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Faculty, News, & Accomplishments


November 2019 Update on News and New Funding


New VA HSR&D Projects Approved for Funding, noting CHERP investigators:

*Strengthening Suicide Prevention Efforts for Women Veterans through the Veterans Crisis Line (IIR); Melissa Dichter, PhD, MSW (PHL) PI; Scarlett Bellamy, ScD (PHL) Co-I

*Addressing Intimate Partner Violence Among Women Veterans: Evaluating the Impact and Effectiveness of VHA's Response (SDR); Melissa Dichter, PhD, MSW (PHL) Co-I (PI: Katherine Iverson, PhD, Boston)

*The Effects of Screening and Referral for Social Determinants of Health on Veterans’ Cardiovascular Outcomes (IIR); Melissa Dichter, PhD, MSW (PHL) Co-I (PI: Deborah Gurewich, PhD, Boston)

*Caregiver SOS:  An Intervention for Employed Caregivers (IIR); Shahrzad Mavandadi, PhD, (PHL) PI

*A Randomized Controlled Trial of Coaching into Care with VA-CRAFT to Promote Veteran Engagement in PTSD Care (IIR); Steve Sayers, PhD (PHL) MPI (PI: Eric Kuhn, PhD, Palo Alto).

*Does Adding a Tailored Cognitive Behavioral Therapy (CBT) Mobile Skills App Mediate Higher Rates of Depression Recovery, Adjustment, and Quality of Life in OEF/OIF Veterans Compared to Standard CBT (IIR); Michael Thase, MD, (PHL) Co-I (PI: Judith Callan, PhD, RN, Pittsburgh)

More new funding

Leslie Hausmann, PhD (PGH) received renewed funding for FY20 from the Office of Health Equity for a partnered initiative to obtain stakeholder input and apply human-centered design principles to test an equity dashboard in the field.

Ann-Marie Rosland, MD, MS (PGH) received renewed funding for FY20 from the VHA Primary Care Analytics Team (PCAT) to support her leadership of the PCAT High Risk Patient Workgroup.

Utibe Essien, MD, MPH (PGH) received a Young Investigator Seed Grant from the American Heart Association to study racial disparities in a national database of over 40,000 patients with atrial fibrillation hosted by the AHA and Duke clinical Research Institute.

Welcome new CHERP Investigator, Katie Suda, PharmD, MS

Katie J. Suda, PharmD, MS, has joined CHERP as Investigator and Associate Director, Clinical Therapeutics. She is also Professor of Medicine at the University of Pittsburgh.  Dr. Suda’s research focuses on outpatient prescribing using national population-level datasets. This includes antibiotics and opioids, Veterans receiving care at multiple health systems, and determining the effectiveness of medication management strategies. She currently leads both NIH and VA-funded studies on overprescribing of antibiotics and opioids by dentists. Link to Dr. Suda bio on CHERP website.   Link to Katie J. Suda on Google Scholar. 

Faculty Accomplishments


Daniel Hall, MD, MDiv, MHS (PGH) was a Gold Status winner in the 2019 VHA Shark Tank Competition. He received bids from the Iowa City, Gainesville, and Lexington VAs for implementation of his practice, “Pre-operative Frailty Screening and Prehabilitation.”  Dr. Hall’s November 12, 2019 article (with Ada Youk et al) in JAMA Surgery on the association of preoperative patient frailty and operative stress with postoperative mortality was briefed to the national VA leadership council.

Research by John Blosnich, PhD, MPH (PGH), Melissa Dichter, PhD, MSW (PHL), and colleagues that examined documentation of social stressors in VA electronic health records and how these social stressors were associated with suicidal ideation and suicide attempt among Veterans was briefed to VA senior leaders (pending publication in the Journal of General Internal Medicine).

The Penn School of Nursing Practice Committee invited Melissa Dichter, PhD, MSW (PHL), to present their Veterans Day Grand Rounds at the Hospital of the University of Pennsylvania (HUP), on Addressing Intimate Partner Violence (IPV) in the Healthcare Setting: Findings from Research with Women Veterans. 

Melissa Dichter, PhD, MSW (PHL) has been selected for the 2019 Cohort of Interdisciplinary Research Leaders by The Robert Wood Johnson Foundation.  “Team Philadelphia,” a three-year initiative led by Dr. Dichter, Ashlee Murray, MD, MPH, an emergency medicine physician at the Children’s Hospital of Philadelphia, and Jessica Palardy, MSW, of Lutheran Settlement House, will address Centering Survivor Voices to Improve Medical-Community Partnerships Addressing Intimate Partner Violence. Link to full description.

During a recent visit by the VA Secretary, Walid Gellad, MD, MPH (PGH) was invited to brief him on the impact of CHERP’s HSR&D funded medication dual use research – specifically how it led to an agreement between VA and CMS to share medication data. The emphasis of the briefing was on how HSR&D can impact clinical care.

Mitesh Patel, MD, MBA, MS (PHL) has been named a Ralph W. Muller Presidential Assistant Professor of Medicine.  The award was newly renamed in honor of Mr. Muller, who served as CEO of the University of Pennsylvania Health System from 2003 to 20019.

 


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Melissa Dichter, PhD, MSW,
(PHL) will present at a special event on Tuesday, October 22, 5 pm - 6:30 pm on "Violence Against Women and the U.S. Military."  Here are more details:

Learn about current policy and research on violence against women and the U.S. military.

Panelists:

Melissa Dichter, Ph.D., M.S.W., Temple University, conducted multiple studies on violence against women service members
 
Andrea Goldstein, MALD, Senior Policy Advisor to the new Women Veterans Task Force, House Committee on Veterans’ Affairs, and former Special Operations Forces troop commander

Andrew Morral, Ph.D., RAND Corporation, who authored several reports to Congress on sexual assault and harassment in the military.
 
Emily Rothman, Sc.D., Boston University and, for 2019-2020, is with the Department of Defense, who just completed sexual assault prevention study in the Navy.
 
Moderator:

Kathleen Brown, Ph.D., Penn Department of History and Director of Gender, Sexuality, and Women's Studies

Tuesday, October 22, 2019 from 5:00 PM to 6:30 PM (EDT)

Fitts Auditorium at Penn Law
3501 Sansom Street
Philadelphia, PA 19104

 Reception to follow.

Register for the event HERE.

