Pilot Testing a Virtual Mindfulness-Based Intervention Aimed at Improving Reintegrating Veterans' Health Outcomes

试点测试基于虚拟正念的干预措施，旨在改善退伍军人重返社会的健康结果

• 批准号: 10749770
• 负责人: Sarah Shue
• 金额: --
• 依托单位: RLR VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10749770
• 关键词: Address; Affect; Anxiety; Applications Grants; Area; Award; Collaborations; Community Healthcare; Consult; Control Groups; Data; Diagnosis; Education; Ensure; Family; Feedback; Funding; Future; Goals; Health; Health Services Research; Healthcare Systems; Intervention; Interview; Investigator-Initiated Research; Life; Manuals; Meditation; Mental Depression; Mental Health; Mental Health Services; Methodology; Methods; Military Personnel; Modality; Outcome; Outcome Assessment; Participant; Patient-Centered Care; Patients; Personal Satisfaction; Persons; Pilot Projects; Procedures; Process; Protocols documentation; Randomized; Randomized, Controlled Trials; Reporting; Research; Research Priority; Resources; Sampling; Scanning; Services; Sleep; Social isolation; Social support; Strategic Planning; Stress; Structure; Subgroup; Suggestion; Testing; United States Department of Veterans Affairs; Update; Veterans; Veterans Health Administration; Work; Yoga; acceptability and feasibility; arm; care delivery; cohort; community reintegration; cost; critical period; depressive symptoms; design; effectiveness evaluation; experience; feasibility testing; hybrid type 1 trial; improved; innovation; interest; internalized stigma; intervention refinement; military service; mindfulness; mindfulness intervention; mindfulness meditation; pilot test; post 9/11; programs; psychoeducation; psychoeducational; psychosocial; psychosocial adjustment; psychosocial stressors; randomized controlled design; randomized trial; recruit; research and development; treatment arm; virtual; virtual delivery; virtual intervention; whole health

Background: Community reintegration is a critical period of transition for post-9/11 Veterans. Difficulties associated with the transition out of military service are well documented and include challenges such as social isolation and loss of structure. Depression is common among reintegrating post-9/11 Veterans and can further complicate these reintegration challenges. Despite the well-documented needs of post-9/11 Veterans and numerous resources, Veterans continue to report inadequate support and are not using available services. As such, it is critical to develop reintegration services that can effectively address Veterans' mental health care needs using approaches that increase the likelihood of Veteran engagement. Significance: The Veterans Affairs (VA) Administration has committed to addressing the transition-related challenges of the post-9/11 Veteran cohort, particularly programming to support their mental health care needs. Mental health is also a priority research area. The VA's 2022-2028 Strategic Plan includes a strategic goal that ensures VA programs and initiatives support the whole person and address mental health and other challenges affecting Veterans' well-being, including the military-to-civilian transition. The REconnecting to Civilian Life using Activities that Improve Mindfulness (RECLAIM) intervention addresses the priority and strategy of addressing reintegrating post-9/11 Veterans' mental health. We will also elicit Veterans' experiences in participating in a virtual intervention to expand the understanding of how best to design and implement interventions with virtual components, which informs another high priority research area. Innovation and impact: RECLAIM introduces a variety of brief mindfulness-based practices (averaging 10 minutes), which are integrated with additional components, such as education and group discussion, that focus on aspects of Veterans' community reintegration (e.g., sleep, relationships). RECLAIM sessions expand on traditional practice offerings (body scan, yoga) to include other mindfulness practices (inner resource, restorative meditations) that have demonstrated positive impacts on participants' overall functioning and can mitigate anxiety, stress, and depression. The variety of brief practices in RECLAIM allows Veterans to easily integrate these practices into their daily lives and explore several types of practices to find what best meets their needs. This approach increases the likelihood of continued engagement and, therefore, continued benefit. Additionally, virtual delivery of RECLAIM is based on previous research suggesting that virtual offerings may enhance Veterans' engagement with mindfulness-based interventions. Specific aims: The specific aims of this project are (1) conduct a randomized controlled pilot study to assess feasibility of the RECLAIM intervention; (2) conduct qualitative interviews to assess acceptability of RECLAIM; and (3) refine and prepare the RECLAIM intervention for broader testing. Methodology: In Aim 1, we will conduct a two-arm randomized controlled pilot study to assess aspects of feasibility (e.g., recruitment, randomization, retention in both the intervention and control arms). In Aim 2, we will use qualitative interviews to elicit input from a purposefully sampled subgroup of Aim 1 RECLAIM participants (N=16) to assess acceptability. We will use rapid qualitative inquiry to conduct the analysis. In Aim 3, we will use the findings from Aims 1 and 2 to iteratively refine the RECLAIM protocol and testing procedures. We will consult with a panel of Veterans from the HSR&D CHIC Research Advisory Panel and operational partners (e.g., Office of Patient Centered Care and Cultural Transformation). Next steps/implementation: Findings from the proposed pilot project will directly inform and provide key pilot data for a Health Services Research and Development (HSR&D) Investigator Initiated Research (IIR) Merit grant application. The future IIR will assess the effectiveness of RECLAIM in a fully powered randomized controlled trial while simultaneously planning for implementation.

