Community Reintegration Research Articles

Psychosocial and clinical profile of chronic long-stay psychiatric patients in teaching institution

Background: A good number of psychiatric patients continue to stay in psychiatric hospitals for longer period of time despite their recovery. Inevitably, they tend to experience limitations to their freedom, personal choice and social isolation, and loss of self. It is important to assess the characteristics of these patients and the challenges in social integration. Materials and Methods: A cross-sectional study was conducted at a mental health hospital from May 2018 to January 2023. The data were collected from a retrospective review of 101 case files of all the long-stay patients (LSPs) who were admitted to psychiatric closed wards. Furthermore, cases were utilized to analyze the psychosocial situations of LSP. Results: This study reveals that the majority of the subjects were unmarried, females, unemployed, and hailing from rural background. Nearly 50% of the patients’ families are untraceable. About three-fourths of those patients had the wrong address and lacked community psychiatric rehabilitation facilities and employment opportunities in their neighborhood. Caregivers’ burden and poverty are major causes for prolonged or long-term hospitalization of patients in the mental hospital and barriers to community reintegration. Conclusion: Facilitating the transition of patients from the psychiatric hospital to community care is the need of the hour.

Reintegration challenges among post-9/11 veterans: The role of mental health symptoms and resilience- and avoidance-based coping strategies

Many returning service members deployed in the wars of Iraq and Afghanistan (Operations Enduring Freedom, Iraqi Freedom and New Dawn) face numerous challenges within post-deployment community reintegration (PDCR), including mild traumatic brain injury, chronic pain, and psychological disorders such as PTSD– a constellation of symptoms referred to as polytrauma. Within a transdiagnostic acceptance and commitment therapy (ACT) framework, optimal PDCR is hindered by excesses in maladaptive avoidance-based coping and deficits in resilience-based coping. The present cross-sectional study examined the relationship between vulnerability (psychological distress, PTSD symptomology, and experiential avoidance) and resilience (values-based living; VBL) factors with PDCR in a sample of 298 Veterans with polytrauma-related concerns (Nmale = 244, Mage = 40.6). Results indicated: 1) higher psychological distress, PTSD symptomology, and experiential avoidance, respectively, and low VBL were significantly associated with greater PDCR difficulty; and 2) Veterans high in VBL (versus low) demonstrated a strengthened association between psychological distress and PTSD symptomology, respectively, with PDCR difficulty. These slope differences revealed a lack of differentiation in PDCR at high levels of distress/PTSD: PDCR difficulty was high for all levels of VBL. Conversely, at low-to-moderate levels of distress/PTSD, differences in PDCR difficulty were observed across VBL levels: PDCR difficulty was lower for Veterans high in VBL (versus low), suggesting VBL as a potential catalyst for facilitating optimal PDCR, but only for a limited range of symptom severity. Findings support the use of transdiagnostic ACT to improve outcomes for Veterans with polytrauma-related concerns.

Barriers and facilitators to community reintegration in adults following traumatic upper limb amputation: an exploratory study

Purpose To explore barriers and facilitators to community reintegration experienced by people following traumatic upper limb amputation (ULA). Methods An exploratory qualitative study was conducted with ten adults with major ULA due to trauma. Data from individual, semi-structured interviews was analysed using Braun and Clarke’s reflexive thematic analysis. Results Underlying and influencing community reintegration for participants, was a process of adjustment to the impacts of amputation on everyday function and re-establishing their identity. Participants felt social networks and peer support facilitated the return to social and community activities, as did drawing on personal attributes such as positivity, resilience and self-belief. Prosthetic devices were facilitative for community reintegration by minimising visible differences and unwanted attention through restored cosmesis and in the performance of functional tasks to fulfil social norms and meaningful roles despite issues with comfort and function. Despite the adaptation and evolution of abilities, perspectives and identities, the functional impact of ULA on everyday community activities was an ongoing challenge for all participants. Conclusion ULA has a significant and lifelong impact on an individual’s ability to complete tasks and fulfil meaningful roles in the community. Recommendations based on the study’s findings will inform clinicians to support community reintegration for people following traumatic ULA.

