Combination outreach and wellness intervention for distressed rural veterans: results of a multimethod pilot study
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Combination outreach and wellness intervention for distressed rural veterans: results of a multimethod pilot study Lilian Dindo1,2,3 · McKenzie K. Roddy4 · Derrecka Boykin5,4 · Ken Woods2,5 · Merlyn Rodrigues2,3 · Tracey L. Smith4 · Raquel D. Gonzalez2,5 · Gala True6,7
Received: 30 May 2020 / Accepted: 30 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract We partnered with veteran-serving nonprofits in order to identify distressed rural veterans and provide them with a mental health workshop in community-based settings. Community organizations helped recruit veterans and provided space for 1-day (5-h) Acceptance and Commitment Therapy (ACT) group workshops conducted in rural locations. Qualitative interviews were conducted at 1- and 3-months post-intervention to assess acceptability. Quantitative measures were conducted at baseline, 1- and 3-months post-intervention to measure effectiveness. We successfully Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10865-020-00177-8) contains supplementary material, which is available to authorized users. * Lilian Dindo [email protected] 1
2
VA Office of Rural Health, Veterans Rural Health Resource Center‑Iowa City (VRHRC‑IC), Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, 2450 Holcombe Blvd Suite 01Y, Houston, TX 77021, USA
3
Department of Medicine, Health Services Research, Baylor College of Medicine, Houston, TX, USA
4
Menninger Department of Psychiatry and Behavioral Medicine, Baylor College of Medicine, Houston, TX, USA
5
South Central Mental Illness, Research, Education and Clinical Center, Michael E DeBakey Veterans Affairs Medical Center, Houston, TX, USA
6
South Central Mental Illness, Research, Education and Clinical Center, Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA
7
Section on Community and Population Medicine, Louisiana State University School of Medicine, New Orleans, LA, USA
engaged community partners throughout every stage of the research and delivered workshops to thirty-one veterans in rural community-based locations. Veterans appreciated the structure, content, and environment of the workshops; most implemented ACT skills into their daily lives and some initiated new treatment following workshop participation. Quantitative measures showed improvements in functioning (Cohen’s d ranging from .27 to .40), reintegration (Cohen’s d = .45), meaning and purpose (Cohen’s d = .40), and reductions in distress (Cohen’s d ranging from .28 to .40) 3-months following workshop participation. Collaborating with rural veteran-serving nonprofit organizations holds promise for engaging hard-to-reach distressed veterans in mental health care. Keywords Acceptance and commitment therapy · Rural · Veterans · Community engagement · Qualitative
Introduction Men and women with a histo
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