Table 2.
CS-PTSD coach facilitators as identified by the qualitative analyses
| Facilitator theme | CFIR construct | Sample quote demonstrating construct |
|---|---|---|
| Stakeholders | ||
| 1. CS-PTSD Coach will help veterans overcome common barriers to receiving PTSD treatment: | Patient needs and resources | “For younger, working people you can sell it as something that isn’t based on fixed face to face visits with providers. It’s flexible to their lifestyle. For the older folks the hook would really be ‘here’s something new and that’s not the standard PTSD therapy you might have been involved with in the past. It’s not a group, it’s not exposure, it’s self-directed, you can choose what you do.’” |
| 2. CS-PTSD Coach fits well into the primary care setting: | Compatibility | “Primary care integration is so problem solution focused. We try to focus on one issue in terms of the referral. We work in the here and now and try to develop better coping strategies. So this does fit well.” |
| 3. Specific features of CS-PTSD Coach will help engage veterans in care: | Patient engagement | “When you combine technology that looks nice graphically, it pulls you in and makes you want to take advantage of the self-management tools. I think the built-in timers and schedules to remind yourself to do those things are very beneficial.” |
| 4. CS-PTSD Coach fits well with the needs and characteristics of primary care patients with PTSD: | Patient needs and resources | “Some patients don’t necessarily have that official diagnosis but they do have a lot of symptoms. This would be something to help them as a way to remind them to do some of the things I talk about with them about.” |
| 5. CS-PTSD Coach addresses a gap in current primary care services: | Tension for change | “I think it’s good for primary care providers who are very frustrated with PTSD because we recognize how much it impacts on all their other physical health. Unlike depression or anxiety, where we feel like we have some capacity to make interventions in primary care, we feel totally lost when it comes to PTSD. We are not aware of any interventions that are really successful that primary care providers can do. You know we prescribe SSRI’s that maybe have some benefit. I think we are aware that the people who have been successful with PTSD treatment are the ones who are fully engaged in it. And we can’t get people to treatment.” |
| 6. CS-PTSD Coach will help primary care patients transition to PTSD specialty care: | Compatibility | “Using this could make the transition a little smoother when they come into specialty care. In the PTSD specialty clinic, we’re doing PCL’s [PTSD Checklists] regularly and we’ll start with a structuralized interview. If they are already monitoring their symptoms it’s not a new burden.” |
| Veterans | ||
| 1. CS-PTSD Coach has an effective design (e.g., amount of information, tools, session number and format). | Design quality and packaging | “It was the right number of sessions, gives you independence but also doesn’t leave you on your own.” |
| 2. Clinician support was important to engaging with the app. | Patient engagement | Veteran regarding the interaction with the clinician: “I began to seek [the PTSD Coach app] out as treatment as opposed to doing it because I had to.” |
| 3. Flexibility with session format and spacing between sessions facilitated completion. | Patient needs and resources | “It was very helpful that she allowed me to do phone and in person appointments… I was happy to be included even though I couldn’t make it every time… the flexibility allowed me to be in this project.” |
| Clinicians | ||
| 1. Flexibility with the protocol is important. | Patient needs and resources | “One of my patients wouldn’t have been able to participate if we hadn’t included the option for conducting phone sessions.” |