 

CHERP Bulletin

September 2019

_______________________________________________________

New Funding

Congratulations to three CHERP investigators who were selected to receive awards from the VISN4 Competitive Career Development Fund (CCDF)

  • Robert Burke, MD, MS (PHL):  Improving Veteran Mobility in Post-Acute Care
  • Utibe Essien, MD, MPH (PGH): The Race, Ethnicity, and Anticoagulant Choice in Atrial Fibrillation (REACH-AF) Study
  • Steven Weisbord, MD, MSc (PGH): Management of Acute Coronary Syndrome Among Veterans with Chronic Kidney Disease

 

Thomas Radomski, MD, MS (PGH) was awarded a K23 grant from the National Institute on Aging to investigate “The Development, Validation, and Application of a Claims-based Metric of Low-Value Prescribing in Older Adults.”

Shari Rogal, MD, MPH (PGH) has received notice of QUERI’s intent to fund her partnered evaluation initiative with the HIV, Hepatitis and Related Conditions Program Office: Using Data-Driven Implementation Strategies to Improve the Quality of Cirrhosis Care.

 

Faculty Accomplishments

Congratulations to Sonya Borrero, MD, MS (PGH) on her promotion to Professor of Medicine; Clinical and Translational Science; and Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine.

Utibe Essien, MD, MPH (PGH) presented “Social Determinants:  The Forgotten Risk Factor in Atrial Fibrillation” for Grand Rounds for the Department of General Internal Medicine at the University of Pittsburgh School of Medicine on September 6.

Hayley Germack, PhD, MHS, RN (PGH) addressed “When Rural Hospitals Close, the Local Physician Workforce Goes” for the Health Services Research Seminar co-sponsored by the University of Pittsburgh Center for Research on Health Care, CHERP, and RAND on September 12.  Read more here

An article by C. Bernie Good, MD, MPH (PGH) was briefed to VHA Senior Leadership.  Varenicline and Nicotine Replacement Use Associated with US Food and Drug Administration Drug Safety Communications. JAMA Network Open. September 4, 2019;2(9):e1910626.

Mitesh Patel, MD, MBA, MS received the BX Award for Outstanding Practitioner of the Year on September 5 in London by the Behavioural Insights Team.  This award is given to one person across all industries internationally who has made an outstanding contribution to the field of behavioral science and policy.  Read more on CHERP’s website.

“The influence of research evidence on dissemination and implementation of social policy: A systematic review,” a poster by Dierdre Quinn, PhD, MS, MLitt (PGH), et al.,  was chosen as the best poster abstract in the “Health Policy Dissemination and Implementation (D&I) Science” track for the AcademyHealth D&I national meeting in December.  It is one of the nine posters to be considered for the 2019 Best Poster award at the meeting. 

 

Mark Your Calendar

Melissa Dichter, PhD, MSW (PHL), will be a panelist on “Violence against Women and the U.S. Military,” to be held at the University of Pennsylvania Law School, October 22, 2019, 5 – 6:30 pm.  Link to register.

Marilyn Schapira, MD, MPH (PHL) will be on an expert panel about “Making Health Interventions Smarter Through Behavioral Science,” contributing her views of shared decision-making, health literacy, risk communication, and women’s health.  Hosted by Penn’s Master of Behavioral & Decision Sciences Program on Sept. 19.  Link to register

 

CHERP @ VA HSR&D/QUERI

Congratulations to the CHERP investigators who were invited to present their work at the VA HSR&D/QUERI national meeting. 

Oral presentations:

Blosnich JR, Montgomery AE, Dichter ME, Gordon AJ, Kavalieratos D, Taylor L, Bossarte RM Leveraging VA Electronic Health Record Data to Assess Associations Of Social Determinants of Health with Suicide Risk among Veterans.

Thorpe CT, Mor MK, Zhang S, Sileanu FE, Zhao X, Aspinall SL, Ersek MJ, Hanlon JT, Hunnicutt J, Niznik JD, Springer S, Gellad WF, Schleiden LJ, Thorpe JM Statin Discontinuation in Veterans Affairs (VA) Community Living Center Residents with Limited Life Expectancy.

Goldberg RG, Chinman M, Peeples AD, McCarthy  SA, Daniels KS, Vineyard NS Evaluating Facilitated Implementation: Peer Specialists in Patient Aligned Care Teams.

Jones A, Burkitt KH, Fine MJ, Hausmann LRM National Media Coverage and Health System Distrust in the Department of Veterans Affairs.

Montgomery AE, Rodriguez K, Klima G, Shipherd J, Kauth M, Harris K, Blosnich JR Housing Instability, Use of VHA Homeless Programs, and Challenges to Accessing Care Among Transgender Veterans.

Quinn DA, Mor MK, Sileanu FE, Zhao X, Callegari LS, Zephyrin L, Borrero S  Assessing Women Veterans' Preconception Wellness.

Rogal S, Yakovchenko V, Gonzalez R, Park A, Lamorte C, Gibson S, Chartier M, Ross D, Comstock, Bajaj, Morgan T Characterizing Patient-Reported Quality of Life and Care Satisfaction in a National VA Quality Improvement Program.

Smith JL, Ritchie MJ, Kim B, Miller CJ, Chinman M, Landes S, Kelly PA, Kirchner JE Getting to Fidelity: Identifying Core Components of Implementation Facilitation Strategies.

Yakovchenko V, Gonzalez R, Park A, Morgan T, Chartier M, Ross D, Chinman M, Rogal S Longitudinal Assessment of Expert Recommendations for Implementing Change (ERIC) Strategies in the Uptake of Evidence-Based Practices for Hepatitis C Treatment in the Veterans Administration.

Zhao X, Vijan S, Maciejewski M, Zulman D, Thorpe J, Batten A, Zhang H, Daniels K, Rosland AM Hospitalization, Re-Hospitalization, Mortality, and Utilization Patterns Predicted by Novel High-Risk Patient Latent Subgroups and Complexity Scores.

Posters:

Aspinall SL, Fina PM, Zhao X, Glassman PA, Moore VR, Au A, Cunningham FEAdverse Drug Event Reporting among Patients who Discontinued Empagliflozin or Apixaban in the Veterans Health Administration.

Aspinall SL, Sylvain N, Zhang R, Dong D, Echevarria K, Glassman PA, Goetz MFluoroquinolone Adverse Drug Events: Results of an Active Surveillance Project.

Chinman M, Oberman RS, Cohen AN, Salyers MP, Twamley EW, Young AS, Hamilton AB Improving Patient Activation in a Cluster Randomized Trial Evaluating Implementation and Outcomes of VA Mental Health Peer Specialists.

