Veterans Social Program for Depression

Overseen By Kendra Pugh, PhD

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Schizophrenia, Bipolar, Dementia, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 18

Duration: 16 weeks

33 Participants Needed

Trial Summary

What is the purpose of this trial?

VOICES Veterans Socials (VS) support Veterans in the community through weekly social groups. Veterans socials have the potential to improve social functioning, mental health symptoms, and create lasting social support. This project aims to evaluate and improve Veterans Socials to help older Veterans with depression by adapting materials, interviewing VS attendees, and collecting questionnaires. The goal is to improve the program based on the results for future use and research.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on social support rather than medication changes.

What data supports the effectiveness of the Veterans Social Program for Depression treatment?

Research suggests that increasing social connections through programs like Veterans Socials can help reduce depressive symptoms and improve access to care among veterans. Studies have shown that social contact is significantly related to changes in depressive symptoms, highlighting the potential benefits of community-based social interventions. ^{1 2 3 4 5}

Is the Veterans Social Program for Depression safe for participants?

The available research on the Veterans Social Program, also known as VOICES, suggests it is generally safe for participants, as it focuses on increasing social connections and access to care without any reported safety concerns. ^{1 5 6 7 8}

How is the Veterans Social Program for Depression treatment different from other treatments for depression?

The Veterans Social Program for Depression is unique because it focuses on increasing social connections and providing information about services through community-based events, rather than traditional medical or psychological treatments. This approach aims to reduce depression by enhancing social support and access to care, which is particularly beneficial for veterans who may experience social isolation. ^{1 9 10 11 12}

Research Team

Jay Gorman, PsyD

Principal Investigator

VA Bedford HealthCare System, Bedford, MA

Eligibility Criteria

This trial is for older veterans who are experiencing depression, isolation, or loneliness. Participants must have a documented depressive disorder or score higher than 2 on the PHQ-2 and be able to give informed consent.

Inclusion Criteria

I have been diagnosed with depression or scored more than 2 on a depression screening.

I am mentally capable of understanding and consenting to participate.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Interviews

13 participants engage in semi-structured interviews about barriers to social engagement and challenges around community-based activities

4 weeks

1 visit (in-person)

Treatment

20 participants engage in weekly 90-minute social groups for social engagement and support

16 weeks

16 visits (in-person)

Follow-up

Participants are monitored for social support and mental health outcomes after the intervention

3 months

1 visit (in-person)

Treatment Details

Interventions

• Veterans Social

Trial Overview The study is testing 'Veterans Socials,' which are weekly social groups aimed at improving social functioning, mental health symptoms, and building lasting support among veterans with depression.

Participant Groups

Group I: Veterans Social Experimental Treatment 1 Intervention

Peer-led weekly community-based social groups (16 weeks)

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Findings from Research

The VOICES intervention, which organizes community-based Veterans Socials, has shown high levels of acceptability and demand among veterans, indicating that they find it valuable and are likely to participate.

This program may enhance social connections and increase the use of VA services, potentially contributing to a reduction in suicide rates among U.S. veterans.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using Veterans Socials to Build a Community: Feasibility of the VOICES Intervention. Gorman, JA., Chamberlin, ES., Stevenson, BJ., et al.[2023]

The Veterans Outcomes Assessment (VOA) program effectively gathers patient-reported outcomes from Veterans receiving mental health treatment, providing valuable data for evaluating treatment programs, especially for those not in ongoing care.

Results indicate that patients who discontinued treatment voluntarily reported better outcomes than those who stopped due to issues, highlighting the importance of understanding patient motivations in treatment effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using patient-reported outcome measures for program evaluation: Design and findings on intention-to-treat outcomes from the Veterans Outcome Assessment survey. Katz, IR., Resnick, SG., Kasprow, WJ., et al.[2020]

In a study of 868 veterans receiving collaborative depression care, higher baseline depressive symptoms were linked to lower perceived social support and less frequent contact with family and friends.

The analysis showed that increased social contact was significantly associated with improvements in depressive symptoms, suggesting that enhancing social interactions could be a key strategy in depression care management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The association between social ties and changes in depressive symptoms among veterans enrolled in a collaborative depression care management program. Mavandadi, S., Ingram, E., Chen, S., et al.[2022]

The CD-based depression training program, based on the IMPACT model, effectively changed care practices among participants, with 250 out of 513 training packets evaluated showing high scores in areas like assessment and communication.

Participants reported positive outcomes in care for older adults, suggesting that the training may enhance nursing practices and improve collaboration with other healthcare providers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Depression training for nurses: Evaluation of an innovative program. Smith, M., Johnson, KM., Seydel, LL., et al.[2022]

In a study of 262 veterans over one year, higher levels of loneliness were linked to a decrease in depression severity and suicidal thoughts, suggesting that loneliness may have a complex relationship with mental health outcomes.

Conversely, having more confidants was associated with increased depression symptoms, while greater emotional support correlated with fewer mental health visits, indicating that emotional support may help reduce the need for mental health services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social connectedness, depression symptoms, and health service utilization: a longitudinal study of Veterans Health Administration patients. Chen, JI., Hooker, ER., Niederhausen, M., et al.[2020]

Veterans recently discharged from psychiatric hospitalization expressed a strong desire for community engagement to enhance their social connectedness, but faced barriers such as low self-confidence and lack of information about available activities.

