Motivationally Driven and Technology Based Interventions for Health Behavior Change Among Veterans

What is it about?

The top ten causes of mortality in the US are, in large part, preventable due to regular engagement in healthy lifestyle behaviors such as smoking cessation, adequate nutrition, regular exercise and stress management, to name a few. Veterans suffering from PTSD are at risk for developing additional medical conditions that include chronic musculoskeletal pain, unexplained somatic symptoms, cardiovascular disease, and gastrointestinal diseases--- all of which are predictors/correlates of premature mortality. Further, associated risky coping behaviors include substance (i.e., tobacco, alcohol and other drugs) use and abuse, maladaptive eating behavior, and suicidal behavior. Such risky behaviors contribute to additional morbidity and premature mortality. Fortunately, these risky behaviors are modifiable lifestyle factors that can be reduced in response to appropriate, tailored and motivationally driven psychological intervention. This paper is a CALL TO ACTION to further study, refine and implement a well substantiated, motivationally-driven, computerized multiple health behavior change intervention to complement existing PTSD treatments across the VA system to improve Veterans' overall health and well-being. The Transtheoretical Model of Health Behavior Change has been applied to the civilian population for decades with robust, positive results in effecting multiple health behavior change in various civilian subpopulations. The flexibility of the TTM-based, computerized system will enable implementation as a stand- alone intervention for Veterans who wish to improve their overall health and well-being and/or as a complement to existing PTSD treatments. The TTM computerized intervention can be delivered remotely, therefore it can increase access to care for Veterans who experience barriers accessing the VA system as well as decrease overall burden on the VA healthcare system. Further development and refinement of the TTM computerized system is needed to elicit Veteran and stakeholder feedback to identify areas of improvement and further tailoring to represent the unique needs of Veterans.

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Why is it important?

Given the current opioid crisis and high rates of suicidality among Veterans suffering from PTSD with multiple comorbid physical and mental health conditions, it is our ethical responsibility, as psychologists and healthcare providers, to shift the treatment focus to extend beyond symptom reduction and offer an effective, tailored and motivationally grounded, nonpharmacological approach toward healthful lifestyle modification. In essence, it is critical to reduce Veterans’ unhealthy behaviors while also helping them adopt and sustain adaptive health behaviors to not only foster and maintain symptom reduction but to also promote their overall well-being and quality of life. Ultimately, this proactive and overall health benefitting approach holds promise for important positive effects for the entire Veteran community as well as significant time and cost saving benefits for the entire VA healthcare system.

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