Peer Support-Led Interventions in Forensic Settings: Listening to Service Users and Peer Support worker’ Perceptions and Experiences

ABSTRACT Repeatedly, peer support (PS) research in mental health settings has indicated the influential impact of PS on recovery outcomes, including community reintegration and overall quality of life. Despite these findings, and the bolstering of PS in UK healthcare policy, PS remains underdeveloped in UK mental health settings. This is particularly pronounced in forensic mental health settings where the development of PS has remained heavily restricted by application difficulties in secure care models. The current study aims to provide one of the first in-depth explorations of PS experiences for both service users (SUs) and peer support workers (PSWs) in UK forensic mental health services. Semi-structured interviews were conducted with 13 participants (ten SUs, three PSWs) and analyzed using thematic analysis. Four primary themes were identified detailing the experiences and challenges of forensic-based PS: Experiences of PS from SU perspective; Experiences of PS from PSW perspective; Contrasting care: Addressing the “Us and them” divide, and Further service development. Recommendations identified for progressing PS center on integration improvements, increasing the variety of peer-led interventions, and incorporating PS’s “flexible” nature into traditional models of care. Further action is needed to develop and embed PS in forensic care, including guidance for the development of strategies and policy, and direction for future research.

82 Needs of stroke survivors after acute stroke and early supported discharge (ESD), at hospital discharge, and at 3- and 6-months

Abstract Background There are gaps in our understanding of the needs of Irish stroke survivors as they return home from hospital, and in the first six months following their stroke. Methods We conducted a prospective cohort study in stroke survivors, recruited from three hospital sites across Ireland and profiled their self-reported needs in relation to information, recovery and community re-integration at discharge to home after acute hospitalisation, rehabilitation or early supported discharge, and described ongoing needs over a 6-month period. Results 72 participants, mean age 70 (SD: 13), 61% female, mean NIHSS score 6.3 (SD 6), were recruited at hospital discharge. Needs were gathered on 59 participants (82%) at 7–10 days post discharge, 54 participants (75%) at 3-months, and 45 participants (63%) at 6-months. 40% of respondents reported no unmet needs at discharge, at 3-months 20% reported no unmet needs. The median number of unmet needs was 3 (range, 1–8). Over 50% of respondents reported not having an opportunity to discuss their transition plan before their discharge home. At hospital discharge, people with stroke reported challenges around mobility and falls (>85%), fatigue (73%), emotional issues (66%), and memory (46%); with emotional problems, fatigue, and memory difficulties rating as highest levels of unmet need. Over 40% needed support with housework. In relation to information after stroke, (80%) needed information about their stroke, support around nutrition (51%), return to driving (40%) and financial concerns (32%). These rehabilitation, information and support needs persisted at 3- and 6- months. Conclusion Successful community re-integration after stroke is a complex process for the person with stroke and their family. Our findings concur with those of international-based researchers, that the prevalence of unmet needs is high among stroke survivors. Profiling needs of people with stroke is important to shape the development of therapies to reduce unmet need following a stroke.

Reducing criminal recidivism in Alaska: The Set Free Model

Crime associated with problematic substance use remains a defining characteristic in the United States criminal justice system. In Alaska, a perennial leader in US criminal recidivism rates, thousands of formerly incarcerated individuals continue to commit crimes and misuse drugs and alcohol following their release from incarceration. The total cost of these crimes to victims and Alaska’s criminal justice system is over $2.3 billion annually. The Set Free Model is a comprehensive intervention addressing the primary risk factors of criminal recidivism within an innovative therapeutic campus environment. Occurring within a four-phase operational framework for an average of 6 to 18 months, participants engage in a suite of services proven to reduce further criminal recidivism. These services include certified peer support, supportive housing, co-occurring substance use disorder treatment, career placement, intensive case management, and positive community reintegration. Over an 18-month period, the nonprofit treatment agency Set Free Alaska provided the Set Free Model to a sample of 32 formerly incarcerated adults at high risk of criminal recidivism. Participants displayed a 21.8% recidivism rate compared with the current rate of 66.4%. Treatment engagement rates significantly improved compared with traditional outpatient rates (94.7% vs. 66.7%). Employment rates were also remarkable compared with national employment rates at 1-year postrelease (100% vs. 37%). Validated calculations indicate the sample population may achieve $6.25 million in cost savings and net economic benefits. Evaluation results indicate the model possesses significant potential to reduce criminal recidivism and should be further expanded and evaluated.

Exploring the experiences of women with acquired brain injury on return to work and entrepreneurial skills development in the Western Cape Metropolitan, South Africa.

