Peer Enhanced Exposure Therapy (PEET)
Phase: NA
Conditions: PTSD
Sponsor: VA Office of Research and Development

Peer Enhanced Prolonged Exposure 
NCT02818114 
Most recent protocol change approved by IRN 5/1/17 
 
 
 

 
2.A.  RESEARCH PLAN 
A.  BACKGROUND AND SIGNIFICANCE 
A.1.  Posttraumatic Stress Disorder (PTSD) is a Debilitating Psychiatric Condition and High Priority for 
Rehabilitation. Guided by the World Health Organization’s International Classification of Functioning, and VA 
Rehabilitation Research & Development’s State of the Art Working Group on Community Reintegration, we 
define community reintegration as meaningful participation in activities, effective role functioning, and 
satisfaction across domains including intimate relationships, social, leisure, and work.2,3 PTSD is associated 
with poor work, intimate partner, and parenting functions.4-8 Several studies have found that PTSD leads to 
deterioration of social resources over time, resulting in isolation and alienation.9,10  Given social deficits leading 
to a spiral of losses, community reintegration is a key rehabilitation target for Veterans with PTSD. Improving 
rehabilitation services for PTSD by targeting social functioning and community reintegration has the potential to 
mitigate significant costs, and substantially improve quality of life for affected Veterans and their families.11  
A.2. Efficacious PTSD Treatments Exist, but their Effectiveness is Threatened by Poor Engagement 
and High Dropout. Robust evidence supports the efficacy of Prolonged Exposure (PE) in reducing PTSD 
symptoms,12 and the VA has invested heavily in PE as an Evidence-Based Psychotherapy (EBP).13-15  
A.2.a. Veterans have difficulty engaging in first-line PTSD treatments. Studies estimate only 6-11% of all 
Veterans with PTSD actually start an EBP.16,17 Among those who do, 30% to 50% fail to show clinically 
significant improvements.18,19 This may be due in part to dropout, which ranges from 30% to 38% in 
randomized trials18-20 and 32% to 49% in clinic based studies.19-21  In a sample of 427 Veterans who were 
scheduled to begin PE or CPT in a VA PTSD Clinic, only 51% completed treatment: 17% dropped out before 
the first session and 34% dropped out later.19 Studies of reasons for dropout have found only a few predictors; 
younger Veterans, Veterans in PE (as compared to CPT), and Veterans using benzodiazepines or alcohol are 
more likely to drop out.19,45 Social and work functioning improve for PE completers, but not for those who drop 
out or evidence poor adherence.22  Given that PE treatment engagement is low,16,17, 19,20 interventions that 
improve treatment engagement and adherence could improve rehabilitation outcomes. 
A.3. New Rehabilitation Approaches are Needed to Improve PTSD and Rehabilitation Outcomes 
Figure 1: Model of Peer Support in Trauma Recovery 
 
 
 
 
 
 
 
 
 
 
 
 
 
A.3.a. Peer support services represent a promising strategy for enhancing adherence and 
improving rehabilitation outcomes.  Peer specialists (PS’s) are individuals in recovery from mental health 
challenges who are trained and supervised to use their lived experience to serve as role models, teachers, 
supporters, and “beacons of hope” for others.23 The VA’s Uniform Mental Health Services Handbook mandates 
PEER SUPPORT 
Education about mental 
health and treatment 
Support for treatment 
engagement and adherence 
Beacons of hope for 
recovery 
Support for social bonds 
TREATMENT 
ENGAGEMENT AND 
ADHERENCE 
Attend sessions 
Complete homework 
Confront Avoidance 
Reduce Dropout 
COMMUNITY 
REENGAGEMENT 
Improve social functioning 
Increase community 
activities 
REDUCTION IN 
POSTTRAUMATIC 
STRESS 
SYMPTOMS 

