Veterans Service Organizations and MHV

BACKGROUND/RATIONALE: Despite the promise of electronic health resources, there is evidence
that they have not led to the improved self management that many envisioned. There is
evidence for this from a variety of sources, including VHA. Although there is appropriate
attention to improving the functionality and ease of use of the system, a key barrier is
patient acceptance and familiarity. Peer support, particularly in group settings, can
improve health-related behaviors. Such approaches may increase and improve MHV use.

OBJECTIVES: Our goal in the present project is to develop and test a peer-based mechanism to
increase MHV use by VSO members. The investigators will address 3 specific aims:

1. To demonstrate that trained members of VSO can provide basic MHV education and support
within their VSO unit using mobile computers.

2. To demonstrate that this intervention increases MHV registration, in person
authentication (IPA), and reported use of MHV among veteran post members.

3. To create clear, concise, and portable resources that will make it possible to
replicate this process in other VSO units or other community settings.

METHODS: This implementation study is a quasi-randomized intervention with delayed controls.
Working with the leadership of selected veterans groups, the investigators will identify 12
posts that have the appropriate resources and interests to serve as pilot posts for the
present project. The investigators will train 2 peer mentors (super-users or SU) from 4 of
these posts using adaptations of the peer training approach the investigators used for a
previous project. The investigators will work with the SU to install computers with wireless
broadband Internet access at their posts. The investigators will load the computers with
software that documents unique sessions, sites visited, and amount of time at each site. The
investigators will help the SU provide lessons regarding MHV use to his/her fellow post
members at 4 monthly post meetings. After 4 months, the investigators will move the
computers to the next 4 posts and repeat the intervention. Finally, the investigators will
move the computers to the last 4 posts, providing remote support and our training materials
to the SU at those posts. The investigators will use computer tracking data, surveys, focus
groups, and interviews to assess the impact of the program. the investigators will test
changes in registration, IPA, and use with before and after surveys. Our analysis will
adjust for clustering within posts. The investigators will transcribe our focus groups and
interviews verbatim and analyze them using a case study approach.

Inclusion Criteria:

Two steps, first a post is enrolled, then a member participates.

Post eligible if:

1. The post leadership agrees that the post will support participation.

2. Two or more members of the post agree to serve as MHV super-users.

3. There is an identifiable location within the post for the computer.

Member eligible if:

1. Member of post

2. Attends the meeting at which the survey is administered

Exclusion Criteria:

1. Does not consent to survey

2. Does not attend meeting where survey administered