Measurement-Based Transition Assistance (MBTA): Evaluating the Promise of a Web-Based Approach to Promote Veterans' Support Seeking

基于测量的过渡援助 (MBTA)：评估基于网络的方法促进退伍军人寻求支持的前景

• 批准号: 10559484
• 负责人: Dawne Suzanne Vogt-Ryan
• 金额: --
• 依托单位: VA BOSTON HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10559484
• 关键词: Address; Area; Attention; Awareness; Chronic; Dissemination and Implementation; Effectiveness; Equipment and supply inventories; Evaluation; Feedback; Goals; Health; Healthcare; Home; Internet; Interruption; Intervention; Interview; Knowledge; Left; Life; Measurement; Measures; Mental Health; Mental Health Services; Methodology; Methods; Military Personnel; Occupations; Online Systems; Outcome; Pattern; Perception; Personal Satisfaction; Pilot Projects; Population Intervention; Privacy; Randomized; Recommendation; Research; Resources; Sampling; Self Administration; Self Direction; Services; Severities; Social support; Summary Reports; Testing; Time; Veterans; Vocation; Work; acceptability and feasibility; barrier to care; compare effectiveness; experience; functional disability; help-seeking behavior; high risk; individualized feedback; innovation; literacy; military service; pilot test; population based; programs; satisfaction; social; suicidal risk; therapy design; therapy development; usability; user centered design; user-friendly; willingness

Background: There is a growing recognition that Veterans’ broader vocational, financial, and social circumstances have substantial implications for their health and health care. These circumstances include factors such as whether a Veteran has a job, can pay his or her bills, and has a strong social support network. Although some Veterans seek help when they experience challenges in these life domains, many do not. One factor that stands in the way of Veterans’ help-seeking is lack of knowledge, both with regard to how severe challenges must be to warrant help-seeking and what resources are available to address these challenges. If not addressed, Veterans’ readjustment challenges may become chronic, escalate in severity, and negatively influence more aspects of Veterans’ lives over time and thus, become more difficult to intervene on. Significance: This study will provide a preliminary examination of the potential benefit of Measurement-Based Transition Assistance (MBTA) in promoting Veterans’ help-seeking. MBTA involves providing individualized feedback on areas in which Veterans would benefit from additional support, along with personalized recommendations for relevant programs, services, and supports. If effective, this scalable, population-based intervention strategy could be used independently or in conjunction with other help-seeking promotion approaches to interrupt high-risk trajectories before they lead to chronic maladjustment and risk for suicide. Innovation and Impact: While there has been substantial attention to the importance of promoting Veterans’ use of mental health care, we are not aware of any broad, measurement-based effort to enhance Veterans’ willingness to seek help for multiple areas of unmet need. In addition, most intervention strategies are targeted to the needs of Veterans with chronic patterns of functional impairment and poor health rather than Veterans who experience initial readjustment challenges as they adapt to post-military life. The current project is innovative in its evaluation of a self-administered, population-based approach to raise Veterans’ awareness of areas in which they may benefit from additional support and to connect them with relevant resources. Given that MBTA may be most beneficial to Veterans who experience initial readjustment challenges as they adapt to post-military life, this intervention will be evaluated among Veterans who have recently left military service. Specific Aim: Aim 1 is to refine MBTA based on input from VA stakeholders (n=6) and qualitative interviews with Veterans (n=12). A key focus of this aim is to determine the optimal approach for presenting results and recommended resources. Aim 2 is to evaluate the feasibility, acceptability, and preliminary effectiveness of MBTA in promoting Veterans’ support-seeking by testing this intervention in a sample of 60 Veterans. Methodology: The proposed work will be guided by established methods for intervention development and implementation that emphasize user-centered design principles and iterative cycles of refinement and pilot testing to enhance MBTA’s effectiveness and scalability. After refining MBTA based on feedback from VA stakeholders and Veterans (Aim 1), a national sample of Veterans will be randomized to MBTA or an assessment-only condition in a pilot RCT (Aim 2). The MBTA assessment will be comprised of validated measures of Veterans’ status, functioning, and satisfaction across life domains, along with well-established mental health screeners. Veterans in the MBTA condition will receive a user-friendly web-based report that summarizes areas of unmet need, as well as tailored recommendations for relevant resources. Feasibility and acceptability will be evaluated based on participation and completion rates, as well as satisfaction and usability ratings. We will also examine preliminary evidence for effectiveness by comparing pre-post changes in support-seeking outcomes for Veterans in intervention and control conditions. Next Steps/Implementation: This pilot study will inform a subsequent IIR proposal for a fully powered RCT to confirm the effectiveness of MBTA and to evaluate strategies to promote its dissemination and implementation.

