Brief Peer-Supported Web-Based Skills Training in Affective and Interpersonal Regulation (BPS webSTAIR) for...

Area of Science:

• Mental Health
• Digital Health
• Psychiatry

Background:

• Peer-supported mobile health (mHealth) programs show promise for improving mental health access and outcomes.
• Limited research exists on peer support's impact on symptom reduction.
• Trauma-exposed populations often experience co-occurring PTSD and depression, impacting daily functioning.

Purpose of the Study:

• To evaluate the effectiveness of a peer-supported, transdiagnostic mHealth program (BPS webSTAIR) on symptom outcomes and functioning.
• To compare BPS webSTAIR against a waitlist control in veterans with PTSD or depression.

Main Methods:

• A randomized controlled trial with 178 veterans (117 BPS webSTAIR, 61 waitlist).
• Assessed PTSD, depression, emotion regulation, and psychosocial functioning pre-treatment, post-treatment, and at 8-week follow-up.
• Used mixed-effects models and exploratory analyses on peer interaction types and frequency.

Main Results:

• BPS webSTAIR participants showed significantly greater improvements in PTSD, depression, emotion regulation, and functional impairment compared to the waitlist control (moderate effect sizes).
• Gains were maintained at 8-week follow-up.
• Higher module completion correlated with greater symptom improvement, while mandatory peer engagement in an initial cohort led to more interactions but fewer completed modules.

Conclusions:

• BPS webSTAIR effectively improved PTSD and depression symptoms, emotion regulation, and psychosocial functioning in community-based veterans.
• Peer-supported, transdiagnostic mHealth programs represent an efficient and effective low-burden mental health intervention for trauma-exposed populations.
• Further research is needed to optimize peer support delivery and identify optimal recipients, potentially expanding the VA workforce and improving veteran care.