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OEF/OIF/OND Reserve and National Guard War Veterans Perceptions of a Decision Aid for PTSD Treatment Options
Sadler AG, Hamilton AB, Booth B, Torner J, Mengeling M. OEF/OIF/OND Reserve and National Guard War Veterans Perceptions of a Decision Aid for PTSD Treatment Options. Poster session presented at: AcademyHealth Annual Research Meeting; 2016 Jun 27; Boston, MA.
Research Objective: Women and OEF/OIF/OND Reserve/National Guard (RNG) war Veterans are among the fastest growing groups of new VA users. Although PTSD is highly prevalent in this group of Veterans, most choose not to seek care for a variety of reasons. The VA provides multiple PTSD treatment options and recent CHOICE legislation may result in additional VA-funded PTSD treatment alternatives in local communities. It is likely that there is variability in both clinician and Veteran understanding of available treatments, as well as the pros and cons of PTSD treatment alternatives. Currently, there is no standardized approach to educating Veterans about PTSD treatment options.
Study Design: Participants completed online screening for a battery of post-deployment mental health concerns including PTSD and had access to study-developed educational materials for all screens. Those who screened positive for PTSD were randomly assigned to one of two RCT-arms (treatment vs. no treatment). Those assigned to the treatment arm participated in a shared-decision making (SDM) intervention for PTSD treatment delivered by a nurse by telephone. The SDM intervention included the Iowa PTSD Treatment Option Grid. The PTSD treatment decision aid was developed by a multi-disciplinary team using the Dartmouth model of option grids along with input from a Veteran consumer advisory group. Six months post-screening, women in both groups were re-contacted to complete a telephone delivered semi-structured interview to discuss their perceptions of their interface, including educational materials.
Population Studied: VA DoD Data Identity Repository provided contact information for this national community sample of Army and US Air Force OEF/OIF/OND RNG servicewomen who had returned from deployment to Iraq/Afghanistan within the preceding 4 years.
Principal Findings: Preliminary data women in the treatment arm (n = 9) who utilized the Iowa Decision aid yielded overall high satisfaction from participants Key themes included: 1) learning new information: "I was not aware I could get these kinds of treatments"; 2) that information was concise: "Liked it was clear cut, the biggest barrier with women and PTSD is . in civilian life there is not a lot of time to do decision-making"; 3)facilitates doctor-patient communication : "It was helpful and could help me to explain my symptoms to my VA doctor". When asked if they would recommend the decision aid to their peers, 100% would. Reasons included: 1) acceptability: " "it is simple and not intimidating"; 2)self-efficacy: "I think a lot are not very knowledgeable and this grid helps them see what would work for them and how it would work for them"; 3) confidentiality; "You are able to look at it in the privacy of your own home and go to the options on your own time frame when you are able to review them".
Conclusions: Female RNG war Veterans reported a positive response to and need for decision aids.
Implications for Policy or Practice: Decision aids can assist with an efficient and consistent way of educating Veterans about PTSD treatment options with the goal of promoting SDM so that they can make informed choices based on their needs, preferences, and values.