Acquired brain injury (ABI) is an important public health problem. Individuals with ABI experience greater challenges with community reintegration and successful return to work (RTW) due to both personal and environmental factors. Empirical evidence has shown that women with brain injury are vulnerable to poorer functional outcomes and have demonstrated lower RTW rates post-injury. Therefore, further research is needed to gain greater insight on women with acquired brain injury's functional and work abilities as well as their experiences of RTW and entrepreneurial skills development. This study aimed to explore and describe women with acquired brain injury's experiences during their rehabilitation process, their resumption of their worker role, and entrepreneurial skills development. This qualitative exploration formed part of a study that resulted in an occupational therapy practice model to enhance the entrepreneurial skills of women with acquired brain injury living in the Cape Metropolitan, Western Cape, South Africa. Semi-structured interviews were conducted with ten females with acquired brain injury. A qualitative approach was employed to thematically analyse the data. Three themes emerged from the study: (1) Barriers within the rehabilitation process, 2) ABI causes loss of a sense of self and financial strain, 3) Entrepreneurship and education as a strategy to empowerment. Unmet individual needs related to occupational engagement results in RTW challenges for women with ABI. ABI sequelae cause activity limitations and hinder gainful occupational participation. A holistic client-centred entrepreneurial skills development approach is a viable and needed strategy to facilitate economic empowerment for women with ABI.

Community Oriented Substance Use Programme in the City of Tshwane: A Cross-sectional Survey of Stakeholder Perceptions

The City of Tshwane and University of Pretoria’s Community Oriented Substance Use Programme (COSUP) is an applied research intervention to address drug use-related harms in the city by using a harm reduction community-oriented primary care approach. This is a study of stakeholder perceptions of South Africa’s first publicly funded community-based harm reduction programme. In late 2021, purposively sampled respondents were surveyed using a cross-sectional survey. Electronically captured data were collected on respondent demographic characteristics, familiarity with COSUP and perceptions of COSUP’s effect on service users’ well-being, access to drug use services, family relationships, community integration, and on effective approaches to managing drug use. Frequencies and proportions were analysed as a total and by the degree of familiarity with COSUP, using descriptive statistics. Overall, 338 (93.1%) of the 363 stakeholders who consented to participate in the study had some familiarity with COSUP. Socio-demographically, 68.1% were female and over half (52.4%) were aged between 25–39 years. Most (70–80%) thought COSUP improved client well-being, family relationships and community re-integration. Most (80–84%) perceived COSUP to have increased service provider willingness to support people who use drugs, improved stakeholder networking and raised awareness of drug-related services. Most (76%) considered harm reduction to be the best approach to manage harmful drug use in the city. Stakeholders exposed to the work of COSUP perceive the intervention to be beneficial for individuals, families and service-providing organisations. Most favour a harm reduction approach to drug use and believe COSUP should be sustained and expanded.

Community Reintegration of Offenders at an Overcrowded Rural Correctional Facility: Work Experiences of Correctional Officials

Community reintegration of offenders is one of South Africa’s methods of rehabilitating offenders who have served a portion of their sentence in a correctional centre. However, overcrowding in the rural correctional facilities that have limited resources have exposed the correctional officials to enormous work-related challenges. This paper discusses the work-related challenges experienced by correctional officials at Rooigrond Correctional Centre, a rural correctional centre in North West Province in South Africa. This study employed a qualitative research approach and a descriptive research design to capture the challenges experienced by correctional officials during reintegration of offenders at Rooigrond Correctional Centre. Due to the different ranks of the correctional officials who participated in the study, a quota sampling technique was used to involve ten correctional officials in face-to-face interviews. Thematic data analysis was used, which showed that correctional officials experience a plethora of challenges which have an impact on work and personal levels. This paper makes significant conclusions and recommendations to improve the work-related experiences of the correctional officials in overcrowded, low-resourced rural correctional facilities.

A developmental formative evaluation of a pilot participatory music program for veterans with housing insecurity