peer support services. . Results of feasibility and pilot studies indicate that Veterans readily accept peer 
support services.24-27 Despite these promising findings and VA mandates for increased peer-support services, 
there is a lack of well-structured models for incorporating peer support into evidence based care for PTSD.   
A.3.b. Conceptual model of peer 
supported PTSD treatment. Figure 1 
above illustrates our recovery-oriented 
conceptual model for peer support 
services adjunct to PE. Peer support has 
the potential to enhance PTSD and 
rehabilitation outcomes by targeting 
treatment engagement, adherence, social 
functioning and community reintegration. 
This model is supported by evidence that 
those receiving adjunctive peer support 
are more likely to initiate treatment, attend 
sessions, complete homework, and 
perceive stronger treatment alliance.28-30, 
46,47 Peer support services enhance social 
functioning and community 
reintegration.30-36 Studies show peer 
support is associated with reduced 
hospitalization as well as increased 
empowerment, hope, and self-efficacy. 
There is strong potential for such 
interventions to enhance rehabilitation 
outcomes among Veterans seeking 
treatment for PTSD.  
Translating the Model into Practice: In 
this intervention, PS’s  will provide 
education about mental health care in an 
initial telephone call, the joint 
education/orientation session with the 
therapist and Veteran, and as needed 
during subsequent telephone coaching 
and support groups.  This may include 
basic information such as therapy 
schedules and social norms in individual 
and group modalities, as well as personal 
experiences in mental health treatment. 
PS’s  will support recovery orientation 
(i.e., hope for recovery) in the initial phone 
call, the joint education/orientation 
session with the therapist and Veteran, and as needed in telephone coaching and support groups.  Support for 
recovery orientation will take the form of sharing the PS’s  personal recovery story, initially describing success 
in therapy and mastery of symptoms.  As the intervention moves to focus on social functioning and community 
reintegration, the PS  should include stories of his or her own successes in improving relationships and 
increasing community functioning.  PS’s  will promote social bonds by a) offering social support before and 
during the initial orientation session, b) providing social support during coaching calls and during support group 
meetings, c) facilitating social support between Veterans at support group meetings, and d) facilitation of 
improved relationship functioning in the Veteran’s community of support.  Increased richness in social 
relationships should result in increased involvement with others in the community, enhancing community 
reintegration. 
A.3.c. Adjunctive peer support services for PE. Standard PE includes education about PTSD, followed by 
imaginal and in vivo exposure.  This series of therapeutic activities provokes and then facilitates habituation to 
arousal, allowing sufficient processing to desensitize clients to inappropriately feared stimuli. Based on 
Table 1: PE Interventions, PEET Interventions, and Model Elements 
Session 
PE Intervention 
PEET Intervention 
Model Elements 
 
 
Invitation Phone Call 
Education, Hope, 
Treatment Engagement 
0 
Assessment, Orientation, 
Informed Consent 
Education, Modeling, 
Establish Rapport 
Education, Hope, 
Treatment Engagement 
 
 
PS coaching calls 
(available throughout) 
Hope, Treatment 
Engagement, Social 
Bonds 
1 
• Overview  Treatment 
Rationale 
• Trauma Assessment 
• Breathing Retraining 
Group1: Rapport, 
purpose, motivation 
Treatment Engagement, 
Hope 
2 
• PTSD psychoeducation 
• Rationale for in vivo 
Exposure 
• Construct In Vivo Exposure  
Hierarchy 
• Begin In Vivo Exposure 
Group 2:Coping 
strategies for 
adherence 
Treatment Engagement, 
Hope 
3 
• Rationale for Imaginal 
Exposure 
• Initial Imaginal Exposure, 
Processing 
• Continue In Vivo Exposure 
Group 3: Follow-up on 
adherence 
Treatment Engagement, 
Hope 
 
 
Telephone check-in 
Treatment Engagement, 
Hope, Social Bonds 
4-5 
• Continue Imaginal Exposure, 
Processing 
• Continue In Vivo Exposure, 
working through hierarchy 
Group 4: PTSD and 
relationships 
Social Bonds, 
Community 
Reintegration 
 
