Feasibility of delivering a virtual 1-day acceptance and commitment therapy workshop to rural veterans through community partnerships.

Dindo L, Chaison A, Rodrigues M, Woods K, Mark A, Boykin D. Feasibility of delivering a virtual 1-day acceptance and commitment therapy workshop to rural veterans through community partnerships. Contemporary clinical trials communications. 2023 Aug 1; 34:101178.

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• IIR 20-079 – Effect of Patient Priorities Care Implementation in Older Veterans with Multiple Chronic Conditions

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Abstract:

BACKGROUND: This single-arm, open pilot study examined the feasibility and initial efficacy of a 1-day virtual Acceptance and Commitment Therapy (ACT) group workshop for distressed veterans. METHODS: We collaborated with veteran-serving community-based organizations to enhance outreach to veterans, especially those in rural areas. Veterans completed a baseline assessment and two follow-up assessments (1 month, 3 months) after workshop participation. Feasibility outcomes included reach (workshop recruitment and completion rates; veteran characteristics) and acceptability (open-ended survey question about satisfaction). Clinical outcomes included psychological distress (Outcome Questionnaire-45), stressor-related distress (PTSD Checklist-5), community reintegration (Military to Civilian Questionnaire), and meaning and purpose (PROMIS Short Form). Psychological flexibility (Action and Acceptance Questionnaire-II) - the proposed change mechanism underlying ACT - was also measured. RESULTS: Sixty-four veterans (50% rural, 39% self-identified as female) participated in a virtual workshop (97.1% completion rate). Overall, veterans liked the format and interactive nature of workshops. Convenience was noted as a benefit, while connectivity issues were highlighted as a drawback. Veterans showed improvements in psychological distress (F(2,109)  =  3.30; p  =  0.041), stressor-related distress (F(2,110)  =  9.50; p  =  0.0002), community reintegration (F(2,108)  =  4.34; p  =  0.015), and meaning and purpose (F(2,100)  =  4.06; p  =  0.020) over time. No between-group differences were detected, based on rurality or gender. CONCLUSION: Pilot findings were promising and warrant a larger randomized trial to assess the efficacy of the 1-day virtual ACT workshop. Integrating community-engaged and participatory-research designs can enhance the external validity of these future studies and promote greater health equity.