Intensive Referral of Veterans to Mutual-Help Groups: A Mixed-Methods Implementation Evaluation

Area of Science:

• Addiction Medicine
• Health Services Research
• Rural Health

Background:

• Community-based support groups are vital for preventing substance use disorder (SUD) relapse.
• Referrals to these groups during SUD treatment are inconsistent and often overlook rural patient barriers.

Purpose of the Study:

• To conduct a formative evaluation of a rural intensive referral intervention (RAIR) for connecting veterans with SUD to community-based support groups.
• To identify patient and staff perspectives on the intervention's components and delivery.

Main Methods:

• Surveyed 145 patients and 28 treatment staff involved in the RAIR program.
• Conducted qualitative interviews with treatment staff.
• Analyzed quantitative ratings of intervention components and qualitative themes regarding delivery.

Main Results:

• Patients and staff reported similar satisfaction and perceived helpfulness of RAIR components.
• Treatment staff cited lack of commitment and resources as primary reasons for inconsistent intervention delivery.
• The RAIR intervention was not consistently implemented as designed.

Conclusions:

• While patients and staff found RAIR components helpful, inconsistent delivery due to staff-identified barriers hinders its potential.
• Addressing resource limitations and fostering staff commitment are crucial for improving the implementation of rural SUD support group referral interventions.