PRIDE In All Who Served
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Share PrintPRIDE In All Who Served is a health promotion group that was designed and refined using human-centered design principles at the Hampton VA Medical Center in 2016. Each one-hour session of the ten-week, manualized, closed group provides an opportunity to connect with other LGBTQ+ Veterans to build a peer support system while improving LGBTQ+ patient health literacy. Connection to social support is a protective factor against suicide, stigma-related stress and other health outcomes for LGBTQ+ individuals. The group facilitation manual provides a comprehensive approach to implementation of the service, staff training, and guidance on how to create a welcoming environment. Veteran reactions to the service include: "I can't believe this group is at the VA!", "My life has gotten better by coming", and "I love this group! I feel better talking to my providers."
Origin:
January 2016, Hampton VA Medical Center
Adoptions:
67 successful, 11 in-progress, 13 unsuccessful
Awards and Recognition:
iNET Seed Investee, iNET Spread Investee, Diffusion of Excellence National Diffusion Practice
Partners:
Diffusion of Excellence, Health Equity, LGBTQ+ Health Program, Mental Health and Suicide Prevention, VHA Innovators Network
Recent Updates
Overview
The problem
Videos
Above:
American Legion National Security Commission Chairman Matthew Shuman is featured in a Veteran's Health Administration's Office of Healthcare Innovation & Learning video promoting VA healthcare in the LGBTQIA+ community.
Links
- Information brief about health disparities among LGBT veterans. VA Office of Health Equity (OHE)
- PRIDE In All Who Served and additional resources are mentioned on Episode 16: Serving LGBTQ+ Veterans National Veterans' Training Institute Podcast - Serving LGBTQ+ Veterans
The solution
A PRIDE in All Who S ... The PRIDE in All Who Served program was developed to fill this critical care gap and to provide a resource for reducing healthcare disparities, including suicide risk. Session content focuses on overall wellness, increasing social connectedness, and empowering Veterans to engage in services related to their personal healthcare needs.
A PRIDE in All Who Served manual for new group facilitators includes session content, handouts, and strategies for adopting and sustaining the group successfully. See more
Images
Above:
Manual for PRIDE Group Facilitators
Files
- March 2021 VVC Telehealth Strong Practice
Links
- Official blog of the U.S. Department of Veterans Affairs. PRIDE program helps employees better care for LGBTQ+ Veterans
- June 2021 PRIDE In All Who Served Press Release
- Veterans Health Equity: Leave No Veteran Behind PRIDE and TelePRIDE Podcast
- Tomah VA Medical Center's TelePRIDE Pilot Program
- PRIDE IN All Who Served improves LGBTQ+ Veterans' health Improving LGBTQ+ Veterans' Whole Health through PRIDE
The results
- increased protective factors (e.g., community involvement, identity certainty)
- reduced likelihood of attempting suicide in the future
- reduced symptoms of depression, anxiety, and concern about not being accepted
Images
Above:
Numbers snapshot (2018-2021)
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Example Results from Veterans (2108-2021)
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Example Results (Item from Brief Suicide-Related Behavior Questionnaire, SBQ-R; 2018-2021)
Files
- Paper published in 2020 on pilot data from the first two VA Medical Centers to offer PRIDE groups. PRIDE In All Who Served: Development, Feasibility, and Initial Efficacy of a Health Education Group for LGBT Veterans
Links
- Paper published in June 2023 on barriers and facilitators to offering PRIDE groups at early adopting VA sites. This paper was also the 2024 winner of the Leonard Matlovich LGBQ+ Research Paper of the Year Award! Rolling out PRIDE in All Who Served: Barriers and Facilitators for Sites Implementing an LGBTQ+ Health Education Group for Military Veterans
- Paper published in February 2022 on outcomes at 10 early adopting PRIDE sites. Full text available by emailing: VAPRIDEinAllWhoServe@va.gov Spreading Pride in All Who Served: A health education program to improve access and mental health outcomes for sexual and gender minority veterans.