Quinn DA, Sileanu FE, Zhao X, Mor MK, Judge-Golden C, Callegari LS, Borrero  S Racial and Ethnic Differences in Women Veterans' History of Unintended Pregnancy and Contraceptive Use.

 

For Your Consideration

Call for Papers:  The American Journal of Public Health (AJPH) will publish a special supplement issue “Aligning Health and Social Service Systems to Improve Population Health:  Science, Policy and Practice.”  The deadline is December 15, 2019.  Here is a link to the AJPH.org Instructions for Authors.

VA QUERI will present a Cyberseminar “Everything You Need to Know About QUERI Non-research (“QI”)  Protocols,” on September 30th from 11am-12:30pm. The Cyberseminar will provide an in-depth review of QUERI policies and procedures, including the definition of non-research (i.e., “quality improvement”- QI) in VA as described in ORD Program Guide 1200.21, and QUERI resources to support non-research work in the VA. Use this link to register

HSR&D is offering a series of Cyberseminars on Communication Strategies for Health Services Researchers – the series focuses on communication strategies specifically for health services researchers. Presenters are researchers or communication professionals working in health services. The series will start with an introduction and overview, then move on to working with stakeholders, identifying your audience, and writing in plain language. Read more and register on HSR&D site.

 

Notices

If you are active on Twitter, we’d like to highlight your work there. Please follow CHERP @vaequity. 

Please notify CHERP when manuscripts you (co-)author are accepted for publication – this includes articles not specific to VA research. Philadelphia faculty:  please send manuscript to Carson Clark (Carson.Clark@va.gov) Pittsburgh faculty: to Karen Evans (Karen.Evans3@va.gov)

Please send updates about funding, publications, presentations, awards, and promotions to Carson.Clark@va.gov.

 

 

 

 



Walid Gellad, MD, MPH, (PGH) has been named a recipient of the Presidential Early Career Award for Scientists and Engineers (PECASE), the highest honor awarded by the federal government to science and engineering professionals in the early stages of their research careers. Dr. Gellad is one of four VA scientists to earn a PECASE this year.  Read more on CHERP’s website

Amol Navathe, MD, PhD, (PHL) has been appointed by the US Government Accountability Office to the Medicare Payment Advisory Commission (MedPAC) for a three-year term. 

Congress established MedPAC in 1997 to analyze access to care, cost and quality of care, and other issues affecting Medicare. MedPAC advises Congress on payments to providers in traditional fee-for-service programs and to health plans participating in the Medicare Advantage program.

 Shari Rogal, MD, MPH, (PGH) presented a talk on “Using Implementation Science to Improve Care for Patients with Chronic Liver Disease” on June 24 for the University of Pittsburgh Provost’s Inaugural Lecture Series.

 Research published by Sonya Borrero, MD, MS (PGH) and CHERP colleagues Colleen Judge-Golden and Maria Mor, PhD in JAMA Internal Medicine on “Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System” was covered by major news outlets, including USA Today, ABC News, NPR, and Reuters.

 Joseph Hanlon, PharmD, MS, (PGH) was recognized by Expertscape as a World Expert in the topic of Medical Errors, https://bit.ly/31SdXVV, based on his contributions to 22 articles from 2008-2019.

 A poster presented by Lena Makaroun, MD, MS, (PGH) at the American Geriatrics Society Annual Scientific Sessions on “Intimate Partner Violence in Middle-Aged and Older Women: Prevalence, Associated Health Conditions and Health Service Utilization” was selected as 1 of 3 (out of 970 posters) to be in the Science and Innovation Walking Tour at the meeting and for the Presidential Poster Award in the epidemiology section. Also, she has been recruited to join VAPHS as a Staff Physician and CHERP Core Investigator; she has also received an appointment as Assistant Professor of Medicine in the University of Pittsburgh Department of Medicine, Division of Geriatric Medicine.

 Sharon McCarthy, PhD, MSW, MBA, (PGH) was invited to participate in the “New Direction for Peer Support: Joining the Patient Aligned Care Team to Improve Population Health and Prevent Suicide” conference hosted by the Office of Mental Health and Suicide Prevention to educate PACT members about the engagement of peer specialists in the primary care setting.

 Joshua Thorpe, PhD, MPH, (PGH)was appointed as a standing study section member of AHRQ’s Healthcare Safety and Quality Improvement Research.

 Kelly Burkitt, PhD, (PGH) was invited to serve as a standing member of the VA QUERI Scientific Merit Review Board.

 The VHA Shark Tank project submitted by Dan Hall, MD, MDiv, MHS, (PGH) “Pre-operative Frailty Screening and Prehabilitation,” is 1 of 100 Semi-Finalists; 15 finalist projects will be selected in August for Shark Tank pitches in Washington DC in October.

 Peter Groeneveld, MD, MS, (PHL) has been named Co-Director of Penn’s Master of Science in Health Policy Research (PennMSHP). The MSHP is a rigorous, skills-based research degree that enables clinicians to leverage their knowledge of medical practice to improve the ways in which health care is organized, financed, managed and delivered. Read more about PennMSHP.

  

 

 New Funding Announcements

Charles Atwood, MD, (PGH) is Site PI on a new HSR&D 3-site pragmatic clinical trial – the DREAM study (Direct Referral for Apnea Monitoring) – led by Katie Sarmiento from the San Francisco VA.

 Lena Makaroun, MD, MS (PGH) is the recipient of FY20 GRECC pilot funding for her project, Provider Perspectives on Elder Abuse Among Veterans;” CHERP collaborators include Keri Rodriguez, PhD and Ann-Marie Rosland, MD, MS (PGH).

 

  Call for Papers

VA HSR&D has issued a Call for Papers on Embedded Research, to be published in Healthcare:  The Journal of Delivery Science and Innovation.  The supplement will be a resource to those aiming to improve the relevance and use of health research to improve patient care. This call for papers closes on Sept. 27, 2019. Read the full call for papers here and submit today!  CHERP Investigator Amol Navathe, MD, PhD (PHL) is a Founding Editor-in-Chief of the Journal. 

 

  Other News

 

If you’d like to stay abreast of the work of Department of Veterans Affairs researchers nationwide, sign up here for email updates from VA’s Office of Research and Development. You will receive emails two to three times per month with links to feature stories, news briefs, researcher interviews, and other content highlighting study findings and other news from VA Research.

 

  Social Media

Follow CHERP on Twitter@vaequity  CHERP Twitter had 11,500 tweet impressions in the past four weeks.  If you are active on Twitter, we’d like to highlight your work, too. 