背景：重返社区是9/11后退伍军人过渡的关键时期。困难 与从兵役中过渡出来有关的挑战有据可查，其中包括社会问题， 隔离和结构损失。抑郁症在9/11后重返社会的退伍军人中很常见， 使这些重返社会的挑战更加复杂。尽管9/11事件后退伍军人的需求有据可查， 尽管有许多资源，但退伍军人继续报告支持不足，没有使用现有的服务。作为 因此，发展能够有效解决退伍军人心理健康问题的重返社会服务至关重要 需要使用增加退伍军人参与可能性的方法。 意义：退伍军人事务部（VA）管理局致力于解决与过渡有关的问题。 后9/11退伍军人群体的挑战，特别是支持他们的心理健康护理的计划 需求心理健康也是一个优先研究领域。VA的2022-2028战略计划包括一个战略 确保VA计划和举措支持整个人并解决心理健康和其他问题的目标 影响退伍军人福祉的挑战，包括从军事到平民的过渡。重新连接到 平民生活使用活动，提高正念（RECLAIM）干预解决的优先事项， 解决9/11后退伍军人心理健康问题的战略。我们还将引发退伍军人的 参与虚拟干预的经验，以扩大对如何最好地设计和 利用虚拟组件实施干预措施，为另一个高度优先的研究领域提供信息。 创新和影响：RECLAIM介绍了各种简短的正念练习（平均10 这些内容与教育和小组讨论等其他内容相结合， 退伍军人重返社区的各个方面（例如，睡眠，关系）。RECLAIM会话扩展到 传统的练习产品（身体扫描，瑜伽），包括其他正念练习（内部资源， 恢复性冥想）对参与者的整体功能产生了积极影响， 缓解焦虑、压力和抑郁。RECLAIM中的各种简短实践使退伍军人可以轻松地 将这些实践融入他们的日常生活，并探索几种类型的实践，以找到最适合的实践 他们的需求这种方法增加了持续参与的可能性，因此也增加了持续受益的可能性。 此外，RECLAIM的虚拟交付基于先前的研究，表明虚拟产品可能 加强退伍军人对正念干预的参与。 具体目的：本项目的具体目的是（1）进行随机对照的初步研究，以评估 RECLAIM干预的可行性：（2）进行定性访谈，以评估RECLAIM的可接受性; 和（3）完善和准备RECLAIM干预措施，以进行更广泛的测试。 方法：在目标1中，我们将进行一项两组随机对照的初步研究，以评估 可行性（例如，招募、随机化、保留在干预组和对照组中）。在目标2中， 我将使用定性访谈，从目标1 RECLAIM的一个有目的的抽样小组中获得输入 参与者（N=16）评估可接受性。我们将使用快速定性调查进行分析。在Aim中 3，我们将使用目标1和2的发现来迭代地改进RECLAIM协议和测试程序。 我们将咨询HSR&D CHIC研究咨询小组的退伍军人小组， 合作伙伴（例如，以患者为中心的护理和文化转型办公室（Office of Patient Centered Care and Cultural Transformation） 今后的步骤/实施：拟议试点项目的调查结果将直接提供信息，并提供关键的试点 卫生服务研究与发展（HSR&D）研究者发起的研究（IIR） 补助金申请未来的IIR将评估RECLAIM在完全随机化中的有效性。 对照试验，同时计划实施。