Understanding the social needs, resources, and group participation barriers of older rural veterans: A clinician survey.

Abstract

Some older veterans experience unmet social needs due to factors including poor health, restricted mobility, and living in rural settings. We surveyed 75 clinicians treating older adults (age > 60) at Veterans Affairs hospitals to (a) explore facilitators and challenges to social connection, (b) describe obstacles to offering groups, (c) determine differences in unmet social needs by rurality, and (d) assess interest in delivering a group-based intervention, Enhancing Social Function for Older Veterans with Posttraumatic Stress Disorder (ESVP). Clinicians reported the percentage of their caseload that was rural, which we dichotomized as rural (≥50% rural; n = 50) or urban (<50% rural; n = 25). Survey items assessed frequency of unmet social needs and barriers/facilitators, which we dichotomized due to nonnormality, and included free response items, which we qualitatively coded. The survey also assessed clinician interest in running an ESVP group. Chi-square tests assessed urban versus rural differences. Almost all clinicians worked with at least some rural veterans, and most reported significant perceived unmet social needs. Perceived unmet social needs, including loneliness and lack of social support, were most often reported by clinicians in rural areas. The majority of clinicians reported that the rural context presents obstacles to social engagement. Despite obstacles to running groups for older veterans endorsed, there was significant interest in ESVP across all clinicians. Rural clinicians, compared to urban clinicians, reported significantly greater unmet social needs among older veterans. There was high interest in ESVP, which may enhance social functioning among older veterans. Flexibility may be required to overcome reported obstacles to running ESVP, especially geographic and digital obstacles, in rural areas. (PsycInfo Database Record (c) 2026 APA, all rights reserved).