 

 

 








Michael Fine, MD, MSc, wins 2019 VA HSR&D Daniel Deykin Award for Outstanding Mentor

The 2019 VA HSR&D Daniel Deykin Award from Outstanding Mentor goes to CHERP Director Michael J. Fine, MD, MSc, in recognition of his extraordinary contributions to a generation of health services researchers at VA and the University of Pittsburgh.  Many of his 68 mentees and trainees have led highly successful research portfolios and become national leaders in VA, academia, and beyond.  Dr. Fine’s mentees’ success is magnified by the impact their scholarship has had in shaping health services research, patient care, and health care policy. 

“Michael has been the driving force behind my academic career development and transition to independence as a VA health services researcher,” wrote Walid Gellad, MD, MPH, CHERP Core Investigator and former VA Career Development Awardee.  “A key to my success as a VA investigator has been the way Michael impressed upon me the importance of ensuring that my work has direct relevance to the VA Healthcare System and Veterans. As my mentor, Michael helped me forge strong partnerships with VA leaders, locally and nationally. These relationships positioned me to identify and act on high impact opportunities for research and quality improvement in VA and supported the dissemination and translation of my work within and beyond VA.”

Just three years after he was recruited to VA Pittsburgh Healthcare System in 1997, Dr. Fine collaborated with David Asch, MD, MBA, to establish the VA Center for Health Equity Research and Promotion (CHERP) as the first two-site Center of Excellence in VA HSR&D. For 18 years, as Director of CHERP, he has led a high-impact national research program focused on improving the quality and equity of health and health care for vulnerable Veteran populations, successfully competing for Center renewal in 2007, 2013, and 2018. 

Dr. Fine’s influential and sustained contributions as a clinical investigator and mentor have been recognized with national research awards, including his election to the American Society of Clinical Investigation (1998) and the Association of American Physicians (2009).  He received the John M. Eisenberg Award for Career Achievement in Research from the Society for General Internal Medicine (SGIM) in 2011.

Dr. Fine will receive the award at the VA HSR&D National Meeting, Summer 2019.  Link to HSR&D Announcement.

Link to PubMed




















(Archived Announcements)

VHA Chief of Staff Carolyn Clancy, MD, officially announced the 11 Gold Status Fellows of the 2018 VHA Shark Tank Competition, including CHERP Co-Director Judith Long’s IMPaCT community health worker program. VA leaders noted that this was a record-breaking year with 450 applications, 20 finalists and 11 winners.  The IMPaCT team will work with the Iowa City VA to implement the model there. 

 To learn more about the “Community Health Worker Boom,” read this NEJM Catalyst article by Shreya Kangovi and David Asch. To learn more about IMPaCT, go to http://chw.upenn.edu/about/

 

Burke Article Named One of 11 Most Effective Articles in Geriatric Medicine

An article by Robert Burke, MD, MS,” How Hospital Clinicians Select Patients for Skilled Nursing Facilities “ was named one of the most effective articles of 2017 by the Journal of Geriatric Medicine.  Dr. Burke moved to CHERP’s Philadelphia site from the Denver-Seattle COIN in June 2018.  He is also a VA HSR&D Career Development Awardee. 

 

Hausmann Clinical Trial in the News

Leslie Hausmann, PhD, was interviewed for a feature story on Healio.com about her HSR&D IIR 13-080, the largest clinical trial, to date, testing the effect of positive psychological intervention for pain and impairment from knee osteoarthritis. Here is a link to the article:  Healio.com

 

Read Dr. Hausmann’s article in JAMA Open Network. “Effect of a Positive Psychological Intervention on Pain and Functional Difficulty Among Adults with Osteoarthritis.”

 

On Oct. 10, Dr. Hausmann presented an HSR&D cyberseminar with newly-appointed Director of the VA Office of Health Equity, Eugene Moy, MD, PhD on how we communicate health equity data to promote health and well-being for Veterans and engender action from stakeholders.

New funding:

Emily Brignone, John Blosnich, Ann Elizabeth Montgomery (VA Birmingham) and Melissa Dichter were awarded a grant from the National Center on Homelessness among Veterans (NCHAV) to examine the relationship between housing instability and suicide risk entitled: Understanding Risk for Suicidality among Veterans Who Experience Housing Instability.

 

Mitesh Patel, MD, MBA, MS will lead his first NIH R01, Behavioral Economic Approaches to Increase Physical Activity among Patients with Elevated Risk for Cardiovascular Disease. This is a $2.5 million grant from NHLBI to test behavioral economic approaches to increase physical activity among patients at elevated risk for cardiovascular disease. Mitesh and colleagues want to see if they can take gamification from the realm of an interesting idea that has only been tested for short durations to an approach that could have longer-term effects on risk reduction.

People: Appointments, Promotions & Awards

New faculty:
• Rebecca Brown, MD (Philadelphia)
• Robert Burke, MD (Philadelphia)
• Manik Chhabra, MD (Philadelphia)
• Utibe Essien, MD, MPH (Pittsburgh)

New fellows
• Beth Field, PhD, OTR/L (CHERP/GRECC; Pittsburgh); focus: care for aging adults with dementia (mentor: Ann-Marie Rosland, MD, MS)
• Stephanie Gannon, MA (Pittsburgh); focus:  addictions and dual diagnosis (mentor: Gretchen Haas, PhD, and Gretchen Hulse, MDiv, MS, BCC)
• Brittany Hollis, PhD (Pittsburgh); focus: women Veterans, military sexual trauma (mentor:  Melissa Dichter, PhD, MSW) Starting in early 2019
• Jacob Hunnicutt, PhD (Pittsburgh); focus:  medication use and safety in older adults (mentor:  Walid Gellad, MD, MPH)
• Jeffrey Lienert, PhD (Philadelphia); focus:  social epidemiologic analyses of electronic medical records to assess how social interactions impact health and outcomes (mentor:  Mitesh Patel, MD, MBA, MS) Starting in November 2018
• Lena Makaroun, MD, MS (Pittsburgh); focus: improving care for vulnerable older adults (mentor:  Ann-Marie Rosland, MD, MS)
• Deirdre Quinn, PhD, MS, MLitt (Pittsburgh); focus:  the impact of military life on relationships and its influence on women Veterans’ reproductive health behaviors (mentor:  Sonya Borrero, MD, MS)
• Michelle Vu, PharmD, MPH (Pittsburgh); focus:  health economics and pharmacoepidemiology (mentor:  Fran Cunningham, PhD)

