JMIR Publications

ABSTRACT

Background:

Over 600,000 student veterans use military benefits to pursue higher education annually, with 75% enrolled as full-time students. Advancing their education is an important step toward improving their employment, financial, and social opportunities. However, student veterans also experience high rates of co-occurring psychiatric concerns like substance use disorder (SUD), posttraumatic stress disorder (PTSD), or depression. For these students, additional psychoeducation, support, and guidance may be required. To support their goals, a mobile application with targeted content for student Veterans managing common psychiatrics concerns could be particularly helpful.

Objective:

The primary aim of this pilot study was to iteratively revise and assess usability, acceptability, and feasibility of the VetEd mobile application and study procedures. The secondary aim was to explore preliminary changes from pre- to post-application use in academic functioning and community reintegration.

Methods:

This study used a mixed methods approach; pilot usability testing and iterative revisions were completed across three waves of participants (wave one=4, wave two=4, wave three=5, total n=13). Usability was measured using the System Usability Scale (SUS), and acceptability was measured using the Acceptability E-Scale (ASES). App use feasibility was collected through app-engagement data from the 4-weeks of mobile app use. Study feasibility was assessed by rate of recruitment, retention, and survey completion. Secondary measures to assess potential mobile app impact included academic self-efficacy, perceived ability to complete cope with education barriers, and community reintegration. Participants were also given the opportunity to complete an exit interview to provide additional usability, acceptability, and outcome information.

Results:

Study feasibility was high, with greater than projected rates of recruitment (4 – 5 per month), retention (100%, 13/13), and survey completion at all three time points (100%, 80%, and 100% respectively). Overall, 85% (11/13) of both usability and acceptability scores were above the pre-defined benchmarks. Engagement with VetEd was high, with participants completing on average 90.8% of requested app activities. Increases in secondary outcomes were reported in 69% (9/13) of students for academic self-efficacy, 69% (9/13) for coping with educational barriers, and 46% (6/13) on improved community reintegration. Exit interviews highlighted that VetEd was easy to use, included pertinent information for both academic and mental health functioning, and had vital information on connecting to additional resources.

Conclusions:

Pilot findings suggested that the VetEd mobile app is usable, acceptable, and provided useful information and resources for improved academic functioning and psychiatric issues like substance misuse, depression, PTSD, and anxiety. Additional research is needed to assess its effectiveness and impact for student Veterans nationwide. Clinical Trial: ClinicalTrials.gov NCT05344092: https://clinicaltrials.gov/study/NCT05344092