 
Discretionary 
Intervention: 
Individual facilitation 
for in vivo exposure 
Treatment Engagement 
and Community 
Reintegration 
 
 
Group 5: Follow-up on 
relationships 
Social Bonds, 
Community 
Reintegration 
6-9 
• Continue Imaginal Exposure, 
working through Hot Spots 
and processing 
• Continue In Vivo Exposure, 
working through hierarchy 
 
Groups  6-9: 
Community activities  
Community 
Reintegration 
10 
• Final Imaginal Exposure 
and processing 
• Review In Vivo Hierarchy 
• Discuss what was 
helpful/not helpful in 
treatment 
• Relapse prevention plan 
Final Group session: 
Termination 
Community 
Reintegration 

empirical support for our model noted above, we have reason to expect that adjunctive peer support services 
can enhance treatment engagement, adherence, social functioning and community reintegration. Within the 
context of supporting PE, PS’s could be trained and supervised to: 1) provide telephone support to promote 
recovery and encourage session attendance and treatment adherence, 2) educate Veterans and significant 
others about treatment and serve as a positive role model when the treatment is described, 3) facilitate weekly 
peer support groups to enhance education, increase available social support, promote treatment engagement 
and adherence to homework, and promote community reintegration and 4) facilitate in vivo exposure as 
recommended by PE providers. This may include facilitating resumption of valued activities by leading group 
outings to community settings (e.g., using public transportation, engaging in community activities). By refining 
an intervention manual with standardized procedures for training and supervising PS’s, we can facilitate 
empirical evaluation of adjunctive peer support services, and likely improve rehabilitation outcomes.  
A.4. Significance of the Research. Development of effective treatment for PTSD is a top priority for the VA; a 
chief goal of VA’s Strategic Plan is the development of recovery-oriented care that emphasizes evidence-
based practices to promote Veterans’ psychosocial rehabilitation and community reintegration. VA has been on 
the forefront of efforts to implement peer support services to create more patient-centered, recovery-oriented 
care. Yet, little research has examined the efficacy of adjunctive peer support services for enhancing PTSD 
and rehabilitation outcomes. This study supports VA Rehabilitation Research and Development priorities in 
that it will a) use Veterans’ qualitative data to create patient-centered care, b) capitalize on peer support to 
establish a recovery-oriented, adjunctive rehabilitation intervention, and c) improve functioning and community 
reintegration outcomes among Veterans with PTSD.   
 
