Even over video, we still bond: vha's rapid implementation of virtual peer-led wellbeing groups in the wake of the COVID-19 pandemic

Objective: Committed to implementing a personcentered, holistic (Whole Health) system of care, the Veterans Health Administration (VHA) developed a peerled, group-based, multi-session Taking Charge of My Life and Health (TCMLH) program wherein Veterans reflect on values, set health and wellbeing-related goals, and provide mutual support Prior work has demonstrated the positive impact of these groups After face-to-face TCMLH groups were disrupted by the COVID-19 pandemic, VHA facilities rapidly implemented virtual (video-based) TCMLH groups We sought to understand staff perspectives on the feasibility and value of conducting TCMLH groups virtually Methods: We completed semi-structured telephone interviews with 18 staff members involved in the rapid implementation of virtual TCMLH groups at 5 VHA facilities about their perspectives and experiences Interview transcripts were analyzed using rapid qualitative analysis Results: Virtual TCMLH groups posed technological and logistical challenges and were perceived as disruptive of the relationship-building and communication observed in faceto- face groups However, participants noted that Veterans still found ways to bond and group facilitators adjusted their approach to improve flow and engagement Participants also described perceived advantages of the virtual format: (1) participating from home was less stressful for Veterans and more conducive to them opening up;(2) being in one's home environment organically facilitated Veteran reflection on values and goals;(3) there are opportunities for wider-scale recruitment, greater accessibility, and potentially better Veteran retention Conclusion: Faced with the disruption posed by COVID- 19, VHA successfully pivoted by rapidly implementing virtual TCMLH groups and addressing challenges of the new format These groups may offer a crucial lifeline for Veterans who are feeling isolated and/or whose wellbeing has suffered during the pandemic A virtual group-based program in which participants set and pursue personally meaningful goals related to health and well-being in a supportive environment of their peers is a promising innovation that can be replicated in other health systems