To improve participation in community activities, veterans suggested the need for centralized information and active support systems to help them connect after hospitalization.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Veteran community engagement and social connection needs following inpatient psychiatric hospitalization. Chen, JI., Ono, SS., Laliberte, AZ., et al.[2023]

A study involving nine outpatients with major depression showed that they preferred more specific wording in e-health dialogues designed to engage at-risk veterans, particularly on sensitive topics like suicide and social isolation.

Feedback indicated that while veterans with depression had better vocabulary comprehension than those with schizophrenia, they were less willing to answer a high number of questions daily, suggesting a need for tailored engagement strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Optimizing Scripted Dialogues for an e-Health Intervention for Suicidal Veterans with Major Depression. Kasckow, J., Zickmund, S., Rotondi, A., et al.[2022]

Engaging veterans in research is crucial for identifying modifiable suicide risk factors and developing effective public health interventions, as highlighted by the contributions of the Veterans Engagement Board to the ASCEND project.

Veteran engagement not only improves communication and sensitivity around topics like firearms and suicide in surveys but also enhances the relevance of research to current events, making it a vital part of suicide prevention efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Veteran Engagement in Survey Research to Prevent Suicide. Wendleton, L., Hoffmire, CA., Drop, S., et al.[2023]

Facebook advertisements successfully reached and recruited Iraq and Afghanistan-era military veterans for a mental health study, generating over 827,000 impressions and 587 completed surveys in just six weeks.

The ads were particularly effective in engaging veterans at risk for mental health issues, with significant rates of positive screens for conditions like PTSD (45%) and suicidality (23%), highlighting the potential of social media as a tool for connecting with underserved populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reaching Those At Risk for Psychiatric Disorders and Suicidal Ideation: Facebook Advertisements to Recruit Military Veterans. Teo, AR., Liebow, SB., Chan, B., et al.[2022]

In a study of 146 US veterans with mental illness, social isolation was found to be strongly linked to lower well-being, indicating that veterans who feel socially isolated are at a higher risk for poor mental health outcomes.

The research showed that social isolation significantly predicts well-being, accounting for 50% of the variance in well-being scores, suggesting that addressing social connections could be crucial for improving mental health in veterans.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social isolation and well-being in veterans with mental illness. Grenawalt, TA., Lu, J., Hamner, K., et al.[2023]

Operation Outreach has provided vital psychosocial services to approximately 100,000 Vietnam veterans since 1979, addressing the effects of posttraumatic stress disorder (PTSD) related to their war experiences.

The program, staffed by veterans and knowledgeable individuals rather than solely mental health professionals, has developed effective treatment methods for PTSD, while also highlighting the challenges faced by veterans upon their return home.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Apocalypse terminable and interminable: operation outreach for Vietnam veterans. Blank, AS.[2019]

The SEEK (Supported Employment: Engage and Keep) intervention aims to prevent job loss among veterans struggling with mental health issues by actively reaching out to those who are already employed, which is a departure from traditional VHA services that focus on unemployed veterans.

By collaborating with employers and providing support for healthcare enrollment and job maintenance, SEEK seeks to reduce the risk of suicide and other negative outcomes associated with untreated mental health concerns, highlighting the importance of proactive mental health support in the workplace.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Preventing job loss and functional decline: Description and demonstration of the Veterans Health Administration supported Employment: Engage and Keep (SEEK) program. Stevenson, BJ., Calixte, RM., Peckham, AD., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Using Veterans Socials to Build a Community: Feasibility of the VOICES Intervention. [2023]

2. Ireland pubmed.ncbi.nlm.nih.gov

Using patient-reported outcome measures for program evaluation: Design and findings on intention-to-treat outcomes from the Veterans Outcome Assessment survey. [2020]

3. United States pubmed.ncbi.nlm.nih.gov

The association between social ties and changes in depressive symptoms among veterans enrolled in a collaborative depression care management program. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Depression training for nurses: Evaluation of an innovative program. [2022]

5. Germany pubmed.ncbi.nlm.nih.gov

Social connectedness, depression symptoms, and health service utilization: a longitudinal study of Veterans Health Administration patients. [2020]

6. United States pubmed.ncbi.nlm.nih.gov

Veteran community engagement and social connection needs following inpatient psychiatric hospitalization. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Optimizing Scripted Dialogues for an e-Health Intervention for Suicidal Veterans with Major Depression. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Veteran Engagement in Survey Research to Prevent Suicide. [2023]

9. Canada pubmed.ncbi.nlm.nih.gov

Reaching Those At Risk for Psychiatric Disorders and Suicidal Ideation: Facebook Advertisements to Recruit Military Veterans. [2022]

10. England pubmed.ncbi.nlm.nih.gov

Social isolation and well-being in veterans with mental illness. [2023]

11. United States pubmed.ncbi.nlm.nih.gov

Apocalypse terminable and interminable: operation outreach for Vietnam veterans. [2019]

12. United States pubmed.ncbi.nlm.nih.gov

Preventing job loss and functional decline: Description and demonstration of the Veterans Health Administration supported Employment: Engage and Keep (SEEK) program. [2023]