Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, Massachusetts, USA.
Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
Health Expect. 2022 Oct;25(5):2548-2556. doi: 10.1111/hex.13581. Epub 2022 Aug 11.
The Veterans Health Administration (VHA) is building a Whole Health system of care that aspires to empower and equip each Veteran to pursue a personally meaningful vision of health and well-being. As part of this effort, VHA has developed Taking Charge of My Life and Health (TCMLH), a peer-led, group-based programme that seeks to support Veterans in setting and pursuing health and well-being goals. Prior research showed TCMLH groups to positively impact Veteran outcomes; yet, little is known about Veterans' own experiences and perspectives.
We completed semi-structured telephone interviews with 15 Veterans across 8 sites who had participated in TCMLH groups offered by the VHA in the virtual format between Summer 2020 and Fall 2021. Inductive thematic analysis was applied to interview transcripts to generate themes.
We identified five themes regarding Veterans' experiences with TCMLH: (1) navigating the virtual format; (2) internalizing the value of health engagement; (3) making healthy lifestyle changes; (4) forging social connections; and (5) taking on a more active role in healthcare.
Veterans perceived virtual TCMLH groups as meaningful and beneficial, yet also highlighted several challenges. Their perspectives speak to the need to supplement time-limited programmes like TCMLH with ongoing, community-based support. Virtual group-based well-being programmes are a promising innovation. Other healthcare systems may draw on VHA's experience while tailoring format and content to the needs of their patient populations.
Veterans were involved as evaluation participants. A Veteran consultant, who is a coauthor on this paper, was engaged through the conceptualization of the evaluation, development of data collection materials (interview guide) and writing.
退伍军人健康管理局（VHA）正在建立一个整体健康护理系统，旨在赋予和装备每一位退伍军人追求个人有意义的健康和幸福愿景的能力。作为这项工作的一部分，VHA 开发了“掌控我的生活和健康”（TCMLH），这是一个由同行领导的、基于小组的项目，旨在支持退伍军人设定和追求健康和幸福目标。先前的研究表明，TCMLH 小组对退伍军人的结果产生了积极影响；然而，人们对退伍军人自己的经验和观点知之甚少。
我们对 15 名退伍军人进行了半结构化电话访谈，这些退伍军人来自 8 个地点，他们在 2020 年夏季至 2021 年秋季期间以虚拟形式参加了 VHA 提供的 TCMLH 小组。对访谈记录进行了归纳主题分析，以生成主题。
我们确定了退伍军人在 TCMLH 方面的五个经验主题：（1）虚拟格式的导航；（2）内化健康参与的价值；（3）改变健康的生活方式；（4）建立社会联系；（5）在医疗保健中发挥更积极的作用。
退伍军人认为虚拟 TCMLH 小组有意义且有益，但也强调了一些挑战。他们的观点表明，需要用持续的、基于社区的支持来补充 TCMLH 等限时项目。虚拟小组为基础的健康计划是一个有前途的创新。其他医疗保健系统可能会借鉴 VHA 的经验，同时根据患者群体的需求调整格式和内容。
退伍军人作为评估参与者参与其中。一位退伍军人顾问作为共同作者参与了本文的撰写，他通过评估的概念化、数据收集材料（访谈指南）的开发和写作参与其中。