BackgroundInterventions are needed to improve well-being and promote community reintegration among Veterans with housing insecurity. The objective was to conduct a developmental formative evaluation of a participatory music program.MethodsThis single-site, pilot study implemented a participatory music program at a U.S. Department of Veterans Affairs (VA) Homeless Domiciliary that included one-hour sessions (group music instruction and ensemble playing), 3 times per week for 3 months. Intervention development was guided by the Model of Human Occupation (MOHO). Evaluation was guided by the MOHO and the Consolidated Framework for Implementation Evaluation (CFIR). Qualitative data were collected via semi-structured interviews from participants and non-participants, and were analyzed using an interdisciplinary, constant comparison qualitative analysis technique.ResultsSixteen program participants and 8 non-participants were enrolled, age range 26–59 (mean 41; standard deviation, 11) years; 75% were White. The sample for this study (N = 12) included five participants and seven non-participants. Semi-structured interview responses produced three salient themes illuminating Veterans’ perspectives: (1) key characteristics of the intervention (the relative advantage of the participatory program over other problem-focused programs; the importance of a supportive, encouraging teaching; the group setting; the role of music); (2) the therapeutic power of the program (based on it being enjoyable; and serving as an escape from preoccupations); and (3) the context and culture (which included Veterans supporting each other and the Domiciliary setting).ConclusionsVeterans described the benefits of a participatory music intervention compared to problem-based groups, which included enjoyment, skill acquisition facilitating pride, escape, reconnecting with their identity prior to current problems, and experiencing positive aspects of Veteran culture such as mutual support and discipline. These data support ongoing research about participatory music programs to support Veterans with housing insecurity.Graphical

Goal-setting and personalization under the International Classification of Functioning, Disability, and Health framework: Community reintegration program for post-stroke patients.

Body functions and structures, activities, and participation are the core components in the International Classification of Functioning, Disability, and Health (ICF) to identify post-stroke patients' health conditions. The specification of health conditions enhances the outcomes of post-stroke rehabilitation. This study aimed to explore the extent and the processes in an ICF-based post-stroke rehabilitation program (ICF-PSRP) that could enhance patients' community reintegration level. Post-stroke patients who completed the ICF-PSRP participated in intake and pre-discharge individual face-to-face semi-structured interviews. In addition, case therapists were invited to a face-to-face semi-structured group interview. Clinician experts were invited to complete an interview with the same interview contents as case therapists but in an online format. All interview recordings were analyzed with the Framework analysis. Patients' treatment goals were mapped with the ICF Core Set for Stroke. Out of 37 invited post-stroke patients, thirty-three of them completed the interview. Three case therapists and five clinicians completed the interviews. The goals set by the patients and their caregivers showed a broadening of their scope over the course of the program. The changes in scope ranged from the activities to the participation and environmental components. Increases in patient-therapist interactions played an essential role in the goal-setting process, which were integral to personalizing the treatment content. These characteristics were perceived by all parties who contributed to the program outcomes. The application of ICF's principles and core components offers a useful framework for enhancing post-stroke patients' community reintegration level. Future studies should explore the way in which patient-therapist interaction, exposure to environmental factors, and personalized interventions maximize the benefits of applying this framework to the community integration of post-stroke patients.

Stroke Systems of Care:: A Systematic Approach to Saving Neurons.

Stroke continues to be a major public health concern, accounting for more than 800,000 strokes per year and remains the leading cause of disability. Stroke systems of care are comprehensive frameworks designed to ensure efficient and effective management of stroke patients. This article provides a brief overview of the coordinated network of healthcare providers, emergency medical services, and hospitals working together to deliver timely and specialized care including pre-hospital care, acute hospital care, rehabilitation, and community reintegration.

Pilot outcomes of a filmmaking intervention designed to enhance treatment entry and social reintegration of veterans.

Military personnel transitioning to civilian life have reported significant challenges in reintegrating into civilian culture. Filmmaking has been used as a therapeutic intervention to enhance the community reintegration of veterans, but there are no published quantitative data documenting its impact. The present study provides outcome data on 40 veterans who participated in the I Was There (IWT) filmmaking workshop. This 3-day (20-hr) group intervention involved veterans working in small teams with a film coach, making short films designed to communicate some aspect of their experience during or after military service, and then creating a screening event to show their films to community members. The sample consisted of community-dwelling veterans who reported at least some mental health symptoms and who were not engaged in mental health treatment for those symptoms. Targeted outcomes included engagement in mental health care, symptoms of posttraumatic stress disorder (PTSD) and depression, and reported perception of community interest in their experience as veterans. Fifty-six percent of participants entered treatment within 4 months of participation. Significant decreases were noted in symptoms of PTSD at 1-month follow-up but not at the 4-month follow-up, while changes in depression were not statistically significant. Participation was related to increased perception of community interest in veterans' experience, and increased interest among community members who viewed the films. These data provide initial support for the conclusion that the IWT film workshop is a potentially effective tool for treatment engagement and for community reintegration among veterans. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Participation in Daily Activities and Quality of Life among Individuals with Paraplegic Spinal Cord Injury in Pakistan

Individuals with paraplegic Spinal Cord Injury (SCI) face various difficulties that limit participation in daily activities and lowered Quality of Life (QOL) after hospital discharge. This cross-sectional study aimed to investigate the level of participation in daily activities and QOL among individuals with paraplegic SCI and to examine the relationship between these two variables. The results revealed that individuals with paraplegic SCI faced significant challenges in social participation, life activities, mobility, getting along, self-care, and cognition, leading to a reduction in overall QOL. Occupational therapists prioritize post-discharge interventions targeting to improve participation and QOL for successful rehabilitation and community reintegration.

