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Pre-implementation Evaluation of PARTNER-MH: A Mental Healthcare Disparity Intervention for Minority Veterans in the VHA

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Abstract

To design PARTNER-MH, a peer-led, patient navigation program for implementation in Veterans Health Administration (VHA) mental health care settings, we conducted a pre-implementation evaluation during intervention development to assess stakeholders’ views of the intervention and to explore implementation factors critical to its future adoption. This is a convergent mixed-methods study that involved qualitative semi-structured interviews and survey data. Data collection was guided by the Consolidated Framework for Implementation Research (CFIR). We interviewed and administered the surveys to 23 peers and 10 supervisors from 12 midwestern VHA facilities. We used deductive and inductive approaches to analyze the qualitative data. We also conducted descriptive analysis and Fisher Exact Test to compare peers and supervisors’ survey responses. We triangulated findings to refine the intervention. Overall, participants viewed PARTNER-MH favorably. However, they saw the intervention’s focus on minority Veterans and social determinants of health framework as potential barriers, believing this could negatively affect the packaging of the intervention, complicate its delivery process, and impact its adoption. They also viewed clinic structures, available resources, and learning climate as potential barriers. Peers and supervisors’ selections and discussions of CFIR items were similar. Our findings informed PARTNER-MH development and helped identify factors that could impact its implementation. This project is responsive to the increasing recognition of the need to incorporate implementation science in healthcare disparities research. Understanding the resistance to the intervention’s focus on minority Veterans and the potential barriers presented by contextual factors positions us to adjust the intervention prior to testing, in an effort to maximize implementation success.

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Data Availability

The datasets during and/or analyzed during the current study available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank the study participants for making this work possible.

Funding

This work was supported by a VA HSR&D Career Development Award CDA 16-153 to Dr. Eliacin. Drs. Eliacin, Matthias, Damush, and Rollins were also supported in part by the VA HSR&D Center for Health Information and Communication, CIN 13-416. Views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

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Authors and Affiliations

  1. VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VAMC, Indianapolis, USA

    Johanne Eliacin, Marianne S. Matthias, Teresa Damush, Caitlin O’Connor & Angela Rollins

  2. Psychology Department, ACT Center of Indiana, IUPUI, Indianapolis, USA

    Johanne Eliacin & Angela Rollins

  3. Regenstrief Institute, Inc, Indianapolis, IN, USA

    Johanne Eliacin, Marianne S. Matthias, Teresa Damush, Tasneem Talib & Angela Rollins

  4. Department of Communication Studies, IUPUI, Indianapolis, USA

    Marianne S. Matthias

  5. Center for Chronic Disease Outcomes Research (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Minneapolis, MN, USA

    Diana J. Burgess

  6. Department of Psychiatry, Richard L. Roudebush VAMC, Indianapolis, IN, USA

    Scott Patterson

  7. General Internal Medicine, Indiana University School of Medicine, Indianapolis, USA

    Teresa Damush

  8. Institute for Patient-Centered Initiatives & Health Equity, George Washington University Cancer Center, Washington, DC, USA

    Mandi Pratt-Chapman

  9. Psychiatry & Behavioral Sciences; Medicine, Stanford University School of Medicine, Stanford, CA, USA

    Mark McGovern

  10. Veterans Integrated Service Network 4 Mental Illness Research, Education and Clinical Center and the Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA

    Matthew Chinman

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  1. Johanne Eliacin
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Contributions

JE, MM, DB, SP, AR, TP, and TT made substantial contributions to the conception or design of the work. JE, SP, CO, and TT collected the data. JE, CO, and TT analyzed the data. JE, MM, DB, AR, TD, SP, and TT interpreted the data. JE drafted the work. JE, MM, AR, DB, and TD substantively revised the work. All authors read and approved the final manuscript.

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Correspondence to Johanne Eliacin.

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The authors declare that they have no competing interests.

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This study was approved by the Indiana University IRB and Roudebush VAMC Research and Development Committee.

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Eliacin, J., Matthias, M.S., Burgess, D.J. et al. Pre-implementation Evaluation of PARTNER-MH: A Mental Healthcare Disparity Intervention for Minority Veterans in the VHA. Adm Policy Ment Health 48, 46–60 (2021). https://doi.org/10.1007/s10488-020-01048-9

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