Development and Piloting of a Mental Health Prevention and Referral Program for Veterans and Their Families in Ukraine

Amanda J. Nguyen; Tara Russell; Stephanie Skavenski; Sergiy Bogdanov; Kira Lomakina; Iryna Ivaniuk; Luke R. Aldridge; Paul Bolton; Laura Murray; Judy Bass

doi:10.9745/GHSP-D-22-00488

Figures & Tables

Figures

Tables

Download figure
Open in new tab
Download powerpoint
FIGURE 1
Change in Outcomes at 1 Month for Common Elements Treatment Approach Psychosocial Support Program Participants in Ukraine
Download figure
Open in new tab
Download powerpoint
FIGURE 2
Implementation Outcome Distributions for Common Elements Treatment Approach Psychosocial Support Program in Ukraine^a
^a N=10; Responses provided on 0–3 scale with high scores indicating a more positive domain rating. Plots display score distributions; boxes indicate interquartile range (i.e., center 50% of scores), and dot indicates outlying value.

Tables

Figures

View popup

TABLE.

Key Aspects of CPSS Iterative Intervention Development in Ukraine

	Stakeholder-Engaged Needs Analysis	Round 1 Implementation	Round 2 Implementation	Formal Pilot Study
Timing	July–August, 2019	September 2019	October 2019	March 2020
Setting	Kyiv and Zaporhizya	Neutral setting	Community setting	Community setting
Stakeholders involved	80 veterans and family members; 58 stakeholders involved in providing supports to veterans and family members; additional representatives from MOVA, MOH, community organizations	62 participants (38 veterans, 9 family members, 15 service providers); implemented by 9 experienced CETA providers with observers from development team	23 new participants (9 veterans, 14 family members); 6 newly trained CPSS providers	24 new participants (8 veterans, 16 family members) Same 6 newly trained CPSS providers as round 2
Intervention	N/A	8 sessions averaging 109 minutes, with manipulation of group size and composition, examples, and individual vs. group exercises; follow-up phone call for safety indication	3 sessions averaging 111 minutes (with break); follow-up call within 1 week for all participants to review assessment results and skill practice	3 sessions averaging 133 minutes (with study procedures); 1-week follow-up calls, 1-month follow-up assessment and referrals
Focus of inquiry	Psychosocial support needs, barriers to help-seeking, potentially acceptable support strategies	Participant acceptability; necessary refinements to intervention	Provider acceptability; feasibility of training and delivery by community-based providers	Refine and practice study procedures; initial trends in outcomes and implementation domains
Information collected	Free lists and in-depth interviews	Focus group discussions; feedback from providers; developer observations	Focus group discussions; feedback from providers	Self-assessment data (pre-post); implementation survey (post)
Key findings	Potential of a brief PSS intervention embedded within trusted networks to strengthen coping skills and foster positive relationships to support referrals	Necessary changes to content (examples and activities); process (contextualization and length), and group dynamics (group activities); led to revised intervention and greater training emphasis on group facilitation	Increased participant acceptability; training and community-based implementation was feasible; continued development of fidelity tracking tools	Positive participant perspectives on implementation domains; positive trends in reduced symptoms and functional impairment; high 1-month attrition potentially due to COVID-19 outbreak

Abbreviations: CETA, Common Elements Treatment Approach; CPSS, CETA Psychosocial Support; MOH, Ministry of Health; MOVA, Ministry of Veterans Affairs; PSS, psychosocial support.