Cortical activation during imagined walking for people with lower limb loss: a pilot study.

Each year in Canada, a substantial number of adults undergo limb amputation, with lower limb amputation (LLA) the most prevalent. Enhancing walking ability is crucial for optimizing rehabilitation outcomes, promoting participation, and facilitating community reintegration. Overcoming challenges during the acute post-amputation phase and sub-acute rehabilitation necessitates alternative approaches, such as motor imagery and mental practice, to maximize rehabilitation success. However, the current evidence on activation patterns using motor imagery in individuals with LLA is limited. The primary objective was to assess the feasibility of observing brain activation during imagined walking in individuals with LLA utilizing 3T functional magnetic resonance imaging (fMRI). Eight individuals with LLA and 11 control subjects participated. Consistent with representations of the lower limbs, both control and amputee groups demonstrated bilateral activation in the medial surface of the primary motor and somatosensory cortices. However, individuals with lower limb amputations exhibited significantly greater activation during imagined walking, particularly in frontal regions and the medial surface of the primary motor and supplementary motor cortices. Furthermore, the volume of activation in the bilateral primary motor cortices was higher for participants with amputations compared to controls. The protocol developed in this study establishes a foundation for evaluating the effects of a gait training program that incorporates mental imagery alongside conventional rehabilitation practices, in contrast to standard care alone. This pilot investigation holds potential to enhance our understanding of brain plasticity in individuals with LLA and pave the way for more effective rehabilitation strategies to optimize functional recovery and community reintegration.

Predictors of long-stay in a tertiary care psychiatry hospital in India.

Many psychiatric patients continue to stay for longer duration in psychiatric institutions. Community reintegration and rehabilitation of such patients needs to be explored to ensure appropriate bed occupancy rates and access to in-patient care for newer patients in need of the same. The aim is to identify the risk and protective factors leading to long-term admission of mentally ill patients in tertiary care hospital. A cross-sectional study was conducted with all patients in the long-stay ward between May 2018 and February 2023. A retrospective chart review followed by cross sectional assessment of risks and disability was carried out with all the patients living in a long-stay psychiatric ward (N = 101) at a tertiary hospital in Bangalore, India, between May 2018 and February 2023. The hospital's average length of stay (LOS) was 5.70 ± 8.30 years. The risk and protective factors for LOS in psychiatric hospitals were analyzed using the Poisson Regression model. The results revealed that the male gender, diagnosis of schizophrenia or psychosis, clinicians' knowledge of family information, good clinical improvement, and higher participation in ward activities are the protective factors for a shorter hospital stay. While higher age, family history of mental illness, being married and employed, absence of children, and/or having family members rarely visiting the patient at the hospital were some factors that increased the risk of LOS. This study highlighted the importance of possible LOS predictors in the tertiary care psychiatric hospital. The multi-disciplinary team may utilize risk and protective factors for delayed LOS to introduce comprehensive psychosocial interventions and policies that reduce the risk of delays or length of stay in mental health hospitals.

Effect of level of injury on disability and community reintegration among spinal cord injury community dwellers: A Pilot study

Background:- Spinal cord injury (SCI) brings a huge number of changes in an individual's life. SCI patients experience a variety of physical and psychosocial challenges when they return to the community in spite of the massive efforts of rehabilitation. In patients with SCI, disability (impairments, activity limitations and participation restrictions) is very important for both patients and physicians. Hence this study aimed to see the effect of level of injury on disability among community dwelling spinal cord injury individuals. Methodology:- This study was carried out in tertiary care hospital Individuals with spinal cord injury were included according to the inclusion criteria. Disability and community integration were assessed by using Craig Handicap Assessment and Reporting Technique (CHART) and Reintegration to normal living index Result:- Statistical analysis was done using descriptive statistics of individuals. Conclusion:- Showed significant decline in CHART And RNL score in cervical level of spinal cord injury patients.

