Veteran Cultural Competence Training: Initial Effectiveness and National-Level Implementation

Joseph C Geraci; Emily R Edwards; David May; Tiffany Halliday; Natesha Smith-Isabell; Paul El-Meouchy; Sarah Lowell; Nicholas Armstrong; Gilly Cantor; Chris DeJesus; Ariana Dichiara; Marianne Goodman

doi:10.1176/appi.ps.202100437

Veteran Cultural Competence Training: Initial Effectiveness and National-Level Implementation

Psychiatr Serv. 2024 Jan 1;75(1):32-39. doi: 10.1176/appi.ps.202100437. Epub 2023 Aug 9.

Affiliation

¹ Transitioning Servicemember/Veteran and Suicide Prevention Center, Veterans Integrated Service Network (VISN) 2, Mental Illness Research, Education and Clinical Center, James J. Peters Department of Veterans Affairs Medical Center, New York City (Geraci, Edwards, May, Halliday, Smith-Isabell, Dichiara, Goodman); Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller Department of Veterans Affairs Medical Center, Waco, Texas (Geraci, Goodman); Resilience Center for Veterans & Families, Teachers College, Columbia University, New York City (May, Halliday); Fielding Graduate University, Santa Barbara, California (El-Meouchy, Lowell); Institute for Veterans & Military Families, Syracuse University, Syracuse, New York (Armstrong, Cantor); Department of Psychology, Hofstra University, Hempstead, New York (DeJesus).

PMID: 37554004
DOI: 10.1176/appi.ps.202100437

Abstract

Objective: Because service professionals often lack cultural competence in working with veterans, veterans often perceive such professionals as "not understanding." The authors developed, evaluated, and implemented Veteran Cultural Competence Training (VCCT), combining educational and experiential components in an in-person training focused on building awareness, knowledge, and skills to better work with veterans.

Methods: Study 1 was a type 1 effectiveness-implementation hybrid trial examining VCCT effectiveness in a sample of social service professionals (N=41) compared with a matched comparison group (N=41) via the Multicultural Counseling Self-Efficacy Scale-Veteran Form (MCSE-V) instrument. In study 2, the authors used the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework to conduct a type 2 effectiveness-implementation hybrid trial and implemented VCCT with an expanded population (N=312) during eight training sessions in three U.S. states.

Results: Results from study 1 indicated that VCCT significantly increased self-efficacy of trainees in veteran cultural competence compared with the matched group (p<0.001). In study 2, the RE-AIM framework highlighted the importance of building coalitions and utilizing implementation facilitation to maintain fidelity. The within-group effectiveness of VCCT was statistically significant and maintained across settings and professions (p<0.001), and trainees were satisfied with VCCT. Maintenance analysis revealed expansion of VCCT after implementation in terms of the number of training sessions (N=9), regions hosting the training (N=5), staff hired (N=13), and trainee applications (N=1,018).

Conclusions: VCCT effectively increases self-efficacy in veteran cultural competence. Gains appeared across different professions, demographic characteristics, and locations. Participation in VCCT may increase professionals' competence in understanding veteran culture, thereby potentially improving veteran services.

Keywords: Competence training; Continuing education; Cultural competence; Military veterans; Veteran cultural self-efficacy; Veterans’ issues.

MeSH terms

Cultural Competency* / education
Educational Status
Humans
Professional Competence
Qualitative Research
Veterans* / psychology