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Methods: Semi-structured interviews were conducted with 51 providers and 30 Veterans across 12 VHA Medical Centers (VAMCs). Interviewees included staff delivering and patients participating in tele WH coaching, tele WH educational classes, and tele-complementary and integrative therapies (e.g., acupuncture, chiropractic, yoga, Tai Chi, mindfulness or meditation). Interviews were transcribed and a content analysis was performed using a rapid approach. Results: Participants described a broad range of benefits associated with Veteran participation in teleWH services. These included: 1) Improved access to services that previously were not widely offered in-person;2) Increased comfort engaging in services, especially for specific Veteran populations (e.g., Veterans with PTSD, LGBTQ, women, and younger Veterans);3) Greater convenience, including less stress related to travel, length of time required to use services, and integration with workday;and 4) Increased engagement in self-care outside of classes or services. Disadvantages included: 1) Decreased socialization and opportunities for group interaction;2) Decreased access to touch-based services (e.g., acupuncture);3) Technological challenges with approved virtual platforms. Facilitator skill and tele health etiquette mattered greatly for satisfaction with tele WH. Background: The Veterans Health Administration (VHA) quickly responded to the COVID-19 pandemic by providing access to care via tele health. This rapid pivot occurred simultaneously with VHA's Whole Health transformation, which includes the integration of complementary and integrative health services, education, and coaching to develop self-care skills. This qualitative study explored providers' and patients' perspectives on the implementation and advantages/ disadvantages of tele-Whole Health services (tele WH). Conclusion: Tele WH is perceived to be a strong complement to in-person services and poses many physical and mental health benefits for patients. Attention to facilitator skills training and ease of virtual platform use is needed to increase engagement and make tele WH a viable patient centered option for care.
RESUMEN
Methods: We are fielding an online survey to approximately 2,000 Veterans using tele-WH services across 10 VHA facilities. The survey contains internally developed questions and validated patient-reported outcome measures (e.g., Perceived Stress Scale). Survey content was developed iteratively and refined based on Veteran feedback. The survey is collecting data on Veteran: (1) use of and interest in, (2) experiences and satisfaction with, (3) perceived outcomes of, and (4) sources of information about tele-WH services. Results: Data collection is underway. We will present data on the percent of respondents who: (1) used and (2) are interested in using each tele-WH service/therapy, (3) learned about tele-WH through various sources, (4) reported satisfaction with tele-WH services/therapies, and (5) reported that tele-WH participation helped them improve outcomes. We will use multivariate analyses to identify factors independently associated with use of tele-WH services and therapies, interest in future use, and perceived impacts on outcomes. Background: The Veterans Health Administration's (VHA) transformation into a 'Whole Health system of care' (WHS) has encompassed a shift in organizational culture, wherein care delivery is focused on Veteran goals and preferences rather than diagnoses alone. VHA's WHS includes offering commensurate services and therapies to Veterans, including complementary and integrative health services. In the wake of COVID-19, VHA rapidly shifted service delivery to a virtual format. For most Whole Health programs, the virtual format (i.e., 'tele-Whole Health' (tele-WH)) was a novel delivery platform. Our goal was to assess Veteran experiences with and perceptions of tele-WH services. Conclusion: Following the pandemic-related shift in services, interest in tele-WH continues to rise. Our data will provide insights regarding Veteran perceptions of tele-WH, including interest in continued use of tele-WH offerings and factors that can be addressed to facilitate participation. Such information can be used by healthcare institutions to plan future availability of tele-WH services.
