Photovoice as an Educational Intervention to Improve Care of OEF/OIF Veterans

Photovoice 作为一种教育干预措施，改善 OEF/OIF 退伍军人的护理

• 批准号: 8201855
• 负责人: Jennifer Gala True
• 金额: --
• 依托单位: PHILADELPHIA VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-10-01 至 2012-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8201855
• 关键词: Afghanistan; Ambulatory Care Facilities; Anxiety; Appointment; Attitude; Caring; Chronic Post Traumatic Stress Disorder; Communication; Communities; Complex; Data Collection; Educational Intervention; Effectiveness; Elements; Employee; Enrollment; Environment; Event; Exhibits; Eye; Face; Family; Fostering; Freedom; Goals; Health; Health Communication; Healthcare; Image; Individual; Institution; Intervention; Iraq; Knowledge; Leadership; Life; Measures; Medical center; Mental Depression; Methods; Military Personnel; Mission; Modeling; Outcome; Pain; Participant; Patient-Centered Care; Patients; Persons; Pilot Projects; Play; Positioning Attribute; Post-Traumatic Stress Disorders; Provider; Published Comment; Qualifying; Quality of Care; Questionnaires; Recruitment Activity; Research; Role; Sampling; Self Efficacy; Site; Social isolation; Training; Traumatic Brain Injury; Trust; Universities; Veterans; Visual; War; Work; Writing; base; chronic pain; combat; design; direct patient care; disability; empowered; experience; follow-up; improved; innovation; meetings; novel strategies; operation; patient oriented; response; skeletal; social; social stigma; tool

DESCRIPTION (provided by applicant): Anticipated Impacts on Veteran's Healthcare: Photovoice is an innovative participatory research tool that empowers individuals to convey their experiences, perspectives, and needs through visual images and first- person narratives. Establishing feasibility of Photovoice with OEF/OIF Veterans will provide a novel approach to engaging Veterans in their own care, improving patient-provider communication, and sensitizing VA providers and staff to the experiences of returning Veterans. Our long-term goal is to develop a scalable version of Photovoice as an educational intervention to enhance the provision of patient-centered care to OEF/OIF Veterans. Project Background: Veterans returning from combat deployments as part of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF) face complex challenges in making the transition to post-deployment life. The VA is uniquely positioned to meet the needs of combat Veterans and support successful reintegration. However, less than half of returning Veterans come to the VA for care, and many of those who do fail to attend follow-up appointments. Many OEF/OIF Veterans lack a sense of connection with the VA, and in return, VA leadership, providers and staff may have difficulty relating to the deployment and post-deployment experiences of combat Veterans. Innovative approaches are needed to help bridge these gaps in knowledge and understanding and to promote an environment of patient-centered care for OEF/OIF Veterans at the VA. Building a sense of connection, rapport, and trust among stakeholders (VA leadership/providers/staff and Veterans) while enabling clinicians to see illness and health through the patient's eyes are key elements of a patient-centered care model, an essential step to improving the equity and quality of care provided by the VA to returning Veterans. Project Objectives: The primary aim of the proposed pilot project is to establish feasibility of Photovoice with OEF/OIF Veterans. Our secondary aims are to explore preliminary effectiveness of Photovoice as an educational intervention to: 1. increase health communication self-efficacy and decrease social anxiety for Veteran participants and 2. positively impact attitudes and knowledge of VA leadership, providers, and staff as relates to the experiences and needs of OEF/OIF Veterans. Findings from the pilot study will inform the design of a multi-site study of Photovoice as an educational intervention for Veterans and VA providers/staff, including identification of appropriate outcome variables and data collection tools. The broad, long-term objective of the work is to improve the quality and equity of care for OEF/OIF Veterans. Project Methods: In this mixed methods study, 40 OEF/OIF Veterans will participate in a Photovoice project to produce statements made up of pictures and words that communicate their experiences and perspectives related to combat deployment(s) and post-deployment reintegration. The sample will include Veterans who are being treated at a VA Medical Center (e.g. for chronic pain, Traumatic Brain Injury, polytrauma and/or PTSD). The sample will also include OEF/OIF Veterans who have not accessed VA care; these participants will be recruited through local universities, National Guard and Reserve units, and Vet Centers. Findings from the Photovoice project will be disseminated to VA leadership, providers and staff through a Photovoice exhibit on- site at the Medical Center, Grand Rounds presentations, and other educational and training events at the Medical Center and associated CBOCs. Preliminary effectiveness of Photovoice participation as an intervention to increase self-efficacy and decrease social anxiety among OEF/OIF Veterans will be measured by change in responses to questionnaires administered before and after Photovoice participation. The impact of attending a Photovoice exhibit or presentation on VA providers and staff will be assessed through written comments and small-group discussions.

