Anticipated Impacts on Veterans Health Care Behavioral health problems among Veterans have raised awareness of the critical need for more reliable, effective, and accessible means to recognize those in need, direct them to help, and ensure that they receive the best treatment available. Research has suggested that people are most responsive to advice and education when it comes from someone to whom they can relate. AboutFace is a peer education program for Veterans developed and launched by the National Center for PTSD. It features the personal stories of Veterans and is designed to reduce stigma and improve attitudes among Veterans toward seeking mental health services. We propose to conduct a pilot evaluation of AboutFace. The feedback we receive in this pilot will be used to strengthen the quality of AboutFace in preparation for large-scale evaluation that will evaluate its reach and effectiveness. If AboutFace is found to increase access to services, data would have broad and significant implications for overcoming barriers to care for Veterans with stigmatized conditions. Background Research suggests that at least 1 in 10 Veterans will meet criteria for posttraumatic stress disorder (PTSD) related to their military experience. Evidence-based treatment is widely available to Veterans with PTSD, and national dissemination initiatives have increased Veterans' access to best-practice interventions. However, treatment seeking remains strikingly low among Veterans with PTSD. In fact, most Veterans with PTSD do not seek mental health services due to perceived stigma and other associated barriers. The National Center for PTSD recently developed and launched AboutFace, a peer-education resource for Veterans. We believe that AboutFace has tremendous potential to reduce stigma and improve attitudes toward seeking mental health services among Veterans. However, it has not yet been evaluated. We have partnered with the National Center for PTSD to launch this pilot evaluation of AboutFace. Objectives We will conduct a sequential mixed methods study with Veterans who are good candidates for PTSD treatment at our local VA facility. First, we will conduct an in-person evaluation of Veterans' use of the site and reactions to the content. Veterans will be recruited individually and will participate in a ~60-min usability testing evaluation in which we observe how Veterans navigate the site and ask them to complete a variety of tasks and answer interview questions relating to key content areas. Second, we will recruit a racially and geographically diverse sample of Veterans to assess recruitment feasibility, use of the site at home, stigma, and attitudes toward seeking mental health services. Pilot data will inform a subsequent Merit application. Methods We will use mixed methods to conduct a pilot evaluation of AboutFace. First, we will conduct usability testing sessions with 20 Veterans who are good candidates for PTSD treatment. We will transcribe and code the audio-recorded sessions. These data will inform improvements to the AboutFace site. Second, we will recruit 60 Veterans to pilot the methodology that we will propose to use in a larger HSR&D Merit application. Specifically, we will randomly assign Veterans to receive AboutFace vs. standard peer education. We will assess stigma, attitudes toward seeking mental health services, and initiation of PTSD treatment on site. These data will be used to guide methodological decisions (e.g., recruitment feasibility, estimating sample size) in a subsequent Merit application.
Behavioral health problems among Veterans have raised awareness of the critical need for more reliable, effective, and accessible ways to recognize those in need, direct them to help, and ensure that they receive the best treatment available. AboutFace is a novel peer education program that features the personal stories of Veterans and is designed to reduce stigma and improve attitudes among Veterans toward seeking mental health services. We propose to conduct a pilot evaluation of AboutFace. The feedback we receive in this pilot will be used to strengthen the quality of AboutFace in preparation for large-scale evaluation that will evaluate its reach and effectiveness. If AboutFace is found to increase access to services, data would have broad and significant implications for overcoming barriers to care for Veterans with stigmatized conditions.
| Bunnell, Brian E; Davidson, Tatiana M; Hamblen, Jessica L et al. (2017) Protocol for the evaluation of a digital storytelling approach to address stigma and improve readiness to seek services among veterans. Pilot Feasibility Stud 3:7 |
| W Adams, Zachary; McClure, Erin A; Gray, Kevin M et al. (2017) Mobile devices for the remote acquisition of physiological and behavioral biomarkers in psychiatric clinical research. J Psychiatr Res 85:1-14 |