B. PRELIMINARY STUDIES 
B.1. Research team is well qualified to undertake this novel treatment development project. The 
proposed project builds on the experience of a strong interdisciplinary team with complementary expertise in 
peer support services, novel treatments for PTSD, and rehabilitation. All of the investigators are experienced in 
PTSD research and rehabilitation. Drs. Harris, Jain, and Hundt are leaders in peer support, Drs. Erbes, Harris, 
Jain, Strom, and Hundt have experience in intervention development and/or dissemination, and Drs. Erbes and 
Polusny have experience in qualitative methods that are critical in early stages of intervention development. 
B.1.a. Team has expertise in peer support interventions. Drs. Harris, Jain, Hundt and Strom are 
experienced peer support supervisors, and Drs. Harris and Jain were involved in the creation of VA peer 
support services at the dawn of the discipline. Dr. Hundt is experienced in peer support and PTSD research 
and is currently developing a manual for peer support services as an adjunct to PTSD treatment.  Dr. Harris 
created policies and procedures for MVAHCS’s peer support services in cooperation with VACO. In that role 
she became a central source of peer support training/supervision expertise for VISN 23. Dr. Jain is a leading 
source of peer support research in PTSD,27,36 has developed a comprehensive model of peer support services 
and is the project director of the Peer Support Program, a clinical demonstration project that integrates peer 
support into the mental health treatment of rural Veterans.  
B.1.b. Team has expertise in PE, rehabilitation outcomes, intervention development and qualitative 
methods. As national trainers and consultants Drs. Strom and Polusny bring expertise in PE, and Dr. Strom 
has experience as a peer support supervisor. Dr. Polusny has collaborated on studies of dropout from EBPs 
for PTSD.19 Drs. Erbes & Polusny have generated analyses of PTSD symptoms and social functioning over 
time8,9 and one of the first reports on vocational functioning among National Guard soldiers.7 Dr. Harris has 
developed an intervention designed to reach Veterans who eschew mental health services, and is currently 
leading a large RCT.38 Dr. Jain has developed peer support interventions detailed above. Dr. Strom is currently 
involved in a clinical trial of vocational rehabilitation for Veterans with PTSD. Dr. Erbes has evaluated novel 
treatments for PTSD including the use of Narrative Therapy,40 and Drs. Polusny and Erbes recently published 
results of a clinical trial of mindfulness-based stress reduction.14  Drs. Erbes and Polusny have experience with 
qualitative methods necessary to move peer support interventions closer to evidence based practice. Dr. Erbes 
has worked with qualitative data related to relationship functioning among Veterans with PTSD,7 and Veterans 
with amputation. Dr. Polusny is PI of a study using qualitative methods to understand chronic pain.  
C. RESEARCH DESIGN AND METHODS 
The National Institutes of Health (NIH) identify six stages of treatment development: Stage 0 (Discovery/Basic 
Research), Stage I (Intervention Generation/ Refinement), Stage II (Pilot/Proof of Concept), Stage III (Hybrid 
Efficacy-Effectiveness), Stage IV (Effectiveness), and Stage V (Implementation and Dissemination). Basic 
research (Stage 0) is summarized above. The current proposal focuses on Stage I; initial development/ 

feasibility testing. Stage IA includes development of the theoretical rationale, intervention manuals, training 
materials, fidelity monitors, and outcome measures. Stage IB includes pilot feasibility testing.41 The resulting 
products will be used in future research addressing Stages II through V.  
 
