https://aub.ie/MilitaryREACH-Dindo2023

Dindo, L., Chaison, A., Rodrigues, M., Woods, K., Mark, A., & Boykin, D. (2023). Feasibility of delivering a virtual 1-day acceptance and commitment therapy workshop to rural veterans through community partnerships. Contemporary Clinical Trials Communications, 34, Article 101178. https://doi.org/10.1016/j.conctc.2023.101178

This pilot study assessed the feasibility, acceptability, and effectiveness of a 6-hour Acceptance and Commitment Therapy (ACT) workshop designed to improve Veterans’ engagement with life (e.g., relationships, meaningful work) and reduce their distress. Eligible participants were former Service members without a history of serious substance use, mental illness, and/or suicidal ideation. 64 Veterans self-reported their psychological distress, posttraumatic stress symptoms (PTSS), post-military community reintegration, and perception of their purpose in life before attending the virtual workshop. Of those, 60 Veterans completed follow-up assessments 1 and/or 3 months after the workshop and reported their satisfaction with the workshop. Overall, the ACT workshop was well-received, reduced Veterans’ psychological distress and PTSS, and improved their community reintegration and perception of their life’s purpose.

https://doi.org/10.1016/j.conctc.2023.101178

Programming
Veterans
Mental health

Army
Navy
Air Force
Marine Corps
Coast Guard
Multiple branches

Veteran

Veteran

Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)

Quantitative Study

Dindo, Lilian, Chaison, Angelic, Rodrigues, Merlyn, Woods, Ken, Mark, Alicia, Boykin, Derrecka

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.

Elsevier

Article
REACH Publication

VA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City Veterans Affairs Health Care System, LD
VA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City Veterans Affairs Health Care System, DB
Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, LD
Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, MR
Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, KW
Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, AM
Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, DB
Department of Medicine, Health Services Research, Baylor College of Medicine, LD
Department of Medicine, Health Services Research, Baylor College of Medicine, MR
Mental Health Care Line, Michael E. DeBakey VA Medical Center, AC
Menninger Department of Psychiatry and Behavioral Medicine, Baylor College of Medicine, AC
Menninger Department of Psychiatry and Behavioral Medicine, Baylor College of Medicine, DB
South Central Mental Illness, Research, Education and Clinical Center, Michael E DeBakey Veterans Affairs Medical Center, KW