(PS7-B40) Pilot Study of Group Telehealth Plus Webstair in VA Primary Care Indicates Hybrid Technology Approach Reduces PTSD and Depression During COVID-19 Pandemic

Introduction:   During the COVID-19 pandemic, VA primary care mental health (PCMH) visits were moved to telehealth appointments. Online resources, including mobile apps and web-based programs, were increasingly used to support PCMH interventions. webSTAIR, based on the skills training in affective and interpersonal regulation (STAIR) program is a 10-module trauma-informed transdiagnostic web-based program designed to reduce symptoms of PTSD and depression. Two studies have found that therapist-supported use of webSTAIR via telehealth sessions improved symptoms of PTSD and depression (Bauer et al., 2020; Fletcher et al. 2021). A third study has found that found that five, bi-weekly coaching sessions (COACH5) was as effective as ten weekly coaching sessions (COACH10) among Veterans in outpatient care (Cloitre et al., in press). While there is evidence for the benefits of this web-based program with individual telehealth intervention in outpatient care, the use of a web-based program in a group telehealth format and in a primary care setting has yet to be examined.

Objective: The primary aim of the current study was to evaluate webSTAIR delivered via telehealth in a group format using the COACH5 model (biweekly telehealth meetings) in a VA primary care setting.   

Method: Thirty-nine Veterans from the American Lake VA in Tacoma, WA enrolled in the program. Assessments for the PTSD Checklist for DSM-5 (PCL-5) and Patient Health Questionnaire (PHQ-9) were completed as part of the program at three different time points (i.e., Pre-treatment, Mid-treatment, Post-treatment).

Results: The average PCL-5 and PHQ-9 baseline scores were 45.06 (SD=16.82) and 13.78 (SD=5.9), respectively. Attrition from the program was 35.90%, and this was a highly trauma-exposed sample with an average of 8.58 total traumatic life events. Repeated measures within-subject ANOVAs comparing total PTSD scores among Pre, Mid, and Post-treatment showed significant pre-to-post symptom reduction for both PCL-5 scores (p=0.003) and PHQ-9 scores (p=0.01). Effect sizes were in the moderate to large range for PTSD (g=0.87) and depression (g=0.79).

Conclusion: These findings support the clinical utility of hybrid technology projects that combine web-based programs, like webSTAIR, with therapist-supported telehealth groups.