Outreach Intervention For OIF Veterans To Promote Use Of Mental Health Services
Tracy A Stecker
Community And Family Medicinedartmouth College
Grant 5R34MH078898-04 from National Institute Of Mental Health, IRG: ZMH1
Abstract: 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
Keywords: early /brief intervention /therapy, health care service utilization, medical outreach /case finding, mental health service, therapy design /development, veteran behavior prediction, belief, cognitive behavior therapy, health behavior, health care service availability, mental disorder, war /peace behavioral /social science research tag, clinical research, health services research tag, human subject, interview, questionnaire
Project start date: 2006-09-28
Project end date: 2009-07-31
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Outreach Intervention For OIF Veterans To Promote Use Of Mental Health Services
Tracy A Stecker
University Of Arkansas Med Scis Ltl Rock 4301 W Markham St Little Rock, Ar 72205
Grant 5R34MH078898-02 from National Institute Of Mental Health, IRG: ZMH1
Abstract: 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.
Keywords: early /brief intervention /therapy, health care service utilization, medical outreach /case finding, mental health service, therapy design /development, veteran, behavior prediction, belief, cognitive behavior therapy, health behavior, health care service availability, mental disorder, war /peace, behavioral /social science research tag, clinical research, health services research tag, human subject, interview, questionnaire
Project start date: 2006-09-28
Project end date: 2007-10-31
5R34MH078898-02 (2007): $213823
Grants awarded to Tracy A Stecker
Outreach Intervention For OIF Veterans To Promote Use Of Mental Health Services
Tracy A Stecker
Community And Family Medicinedartmouth College
Grant 5R34MH078898-04 from National Institute Of Mental Health, IRG: ZMH1
Abstract: 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
Keywords: early /brief intervention /therapy, health care service utilization, medical outreach /case finding, mental health service, therapy design /development, veteran behavior prediction, belief, cognitive behavior therapy, health behavior, health care service availability, mental disorder, war /peace behavioral /social science research tag, clinical research, health services research tag, human subject, interview, questionnaire
Project start date: 2006-09-28
Project end date: 2009-07-31
1R34MH078898-01 (2006): $230548
Mechanisms Of Changing Beliefs About Treatment For Alcohol Use Disorders
Tracy A Stecker
Dartmouth College
Grant 5R21AA017143-03 from National Institute On Alcohol Abuse And Alcoholism, IRG: ZAA1
Abstract: Alcohol use disorders are prevalent, disabling and costly, yet the vast majority of individuals do not seek help for their alcohol problems. In order to better understand the mechanisms underlying the decision to enter treatment for alcohol problems, we propose to use a validated behavioral theory to measure and change beliefs about alcohol use and treatment among primary care patients. The proposed study will build upon a large base of empirical research that conceptualizes decision-making according to the Theory of Planned Behavior (TPB). Cognitive mechanisms will be measured using an instrument we developed based on the TPB, and targeted using cognitive behavioral strategies to encourage entering treatment. The single outcome of entering treatment will be isolated rather than a multitude of other alcohol behaviors in order to assess the impact of the cognitive processes that impact this specific behavior change. Primary care patients in both VA and non-VA settings will be recruited in order to minimize the impact of structural barriers and maximize the external validity of the cognitive mechanisms that underlie treatment seeking behavior. The goal of the proposed research is to articulate and specify the cognitive mechanisms underlying the decision to enter alcohol treatment. The findings will improve clinical practice by providing primary care clinicians more effective and individualized communication with patients with alcohol problems about options for treatment. This may connect more individuals to specialty alcohol treatment, thereby improving substance use and life outcomes. Findings from this research will lay the groundwork for a larger, multi-site study on the effectiveness of this approach for increasing treatment entry among individuals with alcohol problems narrative. The goal of the proposed research is to articulate and specify the cognitive mechanisms underlying the decision to enter alcohol treatment. The findings will improve clinical practice by providing primary care clinicians more effective and individualized communication with patients with alcohol problems about options for treatment. This may connect more individuals to specialty alcohol treatment, thereby improving substance use and life outcomes
Keywords: alcoholism /alcohol abuse therapy, belief, early /brief intervention /therapy, health care service utilization, human therapy evaluation cognition, cognitive behavior therapy, decision making, patient care personnel relations, primary care physician, telemedicine behavioral /social science research tag, health services research tag, human subject, questionnaire
Project start date: 2007-08-01
Project end date: 2009-04-30
1R21AA017143-01 (2007): $222319