Ranney Rachel M, Goldberg Richard, Maguen Shira, Blonigen Daniel
San Francisco VA Health Care System.
Veterans Integrated Services Network 5 Mental Illness Research, Education and Clinical Center.
Psychol Serv. 2025 May;22(2):256-269. doi: 10.1037/ser0000858. Epub 2024 Apr 11.
The Veterans Health Administration (VHA) currently employs over 1,300 peer specialists-veterans with lived experience of mental illness who are in recovery and have been trained to provide support to other veterans experiencing these issues. VHA peer specialists have largely been employed in behavioral health settings. In 2014, VHA began to employ peer specialists in primary care settings via the peers in Patient Aligned Care Team (PACT) program, and congressional legislation was passed to expand this program in 2022. In light of this expansion, it is important to evaluate the effectiveness of interventions provided in the Peers in PACT program. This integrative review of studies of peer specialist-led interventions in VHA primary care includes 13 articles with 11 unique studies represented in these articles. These studies targeted mental health symptoms, substance use, health/well-being, and health/treatment engagement. Seven described single-arm studies, three described two-arm studies with a treatment as usual control group, and three described two-arm studies with an active control group. The majority of these studies demonstrated statistically significant improvements on at least one main outcome. Seven studies also included qualitative interviews with veterans; several common themes emerged, including the importance of working with a veteran peer with shared lived experiences, and finding peers helpful in providing accountability, motivation, encouragement, emotional support, resources, and assistance navigating VA health care. Recommendations for future research on the peers in PACT program are discussed, including a need for more RCTs with active controls. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
退伍军人健康管理局(VHA)目前雇佣了1300多名同伴专家,这些退伍军人有精神疾病的生活经历,正处于康复中,并接受过培训,为其他有这些问题的退伍军人提供支持。VHA同伴专家主要受雇于行为健康机构。2014年,VHA开始通过患者协作护理团队(PACT)项目中的同伴在初级保健机构雇佣同伴专家,2022年通过了国会立法以扩大该项目。鉴于这一扩张,评估PACT项目中同伴提供的干预措施的有效性很重要。对VHA初级保健中同伴专家主导的干预措施研究的这一综合综述包括13篇文章,其中有11项独特的研究。这些研究针对心理健康症状、物质使用、健康/幸福感以及健康/治疗参与度。七项描述了单臂研究,三项描述了有常规治疗对照组的双臂研究,三项描述了有积极对照组的双臂研究。这些研究中的大多数在至少一项主要结果上显示出统计学上的显著改善。七项研究还包括对退伍军人的定性访谈;出现了几个共同主题,包括与有共同生活经历的退伍军人同伴合作的重要性,以及发现同伴在提供问责、动力、鼓励、情感支持、资源以及协助使用退伍军人医疗保健服务方面很有帮助。讨论了对PACT项目中同伴未来研究的建议,包括需要更多有积极对照组的随机对照试验。(PsycInfo数据库记录(c)2025美国心理学会,保留所有权利)