描述（由申请人提供）： 对退伍军人的医疗保健的预期影响：Photovoice是一种创新的参与研究工具，可以通过视觉图像和第一人称叙事来促进个人传达其经验，观点和需求。通过OEF/OIF退伍军人建立光电设备的可行性将提供一种新颖的方法，以使退伍军人参与自己的护理，改善患者提供者的沟通，并使VA提供者和员工敏感到返回退伍军人的经验。我们的长期目标是开发可扩展版本的光电设备作为一种教育干预措施，以增强以患者为中心的护理为OEF/OIF退伍军人提供。项目背景：从战斗部署中返回的退伍军人，作为持久自由（OEF）的行动的一部分，伊拉克自由（OIF）在过渡到剥离后生活时面临着复杂的挑战。 VA是独特的，可以满足战斗退伍军人的需求并支持成功的重返社会。但是，不到一半的退伍军人来到弗吉尼亚州进行护理，许多确实没有参加后续约会的人。许多OEF/OIF退伍军人缺乏与VA的联系感，作为回报，VA领导，提供者和员工可能难以与战斗退伍军人的部署和部署后经历有关。需要创新的方法来帮助弥合知识和理解方面的这些差距，并在VA上促进针对OEF/OIF退伍军人的以患者为中心的护理环境。在利益相关者（VA领导力/提供者/员工和退伍军人）之间建立联系感，融洽和信任感，同时使临床医生能够通过患者的眼睛看到疾病和健康，这是以患者为中心的护理模型的关键要素，这是改善VA提供的护理净值和质量的重要一步。项目目标：拟议的试点项目的主要目的是通过OEF/OIF退伍军人建立光载的可行性。我们的次要目的是探索光伏的初步有效性，作为：1。提高健康沟通自我效能感，减少对退伍军人参与者的社交焦虑和2。对VA领导力，提供者和员工作为与OEF/OIF/OIF/OIF/OIF Veterans的经验和需求相关的态度和知识。试点研究的发现将为对退伍军人和VA提供者/员工的教育干预提供多站点研究的设计，包括识别适当的结果变量和数据收集工具。这项工作的广泛，长期目标是提高OEF/OIF退伍军人的护理质量和公平性。项目方法：在这项混合方法研究中，有40名OEF/OIF退伍军人将参加一个光电库项目，以产生由图片和单词组成的陈述，这些陈述传达了与战斗部署相关的经验和观点，以及剥夺后的重新整合。样本将包括在VA医疗中心接受治疗的退伍军人（例如，用于慢性疼痛，脑外伤，多发性疾病和/或PTSD）。样本还包括未访问VA护理的OEF/OIF退伍军人；这些参与者将通过当地大学，国民警卫队和预备队和兽医中心招募。 Photovoice项目的调查结果将通过医疗中心的Photovoice展览，大回合演讲以及医疗中心和相关CBOC的其他教育和培训活动，将其传播给VA领导，提供者和员工。光箱参与作为提高自我效能感和减少OEF/OIF退伍军人社交焦虑的干预措施的初步有效性，将通过在光盘参与前后对问卷的回答的变化来衡量。参加光盘展览或演讲对VA提供者和员工的影响将通过书面评论和小组讨论进行评估。