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

• Published in: Global advances in health and medicine Vol. 11; p. 21649561211064244
• Main Authors: Anderson, Ekaterina, Dvorin, Kelly, Etingen, Bella, Barker, Anna M., Rai, Zenith, Herbst, Abigail, Mozer, Reagan, Kingston, Rodger P., Bokhour, Barbara
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 2022; Sage Publications Ltd; SAGE Publishing
• Subjects: Coronaviruses; COVID-19; Original; Pandemics; Telemedicine; implementation and dissemination; telemedicine; veterans; support group; qualitative; health coaching
• ISSN: 2164-957X; 2164-9561
• DOI: 10.1177/21649561211064244

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.