Lessons Learned From VHA's Rapid Implementation of Virtual Whole Health Peer-Led Groups During the COVID-19 Pandemic: Staff Perspectives

Ekaterina Anderson; Kelly Dvorin; Bella Etingen; Anna M Barker; Zenith Rai; Abigail Herbst; Reagan Mozer; Rodger P Kingston; Barbara Bokhour

doi:10.1177/21649561211064244

Lessons Learned From VHA's Rapid Implementation of Virtual Whole Health Peer-Led Groups During the COVID-19 Pandemic: Staff Perspectives

Glob Adv Health Med. 2022 Jan 25:11:21649561211064244. doi: 10.1177/21649561211064244. eCollection 2022.

Authors

Ekaterina Anderson^{1

2}, Kelly Dvorin¹, Bella Etingen³, Anna M Barker¹, Zenith Rai¹, Abigail Herbst¹, Reagan Mozer⁴, Rodger P Kingston⁵, Barbara Bokhour^{1

6}

Affiliations

¹ Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, USA.
² Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA.
³ Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines VA Hospital, Hines, IL, USA.
⁴ Department of Mathematical Sciences, Bentley University, Waltham, MA, USA.
⁵ Veteran Engagement in Research Group, VA Bedford Healthcare System, Bedford, MA, USA.
⁶ Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA.

Abstract

Background: Committed to implementing a person-centered, holistic (Whole Health) system of care, the Veterans Health Administration (VHA) developed a peer-led, group-based, multi-session "Taking Charge of My Life and Health" (TCMLH) program wherein Veterans reflect on values, set health and well-being-related goals, and provide mutual support. Prior work has demonstrated the positive impact of these groups. After face-to-face TCMLH groups were disrupted by the COVID-19 pandemic, VHA facilities rapidly implemented virtual (video-based) TCMLH groups.

Objective: We sought to understand staff perspectives on the feasibility, challenges, and advantages of conducting TCMLH groups virtually.

Methods: We completed semi-structured telephone interviews with 35 staff members involved in the implementation of virtual TCMLH groups across 12 VHA facilities and conducted rapid qualitative analysis of the interview transcripts.

Results: Holding TCMLH groups virtually was viewed as feasible. Factors that promoted the implementation included use of standardized technology platforms amenable to delivery of group-based curriculum, availability of technical support, and adjustments in facilitator delivery style. The key drawbacks of the virtual format included difficulty maintaining engagement and barriers to relationship-building among participants. The perceived advantages of the virtual format included the positive influence of being in the home environment on Veterans' reflection, motivation, and self-disclosure, the greater convenience and accessibility of the virtual format, and the virtual group's role as an antidote to isolation during the COVID-19 pandemic.

Conclusion: Faced with the disruption caused by the COVID-19 pandemic, VHA pivoted by rapidly implementing virtual TCMLH groups. Staff members involved in implementation noted that delivering TCMLH virtually was feasible and highlighted both challenges and advantages of the virtual format. A virtual group-based program in which participants set and pursue personally meaningful goals related to health and well-being in a supportive environment of their peers is a promising innovation that can be replicated in other health systems.

Keywords: health coaching; implementation and dissemination; qualitative; support group; telemedicine; veterans.

Grants and funding

K12 HL138049/HL/NHLBI NIH HHS/United States