Olmos-Ochoa Tanya T, Speicher Sarah, Ong Laura E, Kim Jamie, Hamilton Alison B, Cloitre Marylene
Health Services Research and Development Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System.
National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System.
Psychiatr Rehabil J. 2023 Mar;46(1):26-35. doi: 10.1037/prj0000531.
This study examines barriers and facilitators to participation in webSTAIR, a telemental health program providing virtual coaching sessions for veterans with posttraumatic stress disorder (PTSD) and depression symptoms, among women veterans from racial and ethnic minority groups.
Using qualitative interviews (n = 26), we compared women veterans from racial and ethnic minority groups who completed (completers; n = 16) and did not complete (noncompleters; n = 11) webSTAIR at rural-serving facilities in the Veterans Health Administration (VA). Interview data were analyzed using rapid qualitative analysis. Chi-square and t tests assessed differences between completers and noncompleters by sociodemographic characteristics and baseline PTSD and depression symptomatology.
There were no statistically significant sociodemographic differences at baseline between completers and noncompleters; completers reported significantly higher baseline PTSD and depression symptomatology. Noncompleters were more likely to describe feeling angry, depressed, and unable to control their environments during participation in the program as barriers to webSTAIR completion. Completers, despite higher symptomatology, cited internal motivation and support from concurrent mental health services as facilitators. Both groups made recommendations for how VA can better support women veterans from racial and ethnic minority groups, including providing space for peer support and community building, addressing stigma associated with seeking mental health services and fostering mental health provider diversity and retention.
Although previous research has identified racial and ethnic disparities in PTSD treatment retention, mechanisms to improve retention have been unclear. Women veterans from racial and ethnic minority groups should be collaboratively engaged in the design and implementation of telemental health programs for PTSD to improve equitable retention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
本研究探讨了少数族裔退伍女兵参与网络阶梯计划（webSTAIR）的障碍和促进因素。该计划是一项远程心理健康项目，为患有创伤后应激障碍（PTSD）和抑郁症状的退伍军人提供虚拟辅导课程。
我们采用定性访谈（n = 26），比较了在退伍军人健康管理局（VA）农村服务设施中完成（完成者；n = 16）和未完成（未完成者；n = 11）网络阶梯计划的少数族裔退伍女兵。访谈数据采用快速定性分析方法进行分析。卡方检验和t检验评估了完成者和未完成者在社会人口学特征、基线PTSD和抑郁症状方面的差异。
完成者和未完成者在基线时的社会人口学差异无统计学意义；完成者报告的基线PTSD和抑郁症状明显更高。未完成者更有可能将参与项目期间感到愤怒、沮丧和无法控制自己的环境描述为完成网络阶梯计划的障碍。尽管症状更严重，但完成者将内在动力和同期心理健康服务的支持视为促进因素。两组都就VA如何更好地支持少数族裔退伍女兵提出了建议，包括提供同伴支持和社区建设的空间、消除与寻求心理健康服务相关的污名以及促进心理健康服务提供者的多样性和留存率。
尽管先前的研究已经确定了PTSD治疗留存率方面的种族和族裔差异，但改善留存率的机制尚不清楚。少数族裔退伍女兵应共同参与PTSD远程心理健康项目的设计和实施，以提高公平留存率。（PsycInfo数据库记录（c）2023美国心理学会，保留所有权利）
