Pilot Testing a Virtual Mindfulness-Based Intervention Aimed at Improving Reintegrating Veterans' Health Outcomes

试点测试基于虚拟正念的干预措施，旨在改善退伍军人重返社会的健康结果

• 批准号: 10749770
• 负责人: Sarah Shue
• 金额: --
• 依托单位: RLR VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10749770
• 关键词: Address; Affect; Anxiety; Applications Grants; Area; Award; Collaborations; Community Healthcare; Consult; Control Groups; Data; Diagnosis; Education; Ensure; Family; Feedback; Funding; Future; Goals; Health; Health Services Research; Healthcare Systems; Intervention; Interview; Investigator-Initiated Research; Life; Manuals; Meditation; Mental Depression; Mental Health; Mental Health Services; Methodology; Methods; Military Personnel; Modality; Outcome; Outcome Assessment; Participant; Patient-Centered Care; Patients; Personal Satisfaction; Persons; Pilot Projects; Procedures; Process; Protocols documentation; Randomized; Randomized, Controlled Trials; Reporting; Research; Research Priority; Resources; Sampling; Scanning; Services; Sleep; Social isolation; Social support; Strategic Planning; Stress; Structure; Subgroup; Suggestion; Testing; United States Department of Veterans Affairs; Update; Veterans; Veterans Health Administration; Work; Yoga; acceptability and feasibility; arm; care delivery; cohort; community reintegration; cost; critical period; depressive symptoms; design; effectiveness evaluation; experience; feasibility testing; hybrid type 1 trial; improved; innovation; interest; internalized stigma; intervention refinement; military service; mindfulness; mindfulness intervention; mindfulness meditation; pilot test; post 9/11; programs; psychoeducation; psychoeducational; psychosocial; psychosocial adjustment; psychosocial stressors; randomized controlled design; randomized trial; recruit; research and development; treatment arm; virtual; virtual delivery; virtual intervention; whole health

Background: Community reintegration is a critical period of transition for post-9/11 Veterans. Difficulties associated with the transition out of military service are well documented and include challenges such as social isolation and loss of structure. Depression is common among reintegrating post-9/11 Veterans and can further complicate these reintegration challenges. Despite the well-documented needs of post-9/11 Veterans and numerous resources, Veterans continue to report inadequate support and are not using available services. As such, it is critical to develop reintegration services that can effectively address Veterans' mental health care needs using approaches that increase the likelihood of Veteran engagement. Significance: The Veterans Affairs (VA) Administration has committed to addressing the transition-related challenges of the post-9/11 Veteran cohort, particularly programming to support their mental health care needs. Mental health is also a priority research area. The VA's 2022-2028 Strategic Plan includes a strategic goal that ensures VA programs and initiatives support the whole person and address mental health and other challenges affecting Veterans' well-being, including the military-to-civilian transition. The REconnecting to Civilian Life using Activities that Improve Mindfulness (RECLAIM) intervention addresses the priority and strategy of addressing reintegrating post-9/11 Veterans' mental health. We will also elicit Veterans' experiences in participating in a virtual intervention to expand the understanding of how best to design and implement interventions with virtual components, which informs another high priority research area. Innovation and impact: RECLAIM introduces a variety of brief mindfulness-based practices (averaging 10 minutes), which are integrated with additional components, such as education and group discussion, that focus on aspects of Veterans' community reintegration (e.g., sleep, relationships). RECLAIM sessions expand on traditional practice offerings (body scan, yoga) to include other mindfulness practices (inner resource, restorative meditations) that have demonstrated positive impacts on participants' overall functioning and can mitigate anxiety, stress, and depression. The variety of brief practices in RECLAIM allows Veterans to easily integrate these practices into their daily lives and explore several types of practices to find what best meets their needs. This approach increases the likelihood of continued engagement and, therefore, continued benefit. Additionally, virtual delivery of RECLAIM is based on previous research suggesting that virtual offerings may enhance Veterans' engagement with mindfulness-based interventions. Specific aims: The specific aims of this project are (1) conduct a randomized controlled pilot study to assess feasibility of the RECLAIM intervention; (2) conduct qualitative interviews to assess acceptability of RECLAIM; and (3) refine and prepare the RECLAIM intervention for broader testing. Methodology: In Aim 1, we will conduct a two-arm randomized controlled pilot study to assess aspects of feasibility (e.g., recruitment, randomization, retention in both the intervention and control arms). In Aim 2, we will use qualitative interviews to elicit input from a purposefully sampled subgroup of Aim 1 RECLAIM participants (N=16) to assess acceptability. We will use rapid qualitative inquiry to conduct the analysis. In Aim 3, we will use the findings from Aims 1 and 2 to iteratively refine the RECLAIM protocol and testing procedures. We will consult with a panel of Veterans from the HSR&D CHIC Research Advisory Panel and operational partners (e.g., Office of Patient Centered Care and Cultural Transformation). Next steps/implementation: Findings from the proposed pilot project will directly inform and provide key pilot data for a Health Services Research and Development (HSR&D) Investigator Initiated Research (IIR) Merit grant application. The future IIR will assess the effectiveness of RECLAIM in a fully powered randomized controlled trial while simultaneously planning for implementation.

