Developing a Peer Support Protocol for Improving Veterans' Engagement to Computer-Delivered Cognitive Behavioural Therapy.
BACKGROUND
Computer-delivered cognitive behavioural therapy (cCBT) is an effective alternative to provider-delivered treatment for depression and anxiety, but high attrition poses a significant challenge to its use. Peer support is a feasible approach to improving cCBT engagement, but less is known about its acceptability among Veterans.


OBJECTIVE
To obtain feedback from Veterans (n = 24) with depression and/or anxiety on their preferences for (a) activities of Veterans Administration Peer Support Specialists (VA PSS) in helping Veterans use Moving Forward, a cCBT-based protocol developed by VA, and (b) methods for delivering support to Veterans using this programme.


METHODS
Four focus groups (5-7 Veterans per group) provided feedback to be used in the development of a peer-supported engagement intervention to help Veterans with depression and anxiety use Moving Forward. Content areas included roles that a VA PSS might play in supporting the use of and engagement in Moving Forward, as well as methods of delivering that support.


RESULTS
Veteran preferences for PSS activity focused on practical aspects of using Moving Forward, including orientation to the programme, technical support, and monitoring progress. Feedback also suggested that Veterans preferred more personal roles for the PSS, including emotional support, as well as application of Moving Forward to 'real life' problems.


CONCLUSIONS
The findings extend the literature on online, patient-facing mental health protocols by identifying emotional support and 'real life' skills application as Veteran-preferred components of a peer-support protocol designed to enhance use of and engagement in cCBT for depression and anxiety.
Center for Mental Healthcare and Outcomes Research,Central Arkansas Veterans Affairs Healthcare System,North Little Rock,AR 72114,USA.
John M
JM
Ray
Center for Mental Healthcare and Outcomes Research,Central Arkansas Veterans Affairs Healthcare System,North Little Rock,AR 72114,USA.
Lakiesha L
LL
Kemp
Center for Mental Healthcare and Outcomes Research,Central Arkansas Veterans Affairs Healthcare System,North Little Rock,AR 72114,USA.
Amanda
A
Hubbard
Center for Mental Healthcare and Outcomes Research,Central Arkansas Veterans Affairs Healthcare System,North Little Rock,AR 72114,USA.
Michael A
MA
Cucciare
D001007:Anxiety / Q000628:therapy*; D001008:Anxiety Disorders / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000628:therapy*; D003866:Depressive Disorder / Q000628:therapy; D005260:Female; D017144:Focus Groups; D000068156:Formative Feedback; D006801:Humans; D020407:Internet; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010379:Peer Group; D012944:Social Support; D014728:Veterans / Q000523:psychology*
computer-based cognitive behavioural therapy; mental health; peer support; treatment engagement