Alabama Veterans Rural Health Initiative

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

203 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-10-01

Study Completion Date

2013-10-01

Brief Summary

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The purpose of the Alabama Veterans Rural Health Initiative is to better understand access and barriers to health care and to enhance veteran enrollment or engagement in health care services of veterans residing in rural areas. It describes an intervention that is adaptable for use by other VA facilities that serve veterans in rural settings, and importantly, this study will improve our understanding of barriers to care and evaluate a method for enhancing access to care. The anticipated impact is that more veterans in rural areas who were previously under-utilizing VA services will receive and attend a health care appointment. This gain may improve preventative and primary care health care and reduce long term health care morbidity, expense and burden. This study may also identify previously unknown barriers to care that can be surmounted by innovative access and health care delivery approaches.

The primary objective is to evaluate an innovative approach for enhanced enrollment and engagement outreach intervention (EEE intervention) for rural veterans in VA health care services. This study entails a two-cell design, addressing this objective with a prospective, randomized controlled multi-site clinical trial that evaluates an active intervention compared to administrative outreach (AO, control condition) on whether or not a rurally-residing veteran obtains and attends a VA appointment.

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Detailed Description

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Access, enrollment, and engagement with primary and specialty health care services present significant challenges for rural populations worldwide. The Alabama Veterans Rural Health Initiative evaluated an innovative outreach intervention combining motivational interviewing, patient navigation, and health services education to promote utilization of the United States Veterans Administration Healthcare System (VA) by veterans who live in rural locations.

Conditions

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Problems With Access to Health Care Health Behavior

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Prospective randomized control trial

Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

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Enhanced Engagement and Enrollment (EEE)

Enhanced Engagement and Enrollment (EEE) consists of the outreach worker (interventionalist) engaging the participant in education (about VA resources and medical care), navigating the patient through the VA eligibility, enrollment, and scheduling processes, and using motivational interview to focus on ambivalence about attending a VA appointment.

Group Type EXPERIMENTAL

Enhanced Engagement and Enrollment (EEE)

Intervention Type OTHER

Consists of motivational interviewing, educational outreach, and patient navigation.

Administrative Outreach (AO)

Administrative Outreach (AO) consists of the outreach worker giving the participants an application package to VA enrollment or phone number for the scheduling clerk. This intervention does not involve education, patient navigation (guidance through VA eligibility, enrollment, and scheduling processes) or motivational interviews (interviews focused on ambivalence about attending a VA appointment).

Group Type ACTIVE_COMPARATOR

Administrative Outreach (AO)

Intervention Type OTHER

Consists of giving information about enrolling for VA medical care or scheduling an appointment

Interventions

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Enhanced Engagement and Enrollment (EEE)

Consists of motivational interviewing, educational outreach, and patient navigation.

Intervention Type OTHER

Administrative Outreach (AO)

Consists of giving information about enrolling for VA medical care or scheduling an appointment

Intervention Type OTHER

Other Intervention Names

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Enhanced Engagement and Enrollment Treatment-as-usual

Eligibility Criteria

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Inclusion Criteria

* Veterans who live in rural Alabama counties who have either never enrolled or have previously enrolled but have not accessed a VA in 2 years or more
* Signed informed consent
* Any race, social class or ethnicity