Many Veterans experience psychological distress including depression, post-traumatic stress disorder (PTSD), anxiety and problems with sleep and anger. Services to address these problems need to be easy for Veterans to access. VA mobile health applications (mHealth apps) that teach skills to manage psychological distress are widely available. However, Veterans rarely use these apps enough to experience health benefits. Peer specialists are VA employees who are trained to use their lived experiences in mental health recovery to help other Veterans. Peers can provide support and accountability to Veterans as they use mHealth apps. Peers working in VA primary care settings are easily accessible to Veterans who receive VA services. This study aims to improve the health of Veterans by testing the effectiveness of peer-supported mHealth in reducing psychological distress. It will also test how much peer support Veterans need to improve their health with using mHealth apps.
Veteran enrolled in primary care at one of 3 VA facilities (Philadelphia, PA; Ann Arbor, MI; and Bedford, MA)
clinically significant psychological distress on at least one DASS-21 subscale (Depression => 10, Anxiety => 8, Stress => 13)
symptoms that may preclude active engagement in the intervention such as gross cognitive impairment or current symptoms of mania or psychosis
suicide risk as measured by the P4 Suicide Assessment
plan to engage in psychotherapy during the intervention period
started or changed the dose of a psychotropic medication in the last two months
Sequential
Self Managed mHealth
BehavioralPatients use mHealth apps to manage psychological distress
1 session of peer mHealth
BehavioralPatients receive one session with a peer while using mHealth apps to manage psychological distress
4 sessions Peer mHealth
BehavioralPatients receive 4 sessions with a peer while using mHealth apps to manage psychological distress
4 sessions of Peer Whole Health
BehavioralPatients receive 4 session with a peer focused on Whole Health
Depression Anxiety and Stress Scale
Depression Anxiety and Stress Scale is a widely used measure of psychological distress consisting of 21 items measured on a 4-point scale. The total score ranges from 0-63. Higher scores indicate greater severity.
Post Traumatic Stess Checklist-5
Self report measure assessing the 21 symptoms of post-traumatic stress disorder (PTSD) on a 5 point scale. Total score ranges from 0-105. Higher scores indicate greater severity.
Insomnia Severity Index
Self report measure assessing insomnia with 7 questions on a 5 point scale. Total score range from 0-28. Higher scores indicate greater severity.
Dimensions of Anger Reactions
Self report measure assessing anger with 5 items on a 5 point scale. Total score ranges from 5-25. Higher scores indicate greater severity.
Brief Inventory of Psychosocial Functioning
Self report measure of psychosocial functioning measured with 7 items on 7 point scale. Total ranges from 0-42. Higher scores indicate more dysfunction.
University of Rhode Island Change Assessment
Self report measure assessing patient motivation to address psychological distress with 12 items on a 5 point scale. Total score ranges from 12 to 60. Higher scores indicate more motivation.
Coping Self Efficacy Scale
Self report measure to assess patient self efficacy to address psychological distress with 26 items on a 11 point scale. Total score ranges from 0-260 with higher scores indicating greater self-efficacy.
Assessing Circumstances and Offering Resources for Needs
Measure of unmet social needs that include 11 questions. The total score ranges from 0-48 with higher scores indicating more unmet needs.
Click on the lead sponsor to view all of their trials.
