Intensive Referral of Veterans to Mutual-Help Groups: A Mixed-Methods Implementation Evaluation

ABSTRACT

Community-based support group participation protects against substance use disorder (SUD) relapse, but referrals during treatment are inconsistently delivered and may not acknowledge barriers facing rural patients. This formative evaluation of a rural intensive referral intervention (RAIR) to community-based support groups for Veterans seeking SUD treatment surveyed patients (n = 145) and surveyed and interviewed treatment staff (n = 28). Patients and staff did not differ significantly on quantitative ratings of the helpfulness of, or satisfaction with, seven RAIR components, but staff did not deliver the intervention consistently or as designed, citing two themes: lack of commitment and lack of resources.

KEYWORDS:

• Substance use disorder
• mutual-help
• rural
• Veteran
• qualitative
• alcoholics anonymous
• self-help
• social support
• access to care
• relapse

Acknowledgment

The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.

Statement of interest

All authors approved this manuscript and this submission. The authors report no conflicts of interest.

Additional information

Funding

This work was supported by the Department of Veterans Affairs Rural Health Resource Center - Central Region (N32-FY13Q1-S1-P00642) and Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service Quality Enhancement Research Initiative (project no.14-192).