Improved Psychological Health Through a Remote Behavioral Intervention: A Telehealth Pilot Study for Veterans with Chronic Multi-symptom Illness.

Cognitive control enables individuals to imagine future events and develop personal goals, which are critical for sense of purpose. For Veterans with chronic multi-symptom illness (CMI), augmenting cognitive control and other factors related to brain health may improve symptom management and quality of life (QoL). This pilot study utilizes neuroscience evidence to enhance psychological health, with a combination of remote meditation and aerobic exercise (mental and physical [MAP] training) to evaluate what type of distance-based instruction is optimal for Veterans engaged in these health behaviors. Twenty-five Veterans with CMI were randomized to either an eight-week directed MAP (dMAP; n = 12) group where specific instructions were provided via text messaging or an eight week self-guided MAP (sgMAP; n = 13) group where they received the goals of the MAP intervention without weekly guidance. Participants also completed health coaching weekly. Self-report health measures were collected during baseline, post-treatment, and three-month follow-up, with the primary outcome assessed using the Behavior Rating Inventory of Executive Function - Adult Version (BRIEF-A). A significant group-by-time interaction was observed for the BRIEF-A subscales: inhibit and task monitor, both demonstrating differences in the direction of change between the groups. A significant overall time effect was observed for depression, sleep quality, and mental health-related QoL, each demonstrating improvement. MAP training significantly improved multiple symptoms in Veterans with CMI. This suggests that empowering Veterans with goals and support through health coaching may be a viable approach to improving health in those suffering from chronic illness.