Background: Mental health research on Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) Veterans in VHA care highlights the high prevalence of posttraumatic stress disorder (PTSD) among this important population. Although high quality, evidence-based PTSD treatment is available in VHA, and is necessary to help heal these OEF/OIF/OND Veterans with PTSD and to avoid the possibility of chronicity, mental health treatment seeking and utilization is extremely low among those with PTSD. The yearly VHA mandatory PTSD screening program may be an important early identification and treatment access point for OEF/OIF/OND Veterans with PTSD who have not actively sought care for their PTSD symptoms. However, characterizing factors associated with timely treatment initiation and engagement among OEF/OIF/OND patients who are identified with PTSD via the screening program has not been accomplished. Further research is also needed to identify potential ways to increase timely treatment initiation and engagement for all OEF/OIF/OND Veterans with PTSD, to test interventions aimed at enhancing PTSD treatment initiation and engagement, and to understand implementation issues related to maximizing the potential impact of developed interventions. Objectives: The purpose of this project is to provide critical and timely evidence to fill in the existing gaps regarding treatment initiation and engagement among OEF/OIF/OND Veterans with PTSD in VHA.
The specific aims of the proposed CDA-2 research are: (1) to identify patient and provider factors associated with timely treatment initiation and continued engagement among all OEF/OIF/OND Veterans in VHA care who receive positive PTSD screens and are diagnosed with PTSD in primary care; (2) further elucidate patient factors associated with timely initiation and continued engagement in PTSD treatment using a qualitative approach with provider and OEF/OIF/OND Veteran patient focus groups; (

Public Health Relevance

Studies indicate that rates of posttraumatic stress disorder (PTSD) among US Service Members returning from Iraq and Afghanistan are high, yet use of mental health treatment among these individuals is low. Therefore, it is likely that many Veterans of these conflicts receiving their healthcare through the Veterans Health Administration (VHA) have an urgent need for PTSD mental health services. VHA has a mandatory yearly screening program to help identify Veterans with PTSD; however, little VHA system-wide research has examined ways to improve timely PTSD treatment initiation and engagement for those with PTSD identified via the screening program. Therefore, the goals of the proposed CDA are to study factors associated with timely PTSD treatment initiation and engagement, uncover ways to improve treatment initiation and engagement, conduct a small trial aimed at enhancing treatment initiation and engagement, and better understand strategies to implement relevant findings in order to optimize VHA care for all Veterans with PTSD from these conflicts.

Agency
National Institute of Health (NIH)
Institute
Veterans Affairs (VA)
Type
Veterans Administration (IK2)
Project #
5IK2HX000970-04
Application #
10178090
Study Section
HSR&D Career Development Award (CDA0)
Project Start
2014-07-01
Project End
2019-06-30
Budget Start
2017-07-01
Budget End
2018-06-30
Support Year
4
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Veterans Health Administration
Department
Type
DUNS #
096318480
City
Ann Arbor
State
MI
Country
United States
Zip Code
48105