Developing and Testing a Trauma-Informed Exercise Intervention for Women Veterans with histories of Sexual Violence

Women Veterans (WVs) disproportionately experience sexual violence (SV) throughout their lifetime. These experiences of SV are often repeated, resulting in a lifelong pattern of SV victimization which can have profound negative impacts on physical, mental, and psychosocial functioning and quality of life. Current VHA policies highlight the need for integrative interventions which effectively address the diverse negative health sequalae associated with lifetime SV. Yet, there is currently a gap in treatment offerings that address broad psychiatric, physical, and psychosocial health impacts of SV. Exercise has been shown to improve trauma- related mental health conditions among survivors of SV and improve trauma-related multimorbidity among Veterans with a PTSD diagnosis. Yet, many barriers exist to exercise among WVs which contribute to low exercise engagement from this group. This Career Development Award (CDA-2) thus aims to develop and test a trauma-informed telehealth exercise intervention tailored for WVs with histories of SV. Treatment development will be guided by 1) previous interventions completed among Veterans with PTSD, 2) documented preferences among women with histories of SV, and 3) trauma-informed approaches and integration of stakeholder feedback. During phase one of this project, we will conduct pre-implementation stakeholder interviews with 10 WVs with histories of SV and 10 healthcare providers to provide guidance on the structure and content of the proposed intervention. This information will be used to create the program manual for the proposed intervention. During phase two of this project, forty WVs aged 21-65 with lifetime history of SV will be recruited from VISN1 to participate in an open trial consisting of a 12-week, online physical activity program including aerobic and strength training. Qualitative data will be collected in parallel with quantitative outcomes to assesses the primary feasibility and acceptability outcomes. Exploratory outcomes will include functional status. Candidate outcomes to be assessed include physical performance, physical activity level, PTSD, anxiety, depression, psychosocial function, pain, fatigue, health status, quality of life, and exercise motivation. This pilot trail will extend our understanding for trauma-informed exercise approaches for WVs with histories of SV and of the feasibility, acceptability, and potential benefits of exercise for this group. Results will be used to develop a fully powered randomized controlled trial for WVs with histories of SV. Dr. Pebole’s training plan will facilitate completion of all research aims and the development of new skills (e.g., treatment development and testing, implementation science and processes, advanced qualitative and quantitative analytic techniques) and professional development to facilitate her research career to independence. She will participate in didactic and professional development activities throughout the award period to support achievement of these training goals and receive mentorship from a team of experts in rehabilitation-focused intervention for Veterans, sexual and interpersonal violence, exercise, and functioning (Drs. Catherine Fortier, Katherine Iverson, Katherine Hall). Project Number: 1IK2RX005308-01A1 | Fiscal Year: 2025 | NIH Institute/Center: Veterans Affairs (VA) | Principal Investigator: Michelle Pebole | Institution: VA BOSTON HEALTH CARE SYSTEM, BOSTON, MA | Activity Code: IK2 | Study Section: Career Development Program - Panel II[RRD9] View on NIH RePORTER: https://reporter.nih.gov/project-details/11111085