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VA Cooperative Studies Program (CSP)

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Tailoring Interventions for Rural Veterans


Investigator Access

What's Available

Check with the study contact and publications for information on a public dataset, data archive, data enclave, or website where data might be available.

Available Documentation

Dates Data are Available

Access Criteria

Study Characteristics 


To better understand the attitudes, beliefs, and values that influence use of mental health care among rural Veterans. The goal of this project is to improve outcomes of mental healthcare for the 3 million Veterans (41% of all VHA-enrolled-Veterans) living in rural areas.

Era of Service

Korean Conflict, Vietnam, Gulf War, Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF)  


  • Veterans aged 18-70 years who lived at least 50 miles away from their nearest VA Medical Center (VAMC), and who screened positive for depression and/or posttraumatic stress disorder (PTSD) in fiscal year 2010-2012.  
  • Providers who reported having worked with rural Veterans in their Veterans Integrated Service Network (VISN) (VA providers) or state (non-VA providers) for at least 2 years.

Study Design 

Cross-sectional survey using mixed quantitative/qualitative methods

Time Period 

April 2013 - March 2017


Rural Veterans and mental health care providers who served rural veterans in 4 states (Arkansas, Colorado, Maine, and Wisconsin), representing 4 VA regions (VISNs)


  • Phase 1: 25 participants and 11 providers
  • Phase 2: Clarification of survey questions with 5 participants
  • Phase 3: 752 participants

Response Rate


Recruitment Methods   

Several methods were used to inform potential participants about the study:

  • Community-based outpatient clinics’ clinical and administrative personnel posted and distributed flyers describing the study and providing a toll-free telephone number to allow interested Veterans to contact research personnel
  • Alternatively, interested Veterans could complete a “consent-to-contact” form indicating an interest in study participation and providing contact information
  • Recruitment ended when additional interviews added no new information and no new themes or topics emerged.



Data Collected

  • Perspectives on how various attitudinal characteristics interact to influence engagement in mental healthcare
  • Attitudes towards and use of and mental health service
  • Demographics
  • Limited quantitative data such as distance to nearest VA Medical Center facility

Data Collection Methods

Qualitative in-person interviews, telephone survey, and post-survey focus group interviews

Funding Sources 

  • VHA Health Services Research & Development Service Award IIR 11–290
  • VA South Central Mental Illness Research, Education, and Clinical Center


Primary Investigator: Ellen P. Fischer, PhD



Selected Publications 

Miller CJ, Burgess JF, Fischer EP, Hodges DJ, Belanger LK, Lipschitz JM, Easley SR, Koenig CJ, Stanley RL, Pyne JM. Practical application of opt-out recruitment methods in two health services research studies. BMC Medical Research Methodology. 2017 Apr 14; 17(1):57.

Fischer EP, McSweeney JC, Wright P, Cheney A, Curran GM, Henderson K, Fortney JC. Overcoming Barriers to Sustained Engagement in Mental Health Care: Perspectives of Rural Veterans and Providers. J Rural Health. 2016 Sep;32(4):429-438.

More Information

Study website