BACKGROUND/RATIONALE:
Cardiovascular disease is the leading cause of death among women in the United States. Due to elevated rates of cardiovascular disease (CVD) risk factors and inadequate awareness of CVD risk, the growing female veteran population is at significant risk for developing CVD related morbidity and mortality. Compared with non-veteran women, high rates of mental health disease and low levels of social support create unique challenges for traditional models of health behavior interventions for veteran women. Growing evidence supports the use of peer support to deliver health related content for chronic disease management, including in the male Veteran population.

OBJECTIVE(S):
Aim 1: To estimate the prevalence of co-morbid diagnoses, health behaviors and health care preferences among women Veterans at risk for CVD, among those with a diagnosis of CVD, and those not at risk.
Aim 2a: To assess which aspects of social support and modalities for providing peer support would be most effective in improving CVD risk reduction behaviors among female Veterans and to explore potential barriers and facilitators of reciprocal peer support implementation among female Veterans within the context of PACT.
Aim 2b: To develop a reciprocal peer support (RPS) intervention in female Veterans to reduce CVD risk. This will be structured to address areas of greatest impact for CVD risk identified in Aim 1 and shaped to take into consideration Veteran and PACT preferences from Aim 2.
Aim 3: To test the feasibility of a RPS intervention in targeting CVD risk reduction in female Veterans.
Aim 4: To determine the effectiveness of a reciprocal peer support intervention targeting CVD risk reduction in female Veterans at two VA locations, Durham VAMC and Newington, CT VAMC.
Aim5: To assess women Veteran's experiences of participation in a CVD risk reduction intervention

METHODS:
This proposed project has multiple components: 1) A descriptive analysis of existing National Survey of Women Veterans (NSWV) data will identify women with a CVD diagnosis, those at risk for CVD, and those not at risk and then examine relevant types of CVD risk behaviors (smoking, alcohol use, physical activity), common co-morbidities (e.g., depression and PTSD symptoms), and health care preferences in these groups;2) A qualitative assessment of female veterans who receive care at the Durham VAMC about perceived barriers and facilitators to CVD risk reduction and discussion of ways to utilize peer support; 3) The development and pilot testing of the feasibility of a reciprocal peer support intervention for CVD risk reduction; 4) A two-site effectiveness study whose primary goal will be to evaluate effectiveness of the peer support intervention previously piloted; 5) A qualitative analysis of semi-structured interviews with participants of a clinical-pharmacist delivered, telephone-based CVD risk reduction study to obtain patient-level experiences.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
Findings from Aim 1 show that greater than 50% of women Veterans have risk factors for CVD. This is relevant to both VA-based providers and those outside the VA as the majority of women Veterans receive care in the community. Additionally, our findings suggest that women who prefer gender-specific care settings and those with current PTSD symptoms have greater odds of being at risk for CVD. Findings from Aim 2 show that women Veterans desire sharing of a common behavior change goal, being compatible with respect to level of engagement, and need to establish trust with a peer partner. Women also reports that peer support would be helpful for accountability needed to engage with behavior change.

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External Links for this Project

NIH Reporter

Grant Number: IK2HX001540-01A2
Link: https://reporter.nih.gov/project-details/8978386

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PUBLICATIONS:

None at this time.

DRA: Aging, Older Veterans' Health and Care, Cardiovascular Disease
DRE: Treatment - Efficacy/Effectiveness Clinical Trial
Keywords: none
MeSH Terms: none