背景：人们越来越认识到，退伍军人的更广泛的职业，财务和社会 情况对他们的健康和保健有重大影响。这些情况包括 这些因素包括退伍军人是否有工作，是否能支付账单，是否有强大的社会支持网络。 虽然一些退伍军人在这些生活领域遇到挑战时寻求帮助，但许多人没有。一 阻碍退伍军人寻求帮助的因素是缺乏知识，无论是关于如何严重， 挑战必须是需要寻求帮助，以及有什么资源可用于应对这些挑战。如果 如果不加以解决，退伍军人的重新适应挑战可能会成为长期的，严重程度会升级， 随着时间的推移，影响退伍军人生活的更多方面，因此变得更加难以干预。 意义：本研究将对基于测量的 过渡援助（MBTA），促进退伍军人寻求帮助。MBTA涉及提供个性化的 关于退伍军人将从额外支持中受益的领域的反馈，沿着个性化的 提供相关方案、服务和支持的建议。如果有效，这种可扩展的，基于人口的 干预策略可以单独使用，也可以与其他求助促进措施结合使用 在高风险轨迹导致慢性适应不良和自杀风险之前，采取各种方法来中断高风险轨迹。 创新和影响：虽然人们对促进退伍军人权利的重要性给予了极大的关注， 使用精神卫生保健，我们不知道任何广泛的，基于测量的努力，以提高退伍军人的 愿意为多个未满足需求的领域寻求帮助。此外，大多数干预战略都是有针对性的 满足慢性功能障碍和健康状况不佳的退伍军人的需求，而不是退伍军人的需求。 他们在适应退伍生活时经历了最初的重新调整挑战。本项目属 创新的自我管理，以人口为基础的方法，以提高退伍军人的认识， 在这些领域，他们可能受益于额外的支持，并将他们与相关资源联系起来。给定 MBTA可能是最有益的退伍军人谁经历了最初的重新调整挑战，因为他们适应 在退伍后的生活中，将在最近离开军队的退伍军人中评估这种干预措施。 具体目标：目标1是根据VA利益相关者（n=6）的输入和定性访谈完善MBTA 与退伍军人（n=12）。这一目标的一个关键重点是确定展示结果的最佳方法， 推荐资源目的2是评估的可行性，可接受性和初步有效性， MBTA在促进退伍军人的支持寻求通过测试这种干预在60名退伍军人的样本。 方法：拟议的工作将以制定干预措施的既定方法为指导， 强调以用户为中心设计原则和反复的改进和试验的实现 测试，以提高MBTA的有效性和可扩展性。根据VA的反馈改进MBTA后 利益相关者和退伍军人（目标1），退伍军人的国家样本将被随机分配到MBTA或 试验性RCT中的仅评估条件（目标2）。MBTA评估将包括经验证的 退伍军人的地位，功能和生活领域的满意度的措施，沿着与完善的 心理健康筛查MBTA条件下的退伍军人将收到一份用户友好的基于网络的报告， 总结了未满足需求的领域，以及针对相关资源的定制建议。可行性和 可接受性将根据参与率和完成率以及满意度和可用性进行评估 评级.我们还将通过比较以下方面的前后变化来检查有效性的初步证据： 在干预和控制条件下为退伍军人寻求支持的结果。 后续步骤/实施：该试点研究将为后续IIR建议提供信息，以便进行全面的RCT， 确认MBTA的有效性，并评估促进其传播和实施的战略。