A case study in applying the STRIVE3 Mission Acceleration Blueprint™ to a federally funded, evidence-based advertising study for the Michael E. DeBakey VA Medical Center.
The Michael E. DeBakey VA Medical Center in Houston (MEDVAMC) carries one of the most difficult mandates in American healthcare: reaching veterans before a crisis takes hold. Suicide remains the 13th leading cause of death for veterans overall, and the second leading cause of death for veterans under the age of 45. Evidence-based psychotherapies (EBPs) for PTSD have been shown to work. The harder problem was getting the veterans who needed that care to see it, trust it, and take a first step toward it.
MEDVAMC did not come to STRIVE3 needing a single advertisement. It needed a way to find out, with evidence rather than assumption, which message would actually move a veteran who had screened positive for PTSD but had not yet started treatment. That distinction shaped everything that followed.
Working under contract with the Department of Veterans Affairs, STRIVE3 was engaged to research, plan, and produce a set of direct-to-consumer (DTC) video advertisements that MEDVAMC could test head-to-head in a controlled study, then use the results to guide a larger outreach campaign. The engagement followed the same four-stage approach STRIVE3 applies across its mission-driven partnerships: Strategy, Story, Activation, and Momentum.
STAGE ONE — STRATEGY
Understanding What Would Actually Reach a Veteran
Before a single frame was shot, STRIVE3 helped MEDVAMC answer a more fundamental question than “what should the ad say?” The question was, “what kind of message does a veteran with PTSD actually believe?”
STRIVE3 supported MEDVAMC's research team in presenting a full range of established advertising approaches (testimonial, expert opinion, social norms, utility, compare/contrast, and others) to focus groups of veterans and family members, then asked participants which strategies they found most convincing. The findings were clear and, in places, counterintuitive:
- Testimonial messaging, delivered by someone the veteran could relate to, was the strategy veterans trusted most. Participants said a person's story would move them further than statistics or expert opinion.
- Comparing therapy to medication mattered. Because medication is often perceived as the VA's default response, veterans wanted to see the case for psychotherapy made directly against that expectation.
- Language itself was a barrier. Several veterans said they were put off by the term “psychotherapy” and responded better to “therapy” or “counseling.”
- Family involvement surfaced repeatedly as a factor in whether a veteran would seek care, pointing toward a role for family members in the creative itself.
This research became the foundation for everything MEDVAMC and STRIVE3 built next. Rather than guessing at a single creative direction, the strategy phase gave the project a testable hypothesis: message delivery (testimonial versus non-testimonial) and message content (treatment utility versus compare/contrast with medication) would each independently affect how a veteran responded.
STAGE TWO — STORY
Designing a Narrative That Could Be Tested, Not Just Told
Most campaigns choose one story and tell it well. This one required a different kind of storytelling discipline: the same message, told through six distinct creative approaches, precise enough that any difference in how veterans responded could be traced back to a specific storytelling choice rather than noise.
STRIVE3 helped shape a story architecture built around a 2x2 experimental design, crossing delivery method with message content, plus two control videos:
- Testimonial, treatment utility — a veteran describing how EBP treatment worked for them.
- Non-testimonial, treatment utility — the same information delivered as a direct message rather than a personal account.
- Testimonial, compare/contrast — a veteran who had tried both medication and psychotherapy speaking to the difference.
- Non-testimonial, compare/contrast — the same comparison delivered without a personal story.
- Control: a general PTSD education message.
- Control: a standard direct-to-consumer message about health behaviors, unrelated to PTSD treatment.
One idea from the focus groups shaped the creative concept directly: a multicultural father-daughter pairing, with a Vietnam-era veteran father recounting his own path through therapy to his newly discharged daughter. It let the testimonial videos carry an intergenerational, family-centered message without needing to cast a different veteran for every demographic the campaign hoped to reach, while keeping every version of the ad consistent enough for a fair comparison.
The goal was never a single compelling ad. It was a defensible answer to which message actually changes a veteran's mind.
STAGE THREE — ACTIVATION
From Research Design to a Two-Day Shoot in Houston
Turning a research design into six finished videos required the same production discipline as any campaign, plus a layer of precision the study demanded. STRIVE3 built out the full creative brief and storyboards, developed interview questions and subject guidelines, and prepared a shot list and release forms in coordination with MEDVAMC and the VA research team, all reviewed on a defined timeline from kickoff through final approval.
STRIVE3's team traveled to Houston to film on-site at MEDVAMC over a two-day shoot, working with veteran participants, family members, and MEDVAMC clinicians who spoke to the effectiveness of the treatments. The subject matter required particular care as the interview process was built around these delicate treatment options, not just the needs of the shot list.
- Regular project management calls with the VA and MEDVAMC to keep creative direction aligned with the research protocol
- On-site interviews each subject
- B-roll capture to support each of the six message conditions
- Editing, sound design, and color grading for each 60- to 120-second video, carried from rough cut through client revisions to final delivery
Because every version needed to stand up to comparison, consistency mattered as much as craft. The same visual language, pacing, and production quality carried across all six videos, so that when veterans in the study responded differently to one over another, the difference could be attributed to the message, not the execution.
STAGE FOUR — MOMENTUM
Built to Be Measured, Not Just Watched
The videos were never the end product. They were the instrument. MEDVAMC's research team then tested the six advertisements with 600 veterans who screened positive for PTSD but were not yet in treatment, randomly assigning each participant to one video and measuring the outcomes that matter most: attitudes toward psychotherapy, stigma, intention to seek treatment, willingness to recommend therapy to other veterans, and, through chart review, whether veterans went on to actually start care.
That structure is what makes this engagement different from a typical awareness campaign. Instead of launching a message and hoping it resonates, MEDVAMC will know which combination of delivery and content moves veterans closest to treatment, then can direct future outreach dollars toward the approach the data supports rather than the approach that simply felt right in a creative review.
The videos also carry a life beyond the study itself. Once testing is complete, the best-performing content is positioned for wider use across additional direct-to-consumer outreach, media and PR opportunities, social channels, and on-site displays at MEDVAMC, extending the reach of whichever message proves most effective at helping veterans take the first step toward care.
Why This Engagement Matters
Most organizations STRIVE3 partners with are trying to move people toward belief and generosity. This engagement asked something more specific and, in some ways, more consequential: help a group of veterans in crisis feel understood enough to seek care that could save their lives. Applying the same disciplined approach, understanding the audience first, building a story architecture that could carry the mission, executing with care, and designing for measurable results, meant the work could hold up to both creative and clinical scrutiny.
For MEDVAMC and the VA, that combination is the point. A campaign built on assumption might have looked and sounded compelling. A campaign built on evidence gives the VA a defensible, data-informed path to reaching more veterans with the treatments that can help them, and to doing it at scale.
The STRIVE3 approach in viewing the full landscape and context of a problem is what made the difference and what makes every initiative thrive. Building momentum starts with a strategy that anchors execution and drives lasting impact.
