Evaluating a Bio-Terrorism Preparedness Campaign for Veterans
Mary Sano PhD
James J Peters VA Medical Center
Bronx, NY
Funding Period: July 2003 - June 2007

BACKGROUND/RATIONALE:
Optimal response to bioterrorism requires being prepared. While the CDC has developed a strategic plan of preparation, focused on emergency responders, health care workers and state/local agencies, there have been no efforts to prepare the public for such a disaster. The HSR&D funded study “Evaluating a Bio-terrorism Preparedness Campaign for Veterans” (BTI-02-233-1) is a survey study designed to develop appropriate educational materials for veterans about bio-terrorism threats, to provide coping mechanisms to deal with a bio-terrorism disaster, and to evaluate two methods for delivering the material (web-based or print brochure) in both hospital-based and community-based subjects, compared to controls receiving general information on veterans benefits. Our study is based on a validated framework derived from the patient education literature demonstrating that improved knowledge and skills related to chronic illness serve to decrease anxiety and improve outcomes.


OBJECTIVE(S):
(1)To develop a Veterans’ Survey on Bio-Terrorism (VSOB) as an instrument to evaluate the effectiveness of the educational intervention.
(2)To determine the psychometric properties of the VSOB.
(3)To conduct focus groups across the country to determine veterans’ current knowledge, levels of anxiety and educational needs as they pertain to the topic of bio-terrorism.
(4)To develop educational material for veterans that will provide information about bio-terrorism as well as coping mechanisms for dealing with such a disaster.
(5)To assess whether web-based or print educational materials are more effective in disseminating information to veterans.

METHODS:
The randomization scheme both for the hospital based cohort (HBA) and the community based cohort (CBA) were previously developed and implemented. Both the initial and follow-up VSOBs have been sent to consenting subjects, and the returned surveys have been transferred to Phase V Technologies and entered into the database.

FINDINGS/RESULTS:
Previously we reported that recruitment had begun slowly, but the addition of a small reimbursement to subjects improved response. The HBAs had enrolled a total of 2212 veterans by September 2006, exceeding our revised goal of 1328. Of these, 1871 returned the first survey and 1471 (78.6%) returned the second survey. The CBAs had more difficulty in recruiting subjects, enrolling 711 veterans, short of the 800 projected in our revised goal. Of these, 626 returned the first survey and 536 (85.6%) returned the second survey. Overall, of 2923 veterans who signed an informed consent, 2497 (85.4%) returned the initial survey and of these 2007 (80.4%) returned the follow-up survey.




IMPACT:
This study has produced two major products: (1) VSOB, the first instrument ever designed to evaluate veterans’ knowledge, attitudes/beliefs, behavior disposition and anxiety as it relates to bio-terrorism; and (2) the final content of the bio-terrorism preparedness educational campaign, developed by Infectious Disease and Mental Health then reviewed and modified by both patient education experts and veterans representing all of the Veteran Service Organizations (VSOs). Current analyses will permit us to assess the effectiveness of two different delivery systems (print vs. web) for this educational material in those veterans using VA services (HBAs) and those not using VA services (CBAs).


PUBLICATIONS:

Journal Articles

1. Morland L, Goebert D, Onoye J, Frattarelli L, Derauf C, Herbst M, Matsu C, Friedman M. Posttraumatic stress disorder and pregnancy health: preliminary update and implications. Psychosomatics. 2007; 48(4): 304-8.
2. Dunn NJ, Rehm LP, Schillaci J, Souchek J, Mehta P, Ashton CM, Yanasak E, Hamilton JD. A randomized trial of self-management and psychoeducational group therapies for comorbid chronic posttraumatic stress disorder and depressive disorder. Journal of Traumatic Stress. 2007; 20(3): 221-37.
3. Whealin JM, Batzer WB, Morgan CA, Detwiler HF, Schnurr PP, Friedman MJ. Cohesion, burnout, and past trauma in tri-service medical and support personnel. Military Medicine. 2007; 172(3): 266-72.
4. Cordova MJ, Walser R, Neff J, Ruzek JI. Predictors of emotional adjustment following traumatic injury: personal, social, and material resources. Prehospital and Disaster Medicine. 2005; 20(1): 7-13.
5. Schoenfeld FB, Marmar CR, Neylan TC. Current concepts in pharmacotherapy for posttraumatic stress disorder. Psychiatric Services. 2004; 55(5): 519-31.
6. Neylan TC, Lenoci M, Rothlind J, Metzler TJ, Schuff N, Du AT, Franklin KW, Weiss DS, Weiner MW, Marmar CR. Attention, learning, and memory in posttraumatic stress disorder. Journal of Traumatic Stress. 2004; 17(1): 41-6.

DRA: Health Services and Systems, Military and Environmental Exposures
DRE: Technology Development and Assessment
Keywords: Research measure, Research method
MeSH Terms: none