C.1. Overview of Study Design. This pilot refinement/feasibility study of Peer Enhanced Exposure 
Therapy (PEET) will move from Stage IA (Intervention Development/Refinement) through Stage IB 
(Feasibility) in Years 1 and 2. The goal of this project is to refine and pilot test an adjunctive peer support 
intervention manual suitable for implementation and evaluation in VA clinics. The adjunctive intervention, 
PEET, is designed to improve treatment engagement/adherence, and optimize rehabilitation outcomes by 
improving social functioning and community reintegration.    
C.2. Specific Aim 1: Refinement of Preliminary Manual and Training Materials for PEET (Stage IA).  In 
Year 1, we will revise our preliminary manual and PS training materials for PEET. The intervention is adapted 
from our model37 of peer support for PTSD treatment and will be refined based on feedback from focus groups 
with Veterans and PE providers. Focus groups will review components of the intervention manual, and provide 
feedback on each type of intervention (orientation, telephone support, group support, and support for in vivo 
exposure). We will review this data in collaboration with national leaders in peer support and PE, then revise 
the initial framework for the PEET intervention. 
C.2.a. Focus group participants. A sample of 12-16 Veterans who have used PE will be invited to participate 
in one of 4 focus groups. We will use purposeful sampling stratified by treatment engagement (50% who 
engaged and 50% who dropped out). A sample of 8-12 VA providers with at least 2 years of experience 
implementing PE will be recruited from the Minneapolis VA Health Care System (MVAHCS) PTSD treatment 
team to participate in two focus groups. We will strive to include a diverse set of providers, including 
psychologists, social workers, and psychiatrists. Sample size and number of groups were determined on the 
basis of information power, 57 a new and more easily operationalized means of proactively estimating numbers 
needed to attain saturation. The information power for this design is quite high, as a) the goal is feedback on a 
well-defined stimulus, b) the population to be sampled is very specific, c) the procedure is informed by an 
established model36 d) the interviewers are experienced with the information content and qualitative 
interviewing, and e) the analysis plan is highly structured; given the high level of information power available, 
the recommendation is for 2 focus groups per category of participants.57,58 Based on this we will schedule 2 
focus groups for PE completers, 2 for PE dropouts, and 2 for PE providers. 
C.2.b. Focus group procedures. Separate focus groups will be conducted with Veterans and Providers. 
During 60-90 minute focus groups, participants will be provided with information about the intervention and 
asked for feedback about a) the initial, invitation call, b) co-facilitation of orientation sessions with the PE 
provider, c) peer support coaching calls, d) the peer support group, and e) support for in vivo exercises. (See 
Appendix 6 for focus group protocol.) Focus groups will be recorded in digital audio format and transcribed. 
C.2.c. Qualitative analyses. Drs. Harris, Erbes, and the coordinator will conduct qualitative analyses. We will 
use a rapid turn-around analytic approach.42 This technique is well-suited to short-term projects, focus groups 
using targeted interview guides and has been cited over 200 times in the research literature, including 2 VA 
treatment development studies.59,60 This process improves on past rapid procedures through its systematic, 
rigorous approach. While this does not yield the nuanced understanding of older analytic techniques, it is more 
efficient. The rapid turn-around approach uses data reduction (i.e, it sorts, focuses and organizes data43  rather 
than coding as the first step of analysis). Following focus groups, Drs. Harris, Erbes, and the coordinator will 
develop a draft template summarizing each data collection episode (e.g. each transcript). The template will be 
organized with a separate area for each focus group question, unexpected findings, and exemplary quotes. 
The coordinator will field the draft to assess the guide. Following any revisions, Dr. Harris will apply the 
template to remaining transcripts. After transcripts are summarized, Dr. Harris will transfer the summary points 
in a data matrix that organizes the summary points for each main topic of inquiry by population (e.g. Veterans, 
Providers). This will allow the investigators to systematically assess similarities, differences, and trends in 
responses across the focus groups.44 Finally, following an all-staff meeting allowing investigators and expert 
consultants to provide their impression of the matrix contents, Dr. Harris will create a final memo summarizing 
the findings and noting key themes that emerged from the data. 
C.2.d. Treatment and training manual revision.  Using focus group findings, Drs. Harris, Jain, Strom and 
Hundt will revise and refine our a) intervention manual, b) PS training materials, d) fidelity monitors, and e) 
outcome measures. These materials will be iteratively reviewed by the study team, which includes active PE 

