Recruitment of women veterans into suicide prevention research: Improving response rates with enhanced recruitment materials and multiple survey modalities
Abstract: Women veterans (WV) are the fastest growing veteran subpopulation and recognized to be at increased risk for suicide compared with civilians. Improving engagement (e.g., response rates) of WV in survey research is critical to ensuring valid and generalizable findings, which can inform suicide prevention programs tailored for this population. Many factors are known to influence response rates, yet little is known about ways to optimize survey response rates among WV. Three recruitment cohorts (Waves 1 [W1], 2a [W2a], and 2b [W2b]) of WV were invited to participate in an online survey for a national, mixed-methods study examining suicide risk among WV using reproductive health care services paid for or provided by the Veterans Health Administration. To examine the effects of enhanced recruitment efforts, standard recruitment materials were mailed to all three cohorts, with the additions of: a study flyer aiming to build trust between participants and researchers (W2a, W2b) and a paper survey (W2b). Characteristics of responders and non-responders were compared by wave and across survey modalities. Response rates were significantly higher for groups receiving enhanced (W2a = 17.1%; W2b = 24.6%) versus standard (W1 = 12.2%) recruitment materials. WV residing in rural areas were significantly more likely to respond by paper (37.1%) than online (19.8%). Non-respondents were disproportionately racial and ethnic minorities. Disclosure of sensitive information (e.g., military sexual trauma) did not differ by survey modality. Findings suggest that enhanced recruitment materials improve survey response rates among WV, an important consideration for future research with this population.
Abstract: Objective: The present study is a retrospective quasi-experimental study to evaluate the effectiveness of the Warrior PATHH (WP) program at improving posttraumatic growth (PTG) outcomes and reducing PTSD symptoms compared to a waitlist control among a sample of Veterans. Method: Participants (n = 164) were U.S. military Veterans with a history of trauma. Participants were either undergoing the Warrior PATHH program or a waitlist. Primary outcome measures were administered at baseline and at 90-day follow-up and consisted of the Posttraumatic Growth Inventory – Expanded (PTGI-X) and the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). Secondary outcome measures assessed psychosocial functioning and included measures of depression and anxiety symptoms, sleep, wellbeing, and social support. Results: Significant differences were observed between groups on the PTGI-X (F(1, 205) = 23.667, p < .001, partial η2 = 0.103), and the PCL-5 (F(1, 205) = 262.460, p < .001, partial η2 = 0.561) with the WP group showing significant positive psychological change following a traumatic event as measured by the PTGI-X and decreased PTSD symptoms as measured by the PCL-5 compared to those in the waitlist condition. Those in the treatment arm also demonstrated gains to psychosocial functioning. Conclusions: Consistent with previous research, participants in the Warrior PATHH program exhibited significant increases in PTG outcomes, decreased PTSD symptoms, and broad improvements to psychosocial functioning. These findings suggest it is an effective training program to foster PTG outcomes among Veterans. This study is unique as it is the first to compare the effects of WP programming with a sample of waitlisted Veterans.