“Then COVID happened…”: Veterans’ Health, Wellbeing, and Engagement in Whole Health Care During the COVID-19 Pandemic

Abstract

Background Little is known about the COVID-19 pandemic’s impact on US military veterans’ health, wellbeing, and care engagement. Healthcare systems like VA need additional information about the pandemic’s biopsychosocial impacts and how a Whole Health approach may help to address them. Objective To examine how the pandemic has affected veterans’ health, wellbeing, and engagement in the VA Whole Health System of Care. Method We conducted qualitative interviews with 40 veterans at a large multicampus VA healthcare system during the pandemic. Informed by a Whole Health approach, interviews used open-ended questions to holistically explore pandemic impacts on mental and physical health, healthcare access and engagement, social support, coping strategies, and use of VA healthcare and wellness services. Interviews were conducted by telephone, audio-recorded, and analyzed using a matrix-based technique. Interviews were supplemented by an original survey assessing pandemic impacts; descriptive frequencies were calculated to describe and characterize the interviewed sample. Interview Results Nearly, all participating veterans described significant pandemic impacts on their wellbeing, especially loneliness and sorrow stemming from isolation and disruptions to ordinary routines. These emotional impacts—sometimes combined with new constraints on care access and personal mobility—disrupted veterans’ health plans and sometimes deterred engagement in both routine and wellness care. Veterans already struggling with chronic mental and physical health conditions and those who experienced transitions or losses during the pandemic described the most severe impacts on their wellbeing. Virtual VA wellness services, especially health coaching and mind-body wellness groups, were a key source of support and connection for those who engaged in them. Conclusion We discuss the implications of our findings for care systems attempting to implement a Whole Health System of Care, including how they can address postpandemic barriers to engagement in healthcare and wellness programs, and how wellness programs can be leveraged to support those most at risk after the COVID-19 pandemic and in future crises.

Predicting Uptake of the COVID Coach App Among US Military Veterans: Funnel Analysis Using a Probability-Based Panel

“…Loneliness is often a concern among older adults, particularly among individuals with low socioeconomic status [ 11 ], and social isolation and loneliness are associated with increased morbidity and mortality [ 12 ], even outside the context of a global pandemic. Older veterans indicated that the pandemic increased loneliness and sorrow due to the isolation and disruption of their ordinary routines [ 13 ], and researchers also found that a lack of social support and increasing numbers of pandemic-related stressors were associated with mental health difficulties [ 14 ]. In a national sample of US veterans, the pre- to peripandemic prevalence of generalized anxiety disorder increased from 7.1% to 9.4%, with the most pronounced increase observed in veterans aged 45-64 years (8.2% to 13.5%) [ 15 ].…”

‘It Makes You Sit Back and Think Where You Wanna Go’: Veteran experiences in virtual whole health peer‐led groups

“…In some cases, the social connections served as a conduit for the knowledge and skills that the group sought to instil. It is also important to note that the interactions and relationships at the heart of TCMLH might have provided a much‐needed lifeline to Veterans who were socially isolated during early days of the pandemic 32 . All of these findings are consistent with the larger literature that showcases the benefits of peers as health coaches and patient navigators for health engagement, 33–35 as well as the power of peer support to counteract social isolation, including in the times of the COVID‐19 pandemic 36 .…”

Social and Chronic Pain: Veterans Sharing a Path in Developing a Patient-Centered Response to the COVID-19 Pandemic

“…Management of these conditions frequently require more, rather than less, interaction with providers and significant others. However, there is scarce information regarding veterans' perspectives on the effects of pandemic-related isolation on the management of their mental and physical health, including the management of chronic pain (Purcell et al, 2021).…”