Participatory Development of a Complex Cross-Site Logic Model for Community-Based Peer Support Programs Serving Veterans

Background and Purpose

Veterans experience significant challenges during the community reintegration process following military service, including economic insecurity, relationship difficulties, anxiety, substance abuse, depression, a lack of meaning purpose, and social isolation. Peer support programs, which emphasize the importance of camaraderie and social cohesion through shared lived experience and mentorship, are a promising intervention for veterans and their family members. There is however a lack of well-articulated program logic within many such programs, which tend to use non-traditional strategies of engagement and support. Both the Aspen Institute (Anderson, 2005) and the Kellogg Foundation (2004) have emphasized the importance of logic modeling as a practical strategy to help programs define a theory of change to explain the relationship between program activities and desired outcomes. This study describes the use of a participatory process to create a comprehensive logic model across multiple heterogeneous peer support programs serving veterans.

Methods

This study used an approach drawing from participatory models of qualitative research to develop consensus-driven logic models for 11 veteran peer support programs. Though all programs are funded through the same mechanism, each was given maximum latitude to create its own unique program services and operational features. Administrators and staff met with researchers to design and build accurate logic models for each program. The research team then used a team-based process of qualitative content analysis to search for common elements across all programs, with the goal of building a unified theory of change/logic model across all 11 programs. The resulting super-logic model was shared with program staff for member checking.

Results

Ecological systems theory was used as a framework to organize study findings. Nine output domains were identified, documenting intervention strategies at various levels of support. Micro-level outputs include individual mentorship, crisis support services, advocacy, and primary outreach. Mezzo-system outputs incorporate support groups, training, and family engagement domains. Lastly, macro-level outputs emphasize community education and volunteerism as primary functions in peer programming. The nine common outputs were linked to short, medium, and long-term projected outcomes. Common themes across short and medium outcomes are reducing isolation, addressing basic needs, and building camaraderie. Ultimately the super logic model's purpose is to demonstrate the relationship of interventions to long-term goals across a complex array of heterogenous programs. Strengthening the veteran community and supporting pro-social reintegration, empowerment, hope, and suicide reduction emerged as the primary long-term outcomes.

Conclusion

Peer support programs are an effective intervention for veterans yet need better explication regarding the theories of change. The super-logic model provides heterogeneous organizations serving veterans with a cohesive conceptual framework for replication while maintaining flexibility in service delivery. Implications for social work practice, policy and research with veteran programs are significant. While this super-logic model is not prescriptive, it provides social workers and other professionals with important knowledge regarding the program goals, interventions, and projected outcomes of veteran peer support programs.