Promotions: 
• Walid Gellad, MD, MPH was awarded tenure in the University of Pittsburgh School of Medicine (UPMC)
• Pete Groeneveld, MD, MS, was promoted to tenured full Professor at the University of Pennsylvania Perelman School of Medicine
• Dan Hall, MD, MDiv, MHS has a new administrative role at UPMC as Medical Director for High Risk Populations and Outcomes at the Wolff Center

Awards and recognition
• CHERP Co-founder David Asch has received 2 recent honors.
o He just won the AAMC-RWJF David E. Rogers Award. This major award sponsored by both RWJF and the Association of American Medical Colleges (AAMC), recognizes "a medical school faculty member who has made major contributions to improving the health and health care of the American people."
o Penn’s Masters of Science in Health Policy Research (MSHP), run by CHERP Investigators Rachel Werner and Judy Shea, has a new award honoring David.  The David A. Asch Medical Student Scholars in Health Services Research Award pays for 1-2 students per year to complete a dual MD/MSHP degree and covers 100% of the MSHP tuition.

• John Blosnich, PhD, MPH received an ICARE Award for outstanding LGBT Veteran service by the LGBT Program in the Office of Patient Care Services

• Sonya Borrero, MD, MS was invited to serve on the Pennsylvania Maternal Mortality Review Committee signed into law in May by Governor Wolf

• Kelly Burkitt, PhD received the VAPHS 2018 Research Staff Achievement Award

• Matt Chinman, PhD was recently interviewed for a KBIA feature about peer support in the VA
• A paper co-authored by Walid Gellad, MD, MPH was selected by the American Association of Colleges of Pharmacy Social and Administrative Sciences Section for the 2018 Best Research Publication Award [Suda KJ, Smith BM, Bailey L, Gellad WF, Huo Z, Burk M, Cunningham F, Stroupe KT. Opioid dispensing and overlap in veterans with non-cancer pain eligible for Medicare Part D. J Am Pharm Assoc. 2017 May/Jun;57(3):333-340.e3]

• Josh Niznik, PharmD received the Best Paper Award in the Health Services & Policy Research Division at the American Geriatrics Society Annual Meeting for his work “Validating the MDS Mortality Risk Index in Older Adult Veterans Using MDS v3.0.”

• Mitesh Patel, MD, MBA, MS, won two major national awards in 2018: 
o Outstanding Junior Investigator of the Year from the Society of General Internal Medicine
o Alice S. Hersh New Investigator Award from AcademyHealth for “exceptional promise for future contributions to health services research.” 

• Galen Switzer, PhD was selected for the 2018 Excellence in Teaching Award from the University of Pittsburgh Institute for Clinical Research Education


New funding:

HSR&D Merit (IIR), SDR, Pilot (PPO), and QUERI Awards

Bob Burke, MD, MS (Co-I): Evaluating Care Coordination for Community Hospitalized Veterans to Improve Outcomes in Dual Use (ECHOeD) (PI: R. Neal Axon)

Manik Chhabra, MD (Co-I): Development and Pilot Testing of LIMIT: A Multi-Component Tool to Support Opioid Tapering (PI: Liana Fraenkel)

Judith Long, MD (Co-I): Continuing the Conversation: A Multi-Site RCT Using Narrative Communication to Support Hypertension Self-Management Among African American Veterans (PI: Sarah Cutrona)

Yu-Xiao Yang, MD, MS (Co-I): Evaluation of the National Randomized Proton Pump Inhibitor De-Prescribing (RaPPID) Program (PI: Sameer Saini)

Amol Navathe, MD, PhD (PI):  Segmenting High-Need, High-Cost Veterans into Potentially Actionable Subgroups (Co-I:  Ann-Marie Rosland, MD, MS)

Walid Gellad, MD, MPH and Steven Weisbord (Co-PIs): Examining Dual VA and Medicare Receipt of Health Care among Organ Transplant Recipients (Co-Is: Michael Fine, MD, MSc; Peter Groeneveld, MD, MS; Daniel Hall, MD, MDiv, MHS; Maria Mor, PhD; Galen Switzer, PhD)

Operational Funding

Ann-Marie Rosland, MD, MS (PI): Primary Care High Risk Patients Analytic, Evaluation, and Expert Network Core (Co-I: Joshua Thorpe, PhD, MPH)

HSR&D Supplemental and Locally Initiated Project (LIP) Awards

Walid Gellad, MD, MPH: Dissemination and implementation activities for IIR 14-297 (Safety of Opioid Use Among Veterans Receiving Care in Multiple Health Systems)

John Blosnich, PhD, MPH; Leslie Hausmann, PhD; and Melissa Dichter, PhD, MSW: Small Workgroup Meeting to Develop Health Services Research Priorities for Identifying and Addressing Social Determinants of Health among Veterans

Charles Atwood, MD: Qualitative Assessment of Sleep Apnea care for Rural Veterans

Leslie Hausmann, PhD: Using Electronic Health Records to Understand Patient-Reported Experiences with Discrimination in VA Care

Amol Navathe, MD, PhD: Segmenting High-Need, High-Cost Veterans into Potentially Actionable Subgroups (Co-I:  CHERP’s Ann-Marie Rosland, MD, MS)

FY19 VISN4 CHERP Pilot Awards

Leslie Hausmann, PhD: Determining the Feasibility of Using Natural Language Processing to Identify Source of Patient Perceptions of Discrimination from Provider Notes

Lena Makaroun, MD, MS: Describing Characteristics and Identifying Potential Risk Factors for Older Veterans Who May be Experiencing Abuse or Neglect

Ravi Parikh, MD, MPP: Disparities in Treatment Patterns and Survivorship Care Among Veterans with Advanced Prostate Cancer

Upcoming: 
Homeless Evidence and Research Synthesis Roundtable
Addressing Social Determinants of Health: Exploring Implications for Policy through the Veterans Health Administration's Universal Screening for Housing Instability Among Veteran Outpatients
Thursday, September 13, 1:00-2:30 pm EDT
Join the meeting online at http://va-eerc-ees.adobeconnect.com/hers/
Call 800-767-1750 and use access code 70207# for the audio

 






















Investigator Recognition and Achievements

• Walid Gellad, MD, MPH received the 2018 Leadership Award from the Association of Chiefs and Leaders of General Internal Medicine


• An article by Joshua Thorpe, PhD, MPH was selected as the 2017 VA HSR&D Best Research Paper of the Year Award [Thorpe JM, Thorpe CT, Gellad WF, Good CB, Hanlon JT, Mor MK, Pleis JR, Schleiden LJ, Van Houtven CH. Dual Health Care System Use and High-Risk Prescribing in Patients With Dementia: A National Cohort Study. Ann Intern Med. 2017 Feb 7;166(3):157-163]
 In addition, the Rho Chi Society, the School of Pharmacy’s chapter of their national honor society, selected this paper for the faculty “Outstanding Scholarly Contribution Award.”