背景：社区重返社会是9/11后退伍军人的关键时期。困难 与兵役中的过渡相关的已充分记录，包括社会等挑战 隔离和结构损失。抑郁症在9/11后退伍军人之间很常见，可以进一步 使这些重新整合挑战变得复杂。尽管有充分记录的9/11后退伍军人和 大量资源，退伍军人继续报告支持不足，并且没有使用可用的服务。作为 这样的建立可以有效解决退伍军人心理保健的重返社会服务至关重要 需要使用增加退伍军人参与可能性的方法。 意义：退伍军人事务（VA）政府已致力于解决与过渡有关的问题 9/11后老将队列的挑战，特别是为支持其心理保健的编程 需要。心理健康也是优先研究领域。 VA的2022-2028战略计划包括战略 确保VA计划和计划支持整个人的目标，并解决心理健康和其他 影响退伍军人福祉的挑战，包括军事到西维利人的过渡。重新连接 使用改善正念（收回）干预的活动的平民生活解决了优先事项和 解决9/11后退伍军人心理健康的策略。我们还将引起退伍军人的 参与虚拟干预的经验，以扩展对如何最好地设计和 实施虚拟组件的干预措施，这为另一个高优先研究领域提供了信息。 创新和影响：回收引入了各种简短的基于正念的做法（平均10 分钟），与其他组成部分（例如教育和小组讨论）集成在一起的分钟） 关于退伍军人社区重返社会的各个方面（例如睡眠，人际关系）。回收会议扩展 传统的练习产品（身体扫描，瑜伽）包括其他正念练习（内部资源， 恢复性冥想），对参与者的整体功能表现出积极影响，并且可以 减轻焦虑，压力和抑郁。收回的各种简短做法使退伍军人可以轻松 将这些实践融入他们的日常生活中，并探索几种类型的实践，以找到最佳满足 他们的需求。这种方法增加了持续参与的可能性，因此增加了持续的利益。 此外，恢复的虚拟交付是基于以前的研究，表明虚拟产品可能 增强退伍军人参与基于正念的干预措施。 具体目的：该项目的具体目的是（1）进行随机对照试验研究以评估 回收干预的可行性； （2）进行定性访谈以评估回收的可接受性； （3）完善并准备回收干预措施，以进行更广泛的测试。 方法论：在AIM 1中，我们将进行一项两臂随机对照试验研究，以评估 可行性（例如，招募，随机分配，在干预和控制臂中保留）。在AIM 2中，我们 将使用定性访谈从AIM 1的有目的取样子组中引起投入 参与者（n = 16）评估可接受性。我们将使用快速的定性查询进行分析。目标 3，我们将使用目标1和2的发现来迭代地完善回收协议和测试程序。 我们将咨询来自HSR＆D CHIC研究咨询小组和运营的退伍军人小组 合作伙伴（例如，以患者为中心的护理和文化转型办公室）。 下一步/实施：拟议的飞行员项目的调查结果将直接告知并提供关键飞行员 卫生服务研究与发展的数据（HSR＆D）研究者启动研究（IIR）优点 授予申请。未来的IIR将评估完全动力随机的回收有效性 对照试验，同时计划实施。