Co-Design of an Ecosystem of Services to Support Veteran Well-Being and Reduce Excessive Alcohol Consumption

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Expectations Pub Date : 2025-04-17 DOI:10.1111/hex.70262

Julia Carins, Ann-Marie Kennedy, Ekant Veer

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Abstract

Background

Alcohol consumption among veterans has been shown to be higher than that among the general population. Many veterans experience difficulties during the transition to post-service life, and alcohol is used as a coping mechanism. Excessive alcohol use leads to a significant decrease in mental health, quality of life and social functioning, further exacerbating veteran's readjustment to civilian life after service.

Objective

This study aimed to co-design a transition programme to reduce problematic alcohol use. The objectives were to (1) understand which life domains need to be considered within programmes to support successful transition without harmful alcohol consumption and (2) co-design a transition programme with New Zealand veterans (and service providers) to avoid harmful alcohol consumption.

Design

This study offers a novel approach to the development of programmes to reduce excessive alcohol consumption by veterans through the use of a participatory design method. The study involved four co-design workshops with veterans and Defence health professionals, in Aotearoa-New Zealand, and abductive analysis of qualitative data. The analysis compared perspectives obtained from veterans and health professionals with existing well-being and transition frameworks.

Results

Findings supported recommendations within those frameworks for strategies to support mental, physical, social/family and spiritual well-being, as well as finding meaningful work or employment. Themes emerged beyond those frameworks, including a need for programmes to manage loss of identity; lack of trust, scepticism and stigma; and a desire for connected records and networked services.

Conclusions

The research offers practical recommendations for a co-designed veteran well-being ecosystem. This involved early prevention, in-service elements and ongoing support through transition and in post-service life. This was supported with the suggestion for a network of services that is promoted well and makes it easy for veterans to identify services that can increase their feeling of competence as they navigate transition.

Patient or Public Contribution

This study used a co-design process that engaged veterans and Defence health professionals in the design of a programme and programme elements that they would like to see for veterans like themselves or veterans they have encountered in practice.

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共同设计一个服务生态系统，以支持退伍军人的福祉和减少过度饮酒

研究表明，退伍军人的饮酒量高于普通人群。许多退伍军人在过渡到退役后生活的过程中遇到困难，酒精被用作一种应对机制。过度饮酒导致心理健康、生活质量和社会功能显著下降，进一步加剧了退伍军人在服役后对平民生活的重新适应。目的：本研究旨在共同设计一个过渡方案，以减少有问题的酒精使用。其目标是：(1)了解在规划中需要考虑哪些生活领域，以支持在没有有害酒精消费的情况下成功过渡；(2)与新西兰退伍军人（和服务提供者）共同设计过渡规划，以避免有害酒精消费。本研究通过参与式设计方法为制定减少退伍军人过度饮酒的方案提供了一种新的方法。这项研究涉及与退伍军人和国防卫生专业人员在新西兰奥特罗瓦的四个共同设计讲习班，并对定性数据进行了溯因性分析。该分析将从退伍军人和卫生专业人员获得的观点与现有的福利和过渡框架进行了比较。结果调查结果支持在这些框架内提出的战略建议，以支持心理、身体、社会/家庭和精神健康，以及寻找有意义的工作或就业。在这些框架之外还出现了一些主题，包括需要制定管理身份丧失的方案；缺乏信任、怀疑和耻辱；以及对联网记录和联网服务的渴望。结论本研究为共同设计退伍军人福利生态系统提供了实用建议。这包括早期预防、在职内容以及过渡期间和离职后生活中的持续支助。支持这一观点的还有一个建议，即建立一个良好的服务网络，使退伍军人在过渡时期更容易找到可以增加他们能力感的服务。患者或公众贡献本研究采用了共同设计过程，让退伍军人和国防卫生专业人员参与设计他们希望为自己这样的退伍军人或他们在实践中遇到的退伍军人看到的方案和方案要素。

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.