providers, nationally recognized leaders in PE, peer support services, and PS’s (to be named). In addition, we 
will seek feedback from Dan O’Brien-Mazza, the National Director of VA Peer Support Services, and a national 
network of PE trainers and consultants, including Drs. Polusny and Strom. When the team and expert 
consultants are satisfied with the intervention materials, Drs. Harris, Strom, and Polusny  will provide initial 
training to 2 PS’s; training will be evaluated based on written tests and role-played, rated performance of 
manualized techniques. 
C.3. Specific Aim 2: Examine the Feasibility of PEET. In the second half of Year 1, we will begin pilot testing 
PEET (Stage IB) to determine feasibility and acceptability using a series of at least 12 Veterans treated by 2 
providers and 2 PS’s. Veterans referred for PE will be invited to take part in the study. Trained PS’s delivering 
the intervention will be provided with weekly individual and group supervision, and sessions will be recorded so 
that interventions can be rated for fidelity to the manual. 
C.3.a. Participants. Veteran participants will be individuals appropriate for  PE, i.e., Veterans who a) are 
currently seeking PE, b) meet DSM-5 criteria for PTSD or subthreshold PTSD, c) are competent to consent to 
research, and d) do not have levels of other types of psychopathology that would prevent successful 
participation in the intervention.   
C.3.b. Peer Training, Supervision, and Fidelity Monitoring. PS’s hired for this study will be state-certified. 
They will also be able to personally describe and demonstrate high levels of functional recovery from PTSD, 
and a history of successful participation in PE.  Drs. Harris, Strom and Polusny will jointly provide PS’s with 
training on a) PTSD, b) principles of PE, c) the new intervention, and d) the importance of fidelity to the 
treatment manual. PS training will be assessed using a) a written knowledge test, b) role-played peer support 
techniques, and c) written and verbal feedback from PS’s solicited at the end of training, and at the end of the 
study. Dr. Harris will provide at least one hour of individual supervision and 2 hours of group supervision per 
week, with focus on a) reviewing recordings of interventions, b) Veteran safety, and c) model fidelity. Both Dr. 
Harris and the study coordinator will review at least 50% of the peer support sessions and use the developed 
monitoring instrument to assess fidelity. Interrater reliability for fidelity monitoring will be assessed as well. 
C.3.c.  PE Providers. Drs. Strom and Polusny, both licensed mental health providers and national PE trainers 
and consultants, will serve as PE therapists for this study. 
C.3.d. Quantitative Assessment.  Measures will be used to characterize the pilot sample, provide information 
on acceptability and perceptions of the treatment, and test the measurement battery that will be used in later 
Stage II clinical trials. In order to evaluate eligibility for the study, the Clinician Administered PTSD Scale for 
DSM-5 will be administered by the PI. Those Veterans who have a diagnosis of PTSD or subthreshold PTSD 
will then complete a battery of self-report measures for symptoms and quality of life indicators68 at baseline and 
post-treatment. Table 2 outlines the measurement to be used to assess key aspects of our theoretical model, 
as well as schedule for administration and respondents . This battery is being administered to 1) verify that 
outcomes are, at least on their face, similar to those obtained in existing studies of PE with this population and 
2) pilot the feasibility and utility of the assessment protocol for future clinical trials. Post-treatment interviews 
will be used to solicit Veteran, provider, and peer specialist feedback on each component of PEET, especially 
with regard to dropout risks and dropout prevention (see interview schedule, Appendix 6). Interviews will also 
seek feedback on adequacy of PS training and coordination of PEET and PE services. Medical records will be 
reviewed to assess signals for dropout risk, specifically the number of sessions attended and the percentage of 
session notes indicating adherence to homework. 
C.3.f. Analysis.  We will examine responses to the follow-up interviews with Veterans, PE providers, and PS’s 
using the same rapid-turnaround qualitative approach outlined above. Feasibility will be analyzed based on a) 
qualitative feedback, b) PS scores on fidelity instruments, c) indicators of treatment engagement (session 
attendance, homework adherence), d) SES ratings and e) pre-post changes on the MCQ, APQ and CSI.  
Acceptability will be analyzed based on a) qualitative feedback and b) scores on the CES, and CSQ. This 
sample, while small, will be sufficient to provide a preliminary evaluation of the feasibility, and acceptability of 
the intervention.  
C.3.g. Refinement of the Treatment Manual. After completion of the pilot trial, we will review data from 
Veterans, providers, and PS’s, to make edits to the manual and plan for Stage II trials.  
 

