# Connecting Women to Care: Home-based Psychotherapy for Women with MST Living in Rural Areas

> **NIH VA I01** · VETERANS ADMIN PALO ALTO HEALTH CARE SYS · 2024 · —

## Abstract

Background – Military Sexual Trauma (MST) among women Veterans is a problem of epidemic proportion
associated with significant mental health and functional impairment and substantial access to care barriers.
Surveillance data indicate that one in four women Veterans reports MST when screened. Compared to women
Veterans with other service-related stressors, those experiencing MST have greater mental health problems,
are more likely to report difficulty in functioning in social, family and intimate relationships and are more likely to
be unemployed and to report difficulties in finding a job. Nevertheless, women with MST engage less
frequently in VA health care than other women Veterans. Barriers to care include distance from specialty
services, financial difficulties, childcare and family responsibilities, and gender-related discomfort in male-
dominated VA facilities. Research over the past decade has identified the problems and concerns of women
Veterans with MST but programs addressing their mental health needs and responsive to identified barriers
are lacking. The proposed study addresses this gap by evaluating a gender-sensitive, evidence-based skills
training program delivered via home-based video technology.
Specific Aims – The study will conduct a Hybrid Type 1 effectiveness-implementation study to accomplish two
aims. The first is to determine the effectiveness of the HBVT-delivered, Skills Training in Affective Regulation
(STAIR) relative to a HBVT-delivered nonspecific active comparator, Present Centered Therapy (PCT) among
women Veterans with MST. It is hypothesized that STAIR will be superior to PCT in regards to improvement in
CAPS PTSD symptoms (primary outcome) as well as in perceived social support and social engagement
(secondary outcomes). The second aim is to conduct a multi-stakeholder, mixed method evaluation to inform
future potential implementation plans by identify barriers and facilitators of implementing STAIR via HBVT and
to contextualize and interpret the quantitative data on treatment processes and clinical effectiveness.
Methodology – This is a four-year, two-site Hybrid Type 1 effectiveness-implementation study design. A total
of 200 women Veterans with MST and PTSD symptoms (with DSM-5 PTSD Screen cut-off > 3) will be enrolled
into the study. Participants will be stratified by rurality status in a proportion representative of the national
population (34% rural vs. 66% nonrural). Stratification will ensure that resources are dedicated to recruit the
identified number of rural women. Within each level of stratification, participants will be randomized into one of
two treatments conditions, STAIR or PCT, each of which is comprised of 10 weekly sessions. Assessments will
be conducted at five time-points: baseline (week 0), midtreatment (week 5), immediately posttreatment (week
10), 2-month follow-up (week 18) and 4-month follow-up (week 26). Rurality will be included as a covariate and
assessed for variations in aspect...

## Key facts

- **NIH application ID:** 10913286
- **Project number:** 5I01HX002211-05
- **Recipient organization:** VETERANS ADMIN PALO ALTO HEALTH CARE SYS
- **Principal Investigator:** Marylene Cloitre
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-04-01 → 2022-12-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10913286

## Citation

> US National Institutes of Health, RePORTER application 10913286, Connecting Women to Care: Home-based Psychotherapy for Women with MST Living in Rural Areas (5I01HX002211-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10913286. Licensed CC0.

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