Shannon M. Blakey’s research while affiliated with RTI International and other places

Despite a varied selection of available trauma‐focused evidence‐based psychotherapies (TF‐EBPs) for posttraumatic stress disorder (PTSD), few veterans receive a full course of an evidence‐based treatment. A better understanding of and alignment with veterans’ PTSD treatment goals could be one way to improve treatment engagement and adherence, consistent with veteran‐oriented care within the U.S. Department of Veterans Affairs (VA) Healthcare System. Few studies have examined veterans’ specific goals or reasons for seeking treatment for PTSD. We conducted a qualitative analysis using secondary data from a randomized controlled trial (RCT) of 175 veterans who were randomized to receive a TF‐EBP for PTSD. Veterans completed a self‐report questionnaire at baseline and were asked to identify three distinct goals for treatment using a short‐answer format. Two authors coded the data and identified themes. Three themes were identified: improvements in PTSD symptoms, personal well‐being and growth, and improvements in social roles and interpersonal functioning. These findings suggest that veterans with PTSD have both symptom reduction goals and functional goals at the outset of treatment. The findings also emphasize the importance of broadening the scope of treatment outcome monitoring and assessment to better reflect patient‐centered care and veterans’ specific goals.

Background As alcohol misuse remains pervasive within the military, evidence-based prevention programs that are feasible to implement and appropriately tailored to meet the needs and norms of military personnel are critically needed. Further, programs that target future military leaders, such as trainees, recruits, and cadets, may be especially impactful. eCHECKUP TO GO is a web-based, evidence-based brief alcohol intervention designed to reduce alcohol misuse through education and personalized feedback that may be suitable for military trainees. However, because it was developed for civilian students, efforts to adapt the content for military settings are needed. Objective This study aimed to evaluate the acceptability of a military version of eCHECKUP TO GO, tailored to include military-specific terminology and alcohol use statistics. Methods US Air Force Academy cadets were recruited to participate in a single-arm, mixed methods study. Following the completion of eCHECKUP TO GO, participants completed a survey that assessed satisfaction with specific aspects of the user experience, including ease of use, design, and relevance of the information and personalized feedback (range: 1=strongly disagree to 7=strongly agree). A subset of cadets also participated in a focus group to expound on the survey responses. Results Survey participants included 22 cadets (n=12, 55% male; mean age 19.6, SD 1.8 years). In addition, 6 (27%) cadets participated in the focus group. Participants were satisfied with the program overall (mean 5.8, SD 0.9) and gave the highest ratings to ease of use (mean 6.6, SD 0.7), site design (mean 6.5, SD 0.6), and site interactivity (mean 6.4, SD 1.0). Items pertaining to tailoring, relevance, and amount of content specific to cadets scored lowest (mean 5.8, SD 1.4; mean 5.6, SD 1.4; and mean 5.5, SD 1.5, respectively). Most (n=15, 68%) participants said they would act upon the information they were provided. Focus group participants made suggestions for improved tailoring, such as increasing content on social aspects of drinking and military-specific risks of alcohol misuse (eg, Uniform Code of Military Justice violations). Conclusions Although the acceptability of eCHECKUP TO GO was high, continued efforts are needed to ensure the content accurately reflects the experiences of cadets. Researchers who design military health promotion interventions need to consider the varied contexts within the force and rigorously evaluate the acceptability of all content before implementation.