This design will be 
limited to preliminary 
intervention 
refinement and pilot 
feasibility; given 
preliminary work with 
small N’s, findings will 
be qualitative 
foundations for further 
research. The type 
and quantity of data 
collected will be 
insufficient for 
parametric statistics; 
future studies will 
assess effectiveness 
of PEET. 
C.4. Timeline and 
Management.  As 
shown in Table 3, 
Year 1 will include 
project preparation, 
recruiting/implementa
tion/analysis of focus 
group data, 
intervention manual 
revision, and training 
of PS’s. Year 2 will include the initial trial of the PEET intervention. 
As PI, Dr. Harris will be responsible for all aspects of the program; managing staff, implementing focus groups, 
analyzing data, writing the manual, training/supervising PS’s, fidelity ratings, and writing results. Dr. Erbes will 
serve as the data analyst, analyzing focus group and interview data, and writing results. He will also co-
facilitate the Veterans’ focus groups. Drs. Polusny and Strom will serve as the PE experts on the team, working 
with the provider focus groups, assisting in interpreting findings, training PS’s, contributing to the manual and 
training materials, and writing results. Drs. Jain and Hundt will serve as Peer Support experts in interpreting 
focus group data and writing the intervention manual, as well as results. The study coordinator will assist in 
administrative aspects of the study, including coordination with IRB, recruiting and consenting participants, 
coordinating assessments, and participating in qualitative analysis.  
 
 
 
Table 2:  Feasibility Trial Measurement 
Domain/Measure 
Type 
#Items 
α 
Administered 
by 
Respondents 
Week 
1 
Week 10 or  
Dropout  
Symptoms 
 
 
 
 
 
 
 
CAPS48,49 
Interview 
30 
n/a 
Harris 
Veterans 
x 
 
PTSD Checklist50-52(PCL) 
Self-Report 
20 
.89-
.97 
Coordinator 
Veterans 
x 
x 
Hope 
 
 
 
 
 
 
 
Credibility-Expectancy 
Scale 53(CES) 
Self-report 
6 
.79 
Coordinator 
Veterans 
x 
 
Engagement/Adherence 
 
 
 
 
 
 
 
Client Satisfaction Scale-854(CSQ) 
Self-report 
8 
.91 
Coordinator 
Veterans 
 
x 
Service Engagement Scale56(SES) 
Provider 
Rating 
14 
.76-
.90 
Coordinator 
Providers 
 
x 
Number of PE sessions attended/ 
Treatment Completion 
Medical 
Record 
n/a 
n/a 
Coordinator 
Providers 
 
x 
Homework completion 
Medical 
Record 
n/a 
n/a 
Coordinator 
Providers 
 
x 
Endpoint Interview 
Interview 
3 
n/a 
Harris 
Veterans 
Providers 
PS 
 
x 
Social Functioning 
 
 
 
 
 
 
 
Alabama Parenting 
Questionnaire64(APQ) 
Self-Report 
9 
.58-
.77 
Coordinator 
Veterans 
x 
x 
Couples Satisfaction Index65(CSI) 
Self-Report 
4 
.98 
Coordinator 
Veterans 
x 
x 
Endpoint Interview 
Interview 
3 
n/a 
Harris 
Veterans 
Providers 
PS 
 
x 
Community Reintegration  
 
 
 
 
 
 
 
Military to Civilian 
Questionnaire55 
Self-Report 
16 
.95 
Coordinator 
Veterans 
x 
x 
Endpoint Interview 
Interview 
1 
n/a 
Harris 
Veterans 
Providers 
PS 
 
x 
Table 3.  Project Timeline 
Task 
Q1 
Q2 
Q3 
Q4 
Q5 
Q6 
Q7 
Q8 
Hire/Train Staff 
 
 
 
 
 
 
 
 
Obtain IRB approval 
 
 
 
 
 
 
 
 
Recruit focus group participants(Veterans and PE Providers) 
 
 
 
 
 
 
 
 
Implement Focus Groups (Veterans and PE Providers) 
 
 
 
 
 
 
 
 
Qualitative Analysis 
 
 
 
 
 
 
 
 
Review Qualitative Data in Collaboration with PE and Peer Support Leaders 
 
 
 
 
 
 
 
 
Intervention Manual Revision 
 
 
 
 
 
 
 
 
Train PS’s  
 
 
 
 
 
 
 
 
Implement Intervention 
 
 
 
 
 
 
 
 
Semi-structured endpoint interviews/measures 
 
 
 
 
 
 
 
 
Second Intervention Manual Revision 
 
 
 
 
 
 
 
 
Write/disseminate findings