A Pilot Implementation of a Peer-Delivered Service to Increase Behavioral Healthcare Engagement among Rural Veterans

Area of Science:

• Implementation Science
• Veterans Health
• Behavioral Health Services Research

Background:

• Many rural Veterans face barriers to accessing behavioral health care.
• Peer Support for Treatment Seeking (PS-TS) leverages peer specialists to engage Veterans in care.
• PS-TS is a brief intervention focused on treatment-seeking beliefs.

Purpose of the Study:

• To implement and evaluate Peer Support for Treatment Seeking (PS-TS) in rural Veterans Health Administration (VHA) regions.
• To assess the reach, effectiveness, adoption, implementation, and maintenance of PS-TS using RE-AIM framework.

Main Methods:

• Utilized evidence-based implementation strategies, including stakeholder engagement and tailored training.
• Adapted PS-TS content and implementation plans for rural Veterans and peer specialists.
• Tracked adaptations, peer outreach calls, and Veteran engagement in care.

Main Results:

• PS-TS reached 117 Veterans through 364 outreach calls, with 37% initiating VHA behavioral health care.
• Implementation was enabled by tailoring but challenged by peer discomfort and complexity.
• High fidelity was observed, but quality varied, and the program was not maintained post-support.

Conclusions:

• Evidence-based strategies facilitated PS-TS reach and care engagement for rural Veterans.
• Future efforts must focus on enhancing PS-TS delivery quality and ensuring long-term maintenance.
• Addressing implementation barriers is crucial for sustained behavioral health support for Veterans.