• Joshua Niznik, PharmD received the 2018 American Geriatrics Society Scientist-in-Training Research Award presented to a pre-doctoral candidate who submitted the most outstanding abstract for the 2018 AGS Annual Meeting to be held in May [Niznik J, Zhang S, Mor M, Zhao X; Ersek M; Aspinall S; Thorpe J, Gellad W; Hanlon J; Schleiden L; Springer S; Thorpe C. Validating the MDS Mortality Risk Index in Older Adult Veterans using MDS v3.0]

 

New funding and affiliation:

John Blosnich, PhD, MPH is Co-PI (with Emily Williams) on a new NIAAA R21 grant, “Patterns of Alcohol Use and Alcohol-Related Care Among Transgender Persons” John was also invited to join the National Center on Homelessness among Veterans as an affiliated researcher for a 3-year renewable term.


Leslie Hausmann, PhD secured a Spark-Seed-Spread Innovation Investment from the VA Innovators Network for her project, “VHA Equity Explorer: Building an Interactive Equity Dashboard."


• A paper published in 2015 by Carolyn Thorpe, PhD, MPH and CHERP colleagues informed the Standards of Medical Care in Diabetes for Older Adults published by the American Diabetes Association in 2018 [Thorpe CT, Gellad WF, Good CB, Zhang S, Zhao X, Mor M, Fine MJ. Tight glycemic control and use of hypoglycemic medications in older veterans with type 2 diabetes and comorbid dementia. Diabetes Care. 2015 Apr;38(4):588-95]


• VA HSR&D selected CHERP research to highlight for briefing the VA National Leadership Council:

Radomski T, Bixler F, Zickmund S, Roman KL, Thorpe CT, Hale JA, Sileanu F, Hausmann LRM, Thorpe JM, Suda KJ, Stroupe KT, Gordon AJ, Good CB, Fine, MJ, Gellad WF. Physicians’ perspectives regarding prescription drug monitoring program use within the Department of Veterans Affairs: a multi-state qualitative study. Journal of General Internal Medicine (publication pending)

 




New CHERP Research Funding

Melissa Dichter, PhD, MSW (Co-Investigator, Site PI)  IIR 16-062 Recovering from Intimate Partner Violence through Strengths and Empowerment (RISE): Tailoring and Evaluating a Patient-Centered Counseling Intervention for Women Veterans

Melissa Dichter, PhD, MSW (Co-I, Site PI) PPO 17-044 Intimate Partner Violence (IPV) Screening Programs in VHA: Informing Scale-Up and Spread of Best Practices

Walid Gellad, MD, MPH – Moore Foundation:  Conservative Prescribing: Prescriber Profiling and Education Project 

Ann-Marie Rosland. MD, MS – NIDDK R01 proposal: Comparative Effectiveness of Adding Family Supporter Training and Engagement to a CHW-Led Intervention to Improve Behavioral Management of Multiple Risk Factors for Diabetes Complications scored at the 16th percentile

Kevin Volpp, MD, PhD – National Institute of Mental Health (NIMH) to establish a first-of-its-kind center to explore how behavioral economics and implementation science can be combined to improve mental health care treatments.  Link to full story.

 

 

Ersek Receives 2017 Norma M. Lang Award

Mary Ersek, PhD, RN, FPCN, received the 2017 Norma M. Lang Award for Scholarly Practice and Policy, given annually to a Penn Nursing faculty member or a graduate from the School’s doctoral program who has made a distinguished contribution to nursing through scholarly practice.   She delivered the lecture “I WONDER: Questions to Guide a Journey in Palliative Care,” on Wednesday, October 25, 2017 in the Ann L. Roy Auditorium of Claire M. Fagin Hall. Read the full story.

 

VA HSR&D Highlights CHERP Work on Intimate Partner Violence, Family Caregivers

In October, VA HSR&D highlighted current research in Intimate Partner Violence and included work by Melissa Dichter, PhD, MSW, Intimate Partner Violence Screening in the VHA: Demographic and Military Service Characteristics and High Prevalence of Intimate Partner Violence Among Women in VA Primary Care.  Sonya Borrero, MD, MS, was a co-author with Dichter on Intimate Partner Violence, Unhealthy Alcohol Use, and Housing Instability among Women Veterans in the VHA

In November, National Family Caregivers Month was the spotlight.  An article by Shahrzad Mavandadi, PhD, about her recent pilot project was featured.  Dr. Mavandadi  is now PI of merit review IIR 14-080, Comparative Effectiveness of Delivery Methods for Caregiver Support and Education.

 

 

CHERP Research Briefed to VA Senior Management

CHERP research briefed to VA senior management

VA HSR&D selects upcoming publications to distribute to VA senior management, including the Under Secretary for Health, Deputy Under Secretaries and Chiefs, to make them aware of new findings that could inform decision making and/or clinical practice.  Recently two articles by CHERP investigators were featured:  Gellad W, Thorpe J, Zhao X, Thorpe C, Sileanu F, Cashy J, Hale J, Mor M, Radomski T, Hausmann L, Donohue J, Gordon A, Suda K, Stroupe K, Hanlon J, Cunningham F, Good CB, Fine M. Impact of dual use of VA and Medicare Part D drug benefits on potentially unsafe opioid use. American Journal of Public Health.

Schwarz EB, Sileanu FE, Zhao X, Mor MK, Callegari LS, Borrero S. Induced abortion among women Veterans: data from the ECUUN study.  Contraception.

Other News Highlights

David Asch Testifies Before Senate

David Asch, MD, MBA, was one of four top experts to testify on the evolving field of behavioral economics before the U.S. Senate Committee on Health, Education, Labor and Pensions on October 17.  “Our nation has invested considerably in the science of medical treatment but less in the science of behavior change. Our knowledge of how to break old habits and develop healthier ones is rudimentary but it's getting better."  Link here to read more and watch a clip of Asch’s testimony.  

