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开发一种由同伴提供的初级保健干预措施,以提高退伍军人心理健康治疗的参与度。

Development of a peer-delivered primary care intervention to improve veteran mental health treatment engagement.

作者信息

Remmert Jocelyn E, Destefano LiaJo, Chinman Matthew, Oslin David W, Mavandadi Shahrzad

机构信息

Mental Illness Research, Education, and Clinical Center, Corporal Michael C. Crescenz Veteran Affairs Medical Center.

Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System.

出版信息

Psychol Serv. 2025 May;22(2):270-279. doi: 10.1037/ser0000883. Epub 2024 Aug 1.

Abstract

Veteran engagement in mental health treatment (MHT) remains low. Peer specialists (PS) are well positioned to implement interventions addressing barriers to MHT engagement, given their familiarity with the process. This study aimed to develop and assess the acceptability of a primary care-based, PS-delivered intervention to improve MHT initiation. Aim 1 utilized modified Delphi methods with a committee of 12 stakeholders (e.g., PS, psychologists, and veteran patients) who provided input on the proposed PS-delivered MHT engagement intervention. The proposed intervention components included questionnaires to identify barriers to engagement and targeted strategies for the barriers (e.g., motivational interviewing, cognitive restructuring). Aim 2 consisted of qualitative interviews with veterans entering MHT, focused on acceptability and feasibility, and gathered additional feedback for the intervention drafted in Aim 1. PS in primary care also reviewed the intervention and provided feedback. Results from Aim 1 demonstrated the acceptability of PS utilizing questionnaires in their work with Veterans, emphasized the importance of rapport building, and provided consensus on the identification of tailored treatment strategies. Veterans entering MHT ( = 9) reported that they were excited about the option of PS being involved in treatment engagement. PS ( = 18) also reported the overall acceptability of the intervention and provided feedback impacting the implementation of the intervention. Incorporating primary care PS into MHT engagement is acceptable. This study serves as the first step in developing a PS-delivered intervention to improve engagement in veteran MHT with input from a diverse group of stakeholders. Implications and future directions will be explored. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

摘要

退伍军人参与心理健康治疗(MHT)的比例仍然很低。同伴专家(PS)鉴于其对该过程的熟悉程度,非常适合实施解决MHT参与障碍的干预措施。本研究旨在开发并评估一种基于初级保健、由同伴专家提供的干预措施,以促进MHT的启动。目标1采用了改良的德尔菲法,与12名利益相关者组成的委员会(如同伴专家、心理学家和退伍军人患者)合作,他们对提议的由同伴专家提供的MHT参与干预措施提供了意见。提议的干预措施组成部分包括用于识别参与障碍的问卷以及针对这些障碍的针对性策略(如动机访谈、认知重构)。目标2包括对进入MHT的退伍军人进行定性访谈,重点关注可接受性和可行性,并收集对目标1中起草的干预措施的更多反馈。初级保健中的同伴专家也对干预措施进行了审查并提供了反馈。目标1的结果表明,同伴专家在与退伍军人合作中使用问卷是可接受的,强调了建立融洽关系的重要性,并就确定量身定制的治疗策略达成了共识。进入MHT的退伍军人(n = 9)报告说,他们对同伴专家参与治疗参与的选择感到兴奋。同伴专家(n = 18)也报告了干预措施的总体可接受性,并提供了影响干预措施实施的反馈。将初级保健同伴专家纳入MHT参与是可接受的。本研究是开发一种由同伴专家提供的干预措施的第一步,该干预措施在来自不同利益相关者群体的意见输入下,旨在改善退伍军人MHT的参与度。将探讨其意义和未来方向。(PsycInfo数据库记录(c)2025美国心理学会,保留所有权利)

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