Policies and Regulations for Repatriation and Sustainable Reintegration in the ASEAN Region

One of the important human rights enshrined in the Universal Declaration of Human Rights and the International Covenant on the Protection of the Rights of All Migrant Workers and Their Families is the right to citizenship. The process of repatriation of migrants and their reintegration into the community at home is of increasing interest to policy researchers as this process is closely related to the link between migration and development. The temporary migration cycle of a worker always includes three important steps: departure, working and living abroad, and repatriation. Sending countries have also made great efforts in supporting migrant workers to return home, implementing repatriation support programs and especially community reintegration programs after returning home. The basis of this paper is to present definitions of reintegration programs for repatriated migrants. From this basis, the research objective of the article was formed to mention the general principles and conditions for support programs for repatriated workers. To accomplish this research objective, the author presents the success and limitations of some programs in ASEAN. The novelty of the research results is to give some recommendations to improve the programs on supporting migrant workers returning home and re-integrating into the community in the coming time.

Functional Performance and Community Reintegration of Chronic Post-stroke Survivors in Eastern India

Introduction: Stroke is the primary cause of functional dependency in daily activities leading to disability of the individual. It becomes an economic burden for the person and society. Post-stroke management in rehabilitation gives more emphasis on improving functional performance. The improvement in functional activities of post-stroke survivors makes them independent in their daily activities at home but, still an impediment exists to participate in society and reintegrating into the community. The objective of the study is to find the association of community reintegration with the functional performance of one-year post-stroke survivors in eastern India and to compare their functional independence, community reintegration, and participation in instrumental daily living activities between stroke affection side and stroke subtype of the study group.
 Materials and Methods: A cross-sectional observational study was carried out on post-stroke survivors between 30 and 60 years of age without sex barrier. Ninety-four patients (mean age 54.38±12.06) were recruited for the study. The outcome was measured by the community integration questionnaire (CIQ), Lawton instrumental activities of daily living (LIADL), and functional independence measure (FIM).
 Results: Spearman rank order correlation was used and found a significant positive correlation persists between FIM to CIQ as the r=0.565 (P=0.01, 95% CI, -0.40%-0.70%) and LIADL to CIQ r=0.687 (P=0.01, 95% CI, -0.55%-0.79%) FIM to LIADL r=0.532 (P=0.01, 95% CI,
 -0.36%-0.67%). Mann-Whitney U test was done to compare FIM, LIADL, and CIQ between stroke affection side (right vs left) and stroke sub-type (ischemic vs haemorrhagic), and no significant difference was found.
 Conclusion: Functional independence, instrumental activities of daily living, and community reintegration are associated with each other. Hence, community reintegration should be incorporated into stroke rehabilitation to maintain a meaningful life as a part of society and family.

Feasibility of delivering a virtual 1-day acceptance and commitment therapy workshop to rural veterans through community partnerships

BackgroundThis single-arm, open pilot study examined the feasibility and initial efficacy of a 1-day virtual Acceptance and Commitment Therapy (ACT) group workshop for distressed veterans. MethodsWe collaborated with veteran-serving community-based organizations to enhance outreach to veterans, especially those in rural areas. Veterans completed a baseline assessment and two follow-up assessments (1 month, 3 months) after workshop participation. Feasibility outcomes included reach (workshop recruitment and completion rates; veteran characteristics) and acceptability (open-ended survey question about satisfaction). Clinical outcomes included psychological distress (Outcome Questionnaire-45), stressor-related distress (PTSD Checklist-5), community reintegration (Military to Civilian Questionnaire), and meaning and purpose (PROMIS Short Form). Psychological flexibility (Action and Acceptance Questionnaire-II) – the proposed change mechanism underlying ACT – was also measured. ResultsSixty-four veterans (50% rural, 39% self-identified as female) participated in a virtual workshop (97.1% completion rate). Overall, veterans liked the format and interactive nature of workshops. Convenience was noted as a benefit, while connectivity issues were highlighted as a drawback. Veterans showed improvements in psychological distress (F(2,109) = 3.30; p = 0.041), stressor-related distress (F(2,110) = 9.50; p = 0.0002), community reintegration (F(2,108) = 4.34; p = 0.015), and meaning and purpose (F(2,100) = 4.06; p = 0.020) over time. No between-group differences were detected, based on rurality or gender. ConclusionPilot findings were promising and warrant a larger randomized trial to assess the efficacy of the 1-day virtual ACT workshop. Integrating community-engaged and participatory-research designs can enhance the external validity of these future studies and promote greater health equity.