 Walid Gellad Profiled in GEN News

https://genengnews.com/gen-exclusives/walid-gellad-a-unique-voice-in-the-drug-pricing-debate/77901000

Genetic Engineering & Biotechnology News featured a profile of CHERP Investigator Walid Gellad, MD, MPH. 

Mitesh Patel Studies Behavioral Economics and Teens with Diabetes

Mitesh Patel, MD, MBA, MS, published an article in JAMA Pediatrics on the “Effects of Financial Incentive on Glucose Monitoring Adherence and Glycemic Control Among Adolescents and Young Adults with Type 1 Diabetes.” It is randomized controlled trial. In this study adolescents and young adults with type 1 diabetes were nearly three times more likely to monitor glucose levels when given a small financial incentive.  Behavioral economic interventions using financial incentives have been successfully used to increase adherence to chronic disease management regimens in adult populations, but have not yet been widely tested in younger populations. The authors say the study shows that the strategy may be an effective way to reach a population that has historically been considered difficult to engage.  Read more.

Welcome new CHERP faculty and fellows

Gilles Clermont, MD, MSc (associate faculty)

Rachel Bachrach, PhD (Addictions Fellow)

 

 

This bulletin does not necessarily represent the views of the US Department of Veterans Affairs or the US government.

October 2017 Bulletin


New Research Awards


Sonya Borrero, MD, MS:  NIMHD R01: Developing and Testing a Decision Support Tool for Women Making Tubal Sterilization Decisions
Matt Chinman, PhD:  HSR&D Merit Review:  Evaluating the use of Peer Specialists to deliver Cognitive Behavioral Social Skills Training
Walid Gellad, MD, MPH: NIDA R01: Using Machine Learning to Predict Problematic Prescription Opioid Use and Opioid Overdose
Shari Rogal, MD, MPH: ICRE PCOR KL2:  Pain and Opioid Use among Veterans with Chronic Liver Disease
Yu-Xiao Yang, MD, MSCE: IIR 15-346:  Comparative Effectiveness of Split-Dose Colonoscopy Bowel Preparation Regimes.
John Blosnich, PhD, MPH: VISN4 Pilot: Using Electronic Health Records to Identify Social Determinants of Health among VISN4 Veterans
John Blosnich, PhD, MPH: VA Homeless Programs Office Pilot: The Associations of Housing Instability and Housing Services Utilization with Suicide Risk among Transgender Veterans
Carolyn Thorpe, PhD, MPH: Donaghue Foundation: De-Prescribing of Anti-Dementia Medications


Steering Committee Reviews CHERP FY17 Achievements


The annual CHERP Steering Committee Meeting took place in Philadelphia in September.  CHERP Director Michael Fine, MD, MSc and Co-Director Said Ibrahim, MD, MPH, MBA, summarized FY17 accomplishments and discussed CHERP’s plans for FY18. Faculty members then presented talks on three themes:  Health Equity, Healthcare Innovation, and Partner/Stakeholder Engagement.


Health Equity
• Leslie Hausmann, PhD, Principal Investigator (PI) of VA HSR&D IIR 13-080, Staying Positive:  An Intervention to Reduce Osteoarthritis Pain Disparities
• Ann Kutney-Lee, PhD, RN, PI of newly-funded VA HSR&D project, Investigating Multi-Level Determinants of Racial/Ethnic Disparities in Quality of End-of-Life Care for Veterans


Healthcare Innovation
• Matt Chinman, PhD, PI of the VA QUERI project to Evaluate Facilitation of Peer Specialist in VA PACTs
• Mitesh Patel, MD, MBA, MS, Career Development Awardee, Evaluating Connected Health Approaches to improve the Health of Veterans


Partner/Stakeholder Engagement
• Stephen Metraux, PhD, PI of VA HSR&D proposal in revision, Modeling and Assessing Risk for Homelessness among Post-9/11-Era Veterans
• Kimberly Max Brown, PhD, and Kelly Burkitt, PhD, Engaging Stakeholders Through Veteran Community Advisory Boards


Call for Health Equity Abstracts

Health Services Research (HSR) and the Centers for Medicare and Medicaid Services’ Office of Minority Health (CMS OMH) are partnering to publish a Theme Issue on Health Equity. Abstracts of no more than 250 words should be submitted by email to Dr. Beth Watts (HSRspecialissue@NORC.org) by November 1, 2017.  “Instructions for Authors”: http://www.hsr.org/hsr/information/authors/instrucauthors.jsp.

Welcome new CHERP Faculty and Fellows


Ann Marie Rosland, MD, MS is a new CHERP Core Investigator and primary care physician at the VA Pittsburgh Healthcare System. She is also Associate Professor in the Division of General Internal Medicine at the University of Pittsburgh. Dr. Rosland is leading a VA HSR&D randomized clinical trial to determine how technology-enhanced coaching of patients with high-risk diabetes and supportive family members may improve patient engagement and lower risk for complications. She is also co-PI for QUERI project to improve prevention and management of chronic conditions by supporting Veterans and providers in making personalized healthcare decisions that take into account individual patient risk and preferences.


Emily Brignone, PhD – VA Office of Academic Affiliations (OAA) post-doctoral fellow in Health Services Research


Sydney Springer, PharmD, BCPS –VA OAA post-doctoral fellow in Medication Safety & Pharmacy Outcomes


Patience Moyo, PhD – University of Pittsburgh post-doctoral fellow working with Walid Gellad, MD, MPH

New Leadership Roles


Pete Groeneveld, MD, MS, has been appointed Chair of the Research and Development Committee of the Crescenz (Philadelphia) VA Medical Center.  He will assume the role on December 1.


Walid Gellad, MD, MPH has been named Associate Chief for Research, Division of General Internal Medicine, University of Pittsburgh.  In addition, Dr. Gellad appeared on WTAE-TV in a feature story regarding the rising cost of Narcan that aired on Sept 14, 2017.



(From CHERP Bulletin August 2017)

Four pilot research projects submitted by VISN 4 investigators have been recommended for funding from the Center for Health Equity Research and Promotion (CHERP), a VA HSR&D Center of Innovation.  These one-year projects focus on improving equity and/or quality in health and health care among Veterans. Awards are anticipated to begin in FY18, contingent upon availability of funding from VISN4.