Metrics
- Reach of Program = Improved access to affirmative care services for LGBTQ+ Veterans and rural LGBTQ+ Veterans;
- Effectiveness of Program = Improved identity-related protective factors (e.g., identity acceptance, reduced internalized stigma)
- Effectiveness of Program = Reduced symptoms of distress (e.g., symptoms of depression and anxiety)
- Effectiveness of Program = Reduced suicide risk (e.g., reported likelihood of attempting suicide in the future)
- Adoption, Implementation, Maintenance = Number of VA Facilities and Clinical Resource Hubs Consistently Offering PRIDE in All Who Served
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Multimedia
Videos
Above:
PRIDE Awareness Month, June 2021
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PRIDE Awareness Month, June 2021
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PRIDE Awareness Month, June 2021
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PRIDE In All Who Served iEX Talk, October 2021
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Presentation for US Professional Association for Transgender Health, November 2023
Implementation
Timeline
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Pre-Implementation
1. Seek leadership endorsement for participation2. Identify a co-facilitator3. Conduct informal needs assessment to identify pre-implementation tasks4. Complete your facility application for inclusion in the next cohort and complete all required pre-work (e.g., read Facilitator's Manual in its entirety, complete TMS modules) -
Implementation (~4 months)
1. Join weekly implementation cohort calls (16 weeks total)2. Launch group3. Join PRIDE Community of Practice Calls (quarterly)4. Join PRIDE Open Office Hours (monthly)5. Document outcomes and report data for evaluation to PRIDE National Team as requested -
Sustainment
1. Continue participation in PRIDE Community of Practice2. Continue participation in PRIDE Open Office Hours3. Identify next start date for subsequent group cycle
Departments
- LGBTQ+ Veteran care
- Whole health
Core Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
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PROCESSES |
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Optional Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
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TOOLS |
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Support Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
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PROCESSES |
|
TOOLS |
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Risks and mitigations
| Risk | Mitigation |
|---|---|
| LGBTQ+ Veteran risk for suicidal ideation | Pre-Screen appointments to review risk factors, develop safety plan, and refer to appropriate supports |
| Increasing LGBTQ+ Veteran health literacy and visibility may increase pressure to improve access to care for this group (e.g., PrEP availability, Endocrinology) | Consultation calls to assist sites in navigating these situations and developing a coordinated care model within their facility structure |
| Facility environment (lack of visibility, community resources, rurality, or provider biases) | Consultation calls to problem solve local barriers |
Contact
Comment
Comments and replies are disabled for retired innovations and non-VA users.
Email VAPRIDEinAllWhoServe@va.gov with questions about this innovation.
About
Origin story
Original team
Tiffany Lange, PRIDE Program Developer (she/her)
Implementation & Training Lead (2016-2021)
Heather A. Sperry (she/her)
Director of Clinical Implementation (2021-present)
Michelle M. Hilgeman (she/her)
Director of Evaluation (2017-present)
Michelle Wilcox (she/her)
Deputy Director of Clinical Implementation (2021-present)
Robert J. Cramer (he/him)
Evaluation Team (2017-present)
Courtney Houghton (she/her)
Executive Assistant (2021-present)
Teddy Bishop (he/they)
Deputy Director of Evaluation (2019-present)
Blaine Fitzgerald (she/her)
PRIDE Diffusion Specialist (2020-2023)
Sierra Phillips (she/her)
Community Partnerships Program Manager (2021-present)
Anna Craycraft (she/her)
Education Program Manager (2021-present)
Shilpa Trivedi (she/her)
Evidence-Based Practice (EBP) Program Manager (2022-present)
I led a Pride In All Who Serve group at VA Hudson Valley and am currently leading my second cohort. This is a great opportunity for our LGBTQ+ veterans and the feedback from our veterans has been positive.
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What a timely initiative! Much needed for our veterans!❤😊
Good afternoon,
I would like to initiate and lead a "Pride in All Who Served," at our facility. I am at the VA of Western New York in Buffalo. I have read about the purpose of this group and find there is a great need for LGBTQ Veterans at our VA. I need to know how I can get official permission to get this education/support group launched.
I can devote two to three hours per week to lead this gathering, including the consultation session to get started. If anybody can point me in the right direction, please email me at timothy.ward5@va.gov.
Good afternoon. Thank you for your interest and for reaching out to our team on the Marketplace! We plan to launch our next Pride in All Who Served training cohort in October 2021 and will be contacting interested sites soon with next steps! We look forward to partnering with you and the VA Western New York Healthcare System!
The Salt Lake City VA has had great success in implementing "Pride in All Who Served" at our facility. We have received excellent feedback regarding the content of the group manual. The monthly calls are supportive and helpful with the program as well as implementing affirming healthcare overall. I highly recommend it!
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I am the LGBT VCC at a small, rural facility in WI. I was introduced to this project early on and was fortunate to collaborate as an early spread site. This group has been just what our site needed to meet the needs of rural LGBT Veterans who are struggling with limited resources in the community and limited knowledge of VA resources available. Feedback has been overwhelmingly positive in terms of finding meaning, validation of identity and sense of belonging and community. Additionally the evaluations and feedback has been invaluable in terms of Veterans engaging both VA and community partners in LGBT Veteran services. This project has also been a catalyst for increasing visibility and dialogue on the importance of meeting the needs of LGBT Veterans. It has also helped in creating buy-in with leadership in terms of prioritizing and highlighting healthcare disparities and addressing those needs head on.
I'm the LGBT VCC at a small rural outpatient clinic and residential rehabilitation center. I would love to bring this to us in VISN 20, Oregon.
Thanks for the comment. We would love to partner with your site to bring PRIDE to rural Oregon! An email thread is started to find a time to connect!
Hi there, I am new to the VA and work in Columbus, OH as the LGBT Care Coordinator. I would like to learn about the program and try to get it adopted in VISN10
Welcome to the VA! Columbus OH has partnered with us in the past. We will follow up by email to connect.
I am not a direct care provider and I work for RCS/Vet Centers. I would like to learn about the program and try to get it adopted in VISN9/TVHS and in 10RCS/Vet Center Program.
We are thrilled you connected with our team through the Diffusion Marketplace! We look forward to continuing the conversations to move toward adoption in VISN9/TVHS and in the 10RCS/Vet Center Program!
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