E112 - Trauma-Focused Evidence-Based Psychotherapy for Posttraumatic Stress Disorder Delivered via Synchronous Video Telehealth in the Veterans Health Administration
Time: 05:00 PM - 05:50 PMTopics: Mental Health, Dissemination and Implementation
Poster Number: E112
Trauma-focused evidence-based psychotherapy (EBP) is the recommended treatment for posttraumatic stress disorder (PTSD). During and after the COVID-19 pandemic, Veterans health Administration (VHA) policies encouraged increased delivery of general mental health services via clinical video telehealth (CVT) to better serve veterans. However, it remains unclear how these policy changes impact the way veterans are currently receiving PTSD EBP services. Our goal in the current project was to describe the percentage as well as the demographic, military, and clinical characteristics of veterans receiving PTSD EBPs via CVT vs. in-person. Using data from the VHA electronic health record, we identified a national cohort of all-era veterans who received individual PTSD EBP for the first time between 4/2022-4/2023 (n = 24,897). We used VHA clinic stop codes and Current Procedural Terminology codes to identify PTSD EBP delivery modality (CVT vs. in-person). Next, we used multivariable hierarchical Bayesian logistic regression to model the probability of receiving at least 50% of EBP care via CVT. In our sample, 74.4% of veterans who received PTSD EBP used CVT for at least one EBP session and 66.8% of veterans received at least half of their EBP sessions by CVT. Female veterans (Cohen’s d = 0.24; 90% CI = 0.18, 0.29) were more likely to have received their PTSD EBP via CVT, with additional strong and positive interaction effects for Black female veterans, Hispanic female veterans, female officer veterans, and Black officer veterans. CVT delivery of PTSD EBPs was more common than in-person delivery of PTSD EBPs. Consistent with underlying trends in telehealth services, women veterans and particularly women, racial/ethnic minority veterans were more likely to receive PTSD EBP via CVT. Prior work has hypothesized that participation in telehealth treatment may be preferable for women and racial/ethnic minority veterans due to harassment experienced with in person care or to overcome practical barriers to treatment engagement (e.g., transportation, childcare). Future research designed to contextualize the observed differences in CVT delivery of PTSD EBPs should consider the role of social determinants of health in selecting treatment modality.
Keywords: Tele-health, TraumaAuthors and Affliiates
Presenter: Nicholas Holder, San Francisco Veterans Affairs Health Care System; University of California San FranciscoCo-Author: Adam Batten, San Francisco Veterans Affairs Health Care System; University of California San Francisco
Co-Author: Brian Shiner, White River Junction Veterans Affairs Health Care System; National Center for Posttraumatic Stress Disorder, Executive Division; Geisel School of Medicine at Dartmouth
Co-Author: Shira Maguen, PhD, PhD, San Francisco Veterans Affairs Health Care System; University of California San Francisco
E112 - Trauma-Focused Evidence-Based Psychotherapy for Posttraumatic Stress Disorder Delivered via Synchronous Video Telehealth in the Veterans Health Administration
Category
Scientific > Poster/Paper/Live Research Spotlight