Intervention Efficacy in Engaging Black and White Veterans with Post-traumatic Stress Disorder into Treatment

Tracy Stecker, Leslie Adams, Elizabeth Carpenter-Song, Joanne Nicholson, Nicholas Streltzov, Haiyi Xie

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


This study examined racial differences among Black and White Veterans who screened positive for post-traumatic stress disorder (PTSD) but were not in PTSD treatment and were participating in an intervention trial. Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans with PTSD but not yet engaged in treatment were recruited and randomly assigned to control or intervention conditions. Intervention participants received a cognitive-behavioral engagement intervention by phone. All participants received follow-up calls to assess symptoms and utilization of treatment. Black and White participants were compared to assess differences in treatment utilization. Intervention session notes were analyzed qualitatively for explanatory themes. Participants of both races who received the intervention had higher PTSD treatment initiation than their respective control groups (Blacks: 85% vs. 58% and Whites: 53% vs. 45%, respectively). However, Blacks completed fewer PTSD treatment sessions compared to Whites overall (M = 2.06 [SD = 2.3] vs. M = 3.77 [SD = 9.9]; p < .05). Within the intervention condition, Blacks were significantly more likely to initiate treatment (odds ratio = 2.3, p < .04), and had a greater reduction in PTSD symptom compared to Whites (PTSD Checklist - Military Version [PCL] scores: 12.75 vs. 9.68). Based on qualitative analysis of intervention session notes, themes emerged that may suggest cultural differences involving social connection, attitudes towards treatment, and the desire to appear “okay.” Blacks had a higher initiation rate and greater reduction in PTSD severity but completed fewer treatment sessions than Whites. These are promising results with respect to other studies which demonstrate that Black Veterans are less likely to seek treatment for PTSD.

Original languageEnglish (US)
Pages (from-to)481-489
Number of pages9
JournalSocial Work in Public Health
Issue number6
StatePublished - Sep 18 2016
Externally publishedYes


  • OEF/OIF Veterans
  • PTSD
  • Treatment seeking
  • health disparities
  • treatment engagement

ASJC Scopus subject areas

  • Health(social science)
  • Health Policy
  • Public Health, Environmental and Occupational Health


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