Building on theory and previous empirical results, the short term goal of the proposed study will develop a patient-oriented intervention to promote entry into behavioral health treatments for newly returning soldiers deployed for Operation Iraqi Freedom (OIF) who screen positive for a behavioral health disorder. The long term goal of this research is to evaluate the effectiveness of an intervention to improve the likelihood that veterans with combat-related disorders will seek treatments in a timely manner. Using mixed qualitative and quantitative methods, specific aims are as follows: 1) Identify behavioral, normative and control beliefs among returning veterans with combat-related behavioral health disorders about treatment initiation. Beliefs about behavioral health treatments will be identified through qualitative, in-depth interviews. 2) Determine which behavioral, normative and control beliefs are predictive of treatment initiation. Using the beliefs identified in the qualitative interviews, a questionnaire will be developed according to the Theory of Planned Behavior (TpB). Veterans who screen positive for a behavioral health disorder will be administered this questionnaire and participate in a follow-up phone call to assess which veterans initiated treatment. Multivariate regression analysis will be used to determine which beliefs predict behavioral health treatment initiation controlling for other factors known to increase mental health treatment initiation. 3) Develop a brief, individualized intervention for veterans with combat-related behavioral health disorders and assess its acceptability and efficacy. CBT principles will be used to develop a brief structured intervention that targets each specific belief about behavioral health treatments. Only beliefs found to predict treatment attendance will be targeted. A pre-test to assess acceptability will be conducted. In addition, a preliminary assessment of efficacy will be conducted by comparing veterans' intention to initiate behavioral health care before and after the intervention. Treatment initiation rates among returning soldiers are alarmingly low, and research is urgently needed to develop and test interventions to improve treatment initiation. Results of the proposed research will be used as preliminary data for an application for an R01 multi-site study to evaluate the clinical-and cost-effectiveness of a brief intervention to promote entry into treatment for newly returning veterans with combat related disorders. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Planning Grant (R34)
Project #
5R34MH078898-04
Application #
7476494
Study Section
Special Emphasis Panel (ZMH1-ERB-W (08))
Program Officer
Tuma, Farris K
Project Start
2006-09-28
Project End
2010-07-31
Budget Start
2008-08-01
Budget End
2010-07-31
Support Year
4
Fiscal Year
2008
Total Cost
$236,993
Indirect Cost
Name
Dartmouth College
Department
Family Medicine
Type
Schools of Medicine
DUNS #
041027822
City
Hanover
State
NH
Country
United States
Zip Code
03755
Stecker, Tracy; Fortney, John C; Sherbourne, Cathy D (2011) An intervention to increase mental health treatment engagement among OIF Veterans: a pilot trial. Mil Med 176:613-9