Center for Health Equity Research and Promotion
CHERP FY17 Pilots Address Equity
The Center for Health Equity Research and Promotion (CHERP), a VA HSR&D Center of Innovation, has recommended four pilot research projects for funding in FY2017. These one-year projects, submitted by VISN 4 investigators, focus on improving equity and/or quality in health and health care among Veterans.
John Blosnich, PhD: Provider Utilization of the VA Transgender E-consultation Program. To increase VA’s capacity to provide high quality care to transgender Veterans, the VA Office of Patient Care Services developed a transgender e-consultation program as a resource for expert clinical guidance for VA health care providers; the program was implemented nationally in April 2015. This quality improvement project is designed to examine the utility and reach of this program among providers. For providers who used the transgender e-consultation program, interviews will provide information regarding their experiences with the e-consultation program and perceived impact on clinical practice and patient care. For providers who cared for a transgender patient but did not use the program, they will examine clinical practice characteristics and survey these providers regarding reasons for not using the transgender-econsultation program. The ultimate goal of this quality improvement project is to enhance care for transgender Veterans throughout the nation.
Adam Bramoweth, PhD: Increasing Access to Behavioral Insomnia Treatment: A Hybrid Type 1 Pilot Trial. Chronic insomnia is among the most reported complaints of Veterans and military personnel referred for mental health services. It is highly comorbid with medical and psychiatric disorders, and is associated with significantly increased healthcare utilization and costs. Uptake of Brief Behavioral Treatment of Insomnia (BBTI) into VA Patient Aligned Care Teams (PACTs) could effectively and efficiently increase access to insomnia treatment and decrease the risks and burdens associated with chronic insomnia. Although efficacious, it is not known if BBTI achieves the same clinical outcomes as Cognitive Behavioral Treatment for Insomnia (CBTI), a VA supported evidence-based psychotherapy. This pilot project will support a randomized clinical trial to compare the efficacy of BBTI to CBTI and identify implementation factors associated with the delivery of BBTI in PACTs . This information will be used to inform and improve access to insomnia treatment in the VA.
Dagan Coppock, MD: Identification of Men Who Have Sex with Men in the VA Electronic Health Record. Sexual orientation is not systematically documented in the VA electronic health record (EHR), which makes it difficult to understand and address the health-related needs of men who have sex with men (MSM), a potentially vulnerable group of Veterans. Developing a robust way of identifying MSM based on data currently available in the EHR would greatly increase the VA’s capacity to identify and eliminate health and healthcare disparities based on sexual behavior. This study proposes to combine data from the Veterans Aging Cohort Study (VACS) with data from VA electronic health records (EHR) to explore potential ways to identify MSM. This pilot work will form the foundation of future studies examining the health and healthcare needs of MSM in the Veteran patient population.
Shari Rogal, MD, MPH: Prescription Opioid Use in Veterans with Chronic Liver Disease. Using a national database of over 200,000 Veterans with advanced chronic liver disease, this project will seek to determine the prevalence of chronic prescription opioid use in this population, and to relate this use to subsequent major adverse health outcomes, including hospitalization and death. The study will provide information regarding the prevalence and predictors of opioid use in Veterans with cirrhosis and evaluate the differences in health outcomes (i.e., hepatic decompensation, death, and hospitalization) for Veterans with cirrhosis prescribed vs. not prescribed opioids. The longer term plan is to use this pilot as background research focused on devising and implementing strategies to safely manage [chronic] pain and addiction among Veterans with cirrhosis.
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