18.3 IMPROVING COMMUNITY ENGAGEMENT IN VETERANS WITH SCHIZOPHRENIA: QUALITATIVE DATA ANALYSIS FROM AN ONGOING TREATMENT TRIAL.

Background Negative symptoms predict poor outcome in schizophrenia yet there is no recommended evidence-based treatment. Enhancing community functioning and promoting recovery in Veterans with schizophrenia is a VHA priority. Methods This presentation will review the sample, methods, and preliminary qualitative findings from an in-progress, VA-funded trial to evaluate a behavioral intervention to increase community engagement – Engaging in Community Roles and Experiences (EnCoRE) - in Veterans with schizophrenia who receive mental health services at three VA Medical Centers. EnCoRE includes motivational, cognitive, and behavioral skills training strategies aimed at increasing intrinsic motivation to engage in community activities, reduce negative expectancies, and perform skillfully in social situations. To date, 72 Veterans with schizophrenia have enrolled and 56 have completed study assessments. Participants completed post-assessment qualitative interviews about their experiences in EnCoRE, aspects of the program they perceived as more or less helpful, what they found challenging about becoming more active, and other reflections or suggestions about the intervention. Results Interviews were analyzed in 3 phases employing constant comparison of data units with others and data with emerging themes and examining meaning across interviews via focused cross-interview coding to organize themes, variations and interrelationships among the ideas, views, and experiences of the sample. We also examined relationships among using different components of the program and reports of engaging in community activities with intervention engagement and attendance. Participants who attended more frequently reported greater use of EnCoRE skills and strategies to increase participation in community/family activities. Participants reported benefits of specific components – especially detailed Action Planning - and offered suggestions for improvement. Participants reported that the group format, in which they felt that they were accountable to other Veterans, helped them feel more motivated to accomplish the goals they set in each group meeting. Conclusions Veterans with schizophrenia are receptive to a behavioral program to improve community functioning. Features such as focused content with in-depth planning for implementation, small group size, and having other Veterans to help and learn from can help Veterans with schizophrenia participate in new community activities. [Source of funding: VA RR&D (Bennett, PI)] [ABSTRACT FROM AUTHOR]