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.