Congratulations to:
• John Blosnich, PhD Experiences with HUD VASH services among male, female, and transgender Veterans
• Lisa Callegari, MD, with CHERP Co-Investigator Sonya Borrero, MD, The MyPath Reproductive Planning Tool for Women Veterans
• Kevin Ahmaad Jenkins, PhD, with CHERP Co-Investigator Judith Long, MD, An examination of psychosocial stress, race, and racism remains relatively unexplored within chronic kidney disease population
• Tim Sowicz, PhD, MSN, Veterans’ Experiences of Participation in an Opioid Use Review Clinic

Selected recent publications

Chee W, Lee Y, Im EO, Chee E, Tsai HM, Nishigaki M, Yeo SA, Schapira MM, Mao JJ. A culturally tailored Internet cancer support group for Asian American breast cancer survivors: A randomized controlled pilot intervention study. Journal of telemedicine and telecare. 2017 Jul 1; 23(6):618-626. CIN 13-405

Carpenter JG, McDarby M, Smith D, Johnson M, Thorpe J, Ersek M. Associations between Timing of Palliative Care Consults and Family Evaluation of Care for Veterans Who Die in a Hospice/Palliative Care Unit. Journal of palliative medicine. 2017 Jul 1; 20(7):745-751.

Ersek M, Miller SC, Wagner TH, Thorpe JM, Smith D, Levy CR, Gidwani R, Faricy-Anderson K, Lorenz KA, Kinosian B, Mor V. Association between aggressive care and bereaved families' evaluation of end-of-life care for veterans with non-small cell lung cancer who died in Veterans Affairs facilities. Cancer. 2017 Aug 15; 123(16):3186-3194.

Kobayashi T, Glorioso TJ, Armstrong EJ, Maddox TM, Plomondon ME, Grunwald GK, Bradley SM, Tsai TT, Waldo SW, Rao SV, Banerjee S, Nallamothu BK, Bhatt DL, Rene AG, Wilensky RL, Groeneveld PW, Giri J. Comparative Outcomes After Percutaneous Coronary Intervention Among Black and White Patients Treated at US Veterans Affairs Hospitals. Journal of the American Medical Association cardiology Cardiology. 2017 Jul 19

Ibrahim SA, Egede LE, Fine MJ. New Evidence Reflecting VA's Commitment to Achieve Health and Health Care Equity for All Veterans. Medical care. 2017 Sep 1; 55 Suppl 9 Suppl 2:S1-S3.

Miller SC, Intrator O, Scott W, Shreve ST, Phibbs CS, Kinosian B, Allman RM, Edes TE. Increasing Veterans' Hospice Use: The Veterans Health Administration's Focus On Improving End-Of-Life Care. Health affairs (Project Hope). 2017 Jul 1; 36(7):1274-1282.

Houston TK, Fix GM, Shimada SL, Long JA, Gordon HS, Pope C, Volkman J, Allison JJ, DeLaughter K, Orner M, Bokhour BG. African American Veterans Storytelling: A Multisite Randomized Trial to Improve Hypertension. Medical care. 2017 Sep 1; 55 Suppl 9 Suppl 2:S50-S58.

Liao JM, Schapira MS, Navathe AS, Mitra N, Weissman A, Asch DA. The Effect of Emphasizing Patient, Societal, and Institutional Harms of Inappropriate Antibiotic Prescribing on Physician Support of Financial Penalties: A Randomized Trial. Annals of internal medicine. 2017 Aug 1; 167(3):215-216.

Borrero S, Callegari LS, Zhao X, Mor MK, Sileanu FE, Switzer G, Zickmund S, Washington DL, Zephyrin LC, Schwarz EB. Unintended Pregnancy and Contraceptive Use Among Women Veterans: The ECUUN Study. Journal of general internal medicine. 2017 Aug 1; 32(8):900-908.

Ash S, Jester C, York C, Kofman OL, Langey R, Halpin A, Firn K, Dominguez Perez S, Chahine L, Spindler M, Dahodwala N, Irwin DJ, McMillan C, Weintraub D, Grossman M. Longitudinal decline in speech production in Parkinson's disease spectrum disorders. Brain and language. 2017 Aug 1; 171:42-51.

Weintraub D, Chiang C, Kim HM, Wilkinson J, Marras C, Stanislawski B, Mamikonyan E, Kales HC. Antipsychotic Use and Physical Morbidity in Parkinson Disease. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2017 Jul 1; 25(7):697-705.  


Judith Long and Judy Shea, with colleague Kira Ryskina, published an article in Teaching and Learning in Medicine.  The study looks at “Physician Experiences with High Value Care in Internal Medicine Residency.” They surveyed recent graduates of internal medicine residencies (456 of 902 responded). Of note only 24% reported being frequently exposed to teaching about high value care and only 44% felt prepared to use overtreatment guidelines in conversations with patients. On the other hand 86% felt prepared to participate in shared decision making at the conclusion of their training and 85% reported practicing generic prescribing. In particular, the most recent graduates felt most comfortable with generic prescribing and using overtreatment guidelines. http://www.tandfonline.com/doi/full/10.1080/10401334.2017.1335207

 







Medical Care, in collaboration with two national VA HSR&D Centers for Innovation focused on health equity – the Center for Health Equity Research and Promotion (CHERP) and the Health Equity and Rural Outreach Innovation Center (HEROIC), has published a supplemental issue on “The State of Science” in VA Health Equity.

Medical Care Supplement: Health Equity.  September 2017;55(9,Suppl 2);S1-120.

The supplement features key products from the national HSR&D field-based meeting to Engage Diverse Stakeholders and Operational Partners in Advancing Health Equity in the VA Healthcare System, held in Philadelphia in 2016.  You can watch videos of the presentations via this link to the CHERP website.


CHERP Director Michael Fine, MD, MSc and Co-Director Said Ibrahim, MD, MPH, MBA were Co-Editors, along with Leonard Egede, MD, MS, who was Director of HEROIC for 12 years and moved to Medical College of Wisconsin In January 2017.  Their introduction is titled New Evidence Reflecting VA’s Commitment to Achieve Health and Health Care Equity for All Veterans. 

The conference and the supplement highlighted research in:  Racial/ethnic Minority Veterans; Research on Sex, Gender, and with LGBT Veterans; Veteran Homelessness


The articles reflect several key themes and underscore the need to

1.  Address the broad societal factors that are often the root causes of health disparities

2.  Consider the intersectionality of vulnerable populations and how various combinations of vulnerabilities affect Veteran health and healthcare

3.  Engage key stakeholders in efforts to advance health equity

4.  Vigilantly surveil and investigate disparities in recognized and emerging vulnerable Veteran populations


CHERP Investigators contributed the following articles to the supplement:