RESUMEN
Methods: We completed semi-structured telephone interviews with 15 Veterans across 7 VHA facilities who had participated in TCMLH between Summer 2020 and Winter 2021. The interview recording transcripts were coded using a consensus-building process and analyzed to generate themes. Results: Veterans described positive experiences with TCMLH groups, while also suggesting areas for improvement. Interviewees generally appreciated the core elements of TCMLH curriculum;difficulties that were reported related to group pace and content. Social dynamics - interactions and relationships between TCMLH participants - took center stage in the interviews, with positive comments on the value of connecting with others, sharing and learning new ideas, and providing mutual support and accountability. Some challenging interactions with groupmates were also recounted. The virtual format of the TCMLH groups, which VHA rapidly adopted in the wake of the COVID-19 pandemic, was perceived as both facilitating and constraining engagement and relationships. Finally, Veteran interviewees described diverse ways in which they thought the group participation had enhanced their lives. These perceived impacts of TCMLH participation included positive changes in attitude, acquiring healthy habits, improvements in social life, and shifts in healthcare (i.e., trying new modalities, changing one's interactions with their clinical team). Background: As part of its emerging Whole Health (patient centered, holistic) system of care, the Veterans Health Administration (VHA) offers 'Taking Charge of My Life and Health' (TCMLH), a peer-led, group-based course in which Veterans explore how different areas of life impact their health and wellbeing and support one another in setting and pursuing personally meaningful health goals. We sought to understand Veteran perspectives on and experiences in TCMLH groups. Conclusion: Veterans perceived TCMLH groups to be meaningful, engaging, and impactful, offering valuable recommendations to further improve the group experience. Other health systems may consider developing similar group based programs to bolster guided self-reflection, goal setting, and peer support among patients.
RESUMEN
Objective: In recent years, the Veteran's Health Administration (VA) has been engaged in a large-scale transformation towards a Whole Health System (WHS) model of care. Major shifts include moving from a disease-focused model to one that incorporates complementary and patient-centered approaches to improve overall health and well-being. A key component of this model is supporting employee well-being. The SARS-CoV-2 pandemic disrupted VA healthcare systems and increased stress and anxiety for employees. This study sought to examine how VA's WHS transformation efforts intersected with its SARSCoV- 2 pandemic response. Methods: A single, multi-person qualitative interview was conducted at each of the 18 VA Medical Centers as part of an ongoing, multi-year evaluation of WH transformation. Sixty-one Whole Health leaders and staff participated in the interviews that focused on how WH transformation had been affected by the SARS-CoV-2 disruption and how WH was used to support employee needs during the pandemic. We used a rapid approach to conduct a directed content analysis, using a priori and emergent categories. Results: While the pandemic initially slowed organizational and cultural transformation efforts, medical centers intentionally embraced a Whole Health approach to support employees during this crisis. These efforts included promoting complementary and integrative Health (CIH) therapies and WH concepts to combat stress. Sites supported employee well-being by offering an extensive variety of self-care activities for staff. The need for stress-reducing supports elevated the perceived value of the WHS, generating endorsement from hospital leadership. Conclusion: At a time of crisis, most sites leaned into Whole Health, using it as a key strategy to support employee well-being. This demonstrates the promise of using a WH approach for addressing stress and anxiety in health care workers. Additionally, aligning ongoing transformation efforts with immediate crisis-related needs can help ensure continued progress even while organizational priorities may temporarily lie elsewhere.
RESUMEN
Objective: Committed to implementing a personcentered, holistic (Whole Health) system of care, the Veterans Health Administration (VHA) developed a peerled, group-based, multi-session Taking Charge of My Life and Health (TCMLH) program wherein Veterans reflect on values, set health and wellbeing-related goals, and provide mutual support. Prior work has demonstrated the positive impact of these groups. After face-to-face TCMLH groups were disrupted by the COVID-19 pandemic, VHA facilities rapidly implemented virtual (video-based) TCMLH groups. We sought to understand staff perspectives on the feasibility and value of conducting TCMLH groups virtually. Methods: We completed semi-structured telephone interviews with 18 staff members involved in the rapid implementation of virtual TCMLH groups at 5 VHA facilities about their perspectives and experiences. Interview transcripts were analyzed using rapid qualitative analysis. Results: Virtual TCMLH groups posed technological and logistical challenges and were perceived as disruptive of the relationship-building and communication observed in faceto- face groups. However, participants noted that Veterans still found ways to bond and group facilitators adjusted their approach to improve flow and engagement. Participants also described perceived advantages of the virtual format: (1) participating from home was less stressful for Veterans and more conducive to them opening up;(2) being in one's home environment organically facilitated Veteran reflection on values and goals;(3) there are opportunities for wider-scale recruitment, greater accessibility, and potentially better Veteran retention. Conclusion: Faced with the disruption posed by COVID- 19, VHA successfully pivoted by rapidly implementing virtual TCMLH groups and addressing challenges of the new format. These groups may offer a crucial lifeline for Veterans who are feeling isolated and/or whose wellbeing has suffered during the pandemic. A virtual group-based program in which participants set and pursue personally meaningful goals related to health and well-being in a supportive environment of their peers is a promising innovation that can be replicated in other health systems.