Christine E Gould1, Aimee Marie L Zapata1, Janine Bruce2, Sylvia Bereknyei Merrell3, Julie Loebach Wetherell4, Ruth O'Hara5, Eric Kuhn5, Mary K Goldstein1, Sherry A Beaudreau5. 1. Palo Alto Geriatric Research,Education,and Clinical Center (GRECC),VA Palo Alto Health Care System,Palo Alto,CA,USA. 2. Department of Pediatrics,Division of General Pediatrics,Stanford University School of Medicine,Stanford,CA,USA. 3. Department of Medicine,Division of General Medical Disciplines,Stanford University School of Medicine,Stanford,CA,USA. 4. Psychology Service,VA San Diego Healthcare System,San Diego,CA,USA. 5. Department of Psychiatry and Behavioral Sciences,Stanford University School of Medicine,Stanford,CA,USA.
Abstract
BACKGROUND: Behavioral treatments reduce anxiety, yet many older adults may not have access to these efficacious treatments. To address this need, we developed and evaluated the feasibility and acceptability of a video-delivered anxiety treatment for older Veterans. This treatment program, BREATHE (Breathing, Relaxation, and Education for Anxiety Treatment in the Home Environment), combines psychoeducation, diaphragmatic breathing, and progressive muscle relaxation training with engagement in activities. METHODS: A mixed methods concurrent study design was used to examine the clarity of the treatment videos. We conducted semi-structured interviews with 20 Veterans (M age = 69.5, SD = 7.3 years; 55% White, Non-Hispanic) and collected ratings of video clarity. RESULTS: Quantitative ratings revealed that 100% of participants generally or definitely could follow breathing and relaxation video instructions. Qualitative findings, however, demonstrated more variability in the extent to which each video segment was clear. Participants identified both immediate benefits and motivation challenges associated with a video-delivered treatment. Participants suggested that some patients may need encouragement, whereas others need face-to-face therapy. CONCLUSIONS: Quantitative ratings of video clarity and qualitative findings highlight the feasibility of a video-delivered treatment for older Veterans with anxiety. Our findings demonstrate the importance of ensuring patients can follow instructions provided in self-directed treatments and the role that an iterative testing process has in addressing these issues. Next steps include testing the treatment videos with older Veterans with anxiety disorders.
BACKGROUND: Behavioral treatments reduce anxiety, yet many older adults may not have access to these efficacious treatments. To address this need, we developed and evaluated the feasibility and acceptability of a video-delivered anxiety treatment for older Veterans. This treatment program, BREATHE (Breathing, Relaxation, and Education for Anxiety Treatment in the Home Environment), combines psychoeducation, diaphragmatic breathing, and progressive muscle relaxation training with engagement in activities. METHODS: A mixed methods concurrent study design was used to examine the clarity of the treatment videos. We conducted semi-structured interviews with 20 Veterans (M age = 69.5, SD = 7.3 years; 55% White, Non-Hispanic) and collected ratings of video clarity. RESULTS: Quantitative ratings revealed that 100% of participants generally or definitely could follow breathing and relaxation video instructions. Qualitative findings, however, demonstrated more variability in the extent to which each video segment was clear. Participants identified both immediate benefits and motivation challenges associated with a video-delivered treatment. Participants suggested that some patients may need encouragement, whereas others need face-to-face therapy. CONCLUSIONS: Quantitative ratings of video clarity and qualitative findings highlight the feasibility of a video-delivered treatment for older Veterans with anxiety. Our findings demonstrate the importance of ensuring patients can follow instructions provided in self-directed treatments and the role that an iterative testing process has in addressing these issues. Next steps include testing the treatment videos with older Veterans with anxiety disorders.
Authors: Judith Borghouts; Elizabeth Eikey; Gloria Mark; Cinthia De Leon; Stephen M Schueller; Margaret Schneider; Nicole Stadnick; Kai Zheng; Dana Mukamel; Dara H Sorkin Journal: J Med Internet Res Date: 2021-03-24 Impact factor: 5.428