Conditions
DRE: Prevention, Technology Development and Assessment, Treatment - Preclinical
Keywords: none
MeSH Terms: none