Click to Enlarge: M indicates mean; MSPSS, Multidimensional Scale of Perceived Social Support; PCL-5, PTSD Checklist for DSM-5; PHQ-8, Patient Health Questionnaire-8; PTSD, post-traumatic stress disorder; QOLI, Quality of Life Inventory. Source: Lippincott Open Access
BOSTON — Women veterans who participated in a peer-led, social support group showed improvements in well-being outcomes, including a greater sense of belonging, higher quality of life and decreased post-traumatic stress disorder (PTSD) and depression, according to a recent study.
The study published in Medical Care assessed how participation in a peer-led, structured, social support group-based network impacted outcomes related to women veterans’ well-being, such as belongingness, social support, quality of life, PTSD and depression. Study authors are affiliated with VA Boston (MA) Healthcare System.1
“Women veterans may be at particular risk for loneliness, isolation and thwarted belongingness after service,” explained Tara Galovski, PhD, director of the Women’s Health Sciences Division of the National Center for PTSD at VA Boston Healthcare System and professor of psychiatry at the Chobanian and Avedisian School of Medicine at Boston University. “These are conditions which are known risk factors for poor mental health and well-being.”
Negative outcomes of loneliness, isolation and lack of belonging in women veterans could include PTSD, depression, anxiety and even suicide, according to a Boston University press release about the study.
The elevated risk for poor belongingness and related aspects of well-being, such as social functioning, in women veterans may be due to several factors, including low base rates in civilian communities, lack of recognition or disregard of their service and sacrifice by the general population, and barriers to many veteran services and resources that are more typically geared to men, Galovski explained.
“We developed WoVeN [Women Veterans Network] to help women veterans find one another across the nation and, through a structured eight-session supportive program led by trained peers, mitigate the effects of loneliness and isolation,” Galovski told U.S. Medicine.
WoVeN, a national peer support program developed through Boston University with the support of several foundations, was founded in 2017 and has grown to nearly 5,000 women veterans nationwide, the press release pointed out.
This study included 393 participants in the WoVeN group program who completed at least one follow-up survey. The participants, who served across military branches with the majority serving in the Army (44.5%), had an average age of 41 years old. Of these women, 86.8% identified as non-Hispanic and 50.1% identified as White. Also, individuals with probable PTSD and/or depression were slightly younger, overrepresented in lower socioeconomic status categories, less likely to be working full-time and more likely to identify as disabled, the authors reported.
Participants completed assessments online through Qualtrics Research Suite, a secure, online platform used for collecting self-report data or through a paper and pencil survey, if requested. The researchers analyzed survey data collected at three timepoints: baseline, post-group (up to six weeks after group completion) and 3-month follow-up. They also completed subgroup analysis to examine the program’s impact on participants reporting clinical levels of PTSD and depression symptoms.
“We found that women veterans who participated in the eight-session, peer-led Women Veterans Network (WoVeN) program experienced improvements in several ways,” Galovski said. “Because about half of the 393 women included in this study were already reporting positive well-being and minimal distress, we were particularly interested in the impact of the program on those who were suffering clinical levels of PTSD and/or depression.”
“We were delighted to see that this most vulnerable group reported significant improvements not only in the expected outcomes of belongingness and quality of life, but also significant decreases in both PTSD and depression,” she added, suggesting the value of peer support is “quite profound.”
“Although we did not report this in our study outcomes, it is common for us to hear that ‘this program saved my life,’” Galovski pointed out. “Finding others who have walked the unique journey of a woman in military service has been a healing and empowering experience for many of the women who participate in WoVeN. We often hear that our women have not only found their sisterhood, but they have also found their voice again.”
The investigators noted that belongingness in the women veterans improved, while perceptions of support from friends didn’t improve. This could suggest that even though women might not develop close interpersonal relationships during their group experiences, they may still benefit from being reconnected with their military community, according to the study.
Galovski recommended for healthcare professionals treating women veterans to dedicate some time and energy to understanding the unique aspects of military service that might impact their mental and physical health conditions.
“Unit cohesion and belongingness are very important concepts in military service and can be significantly disrupted during separation from service and reintegration into civilian life,” she pointed out. “Assessing and intervening in these domains if necessary is important in achieving the ultimate goal of well-being.”
This model of peer-led social support can be easily translated to other vulnerable populations and provide a sustainable and easily replicable model of care for at-risk populations to help move the needle further toward better mental health and greater well-being, Galovski recommended in a Boston University press release.
While this model isn’t a frontline intervention for PTSD, future research might consider testing the effects of this intervention in combination with evidence-based therapies for PTSD. This type of program could help women overcome barriers to care and provide a means for increasing access to resources for women veterans, study authors suggested.
- Galovski TE, Street AE, Cooney CC, Winters MR. Evaluating the Impact of a Peer Support Program on Participants’ Well-Being: Finding Belongingness Through the Women Veterans Network. Med Care. 2024 Dec 1;62(12 Suppl 1):S43-S49. doi: 10.1097/MLR.0000000000002039. Epub 2024 Nov 11. PMID: 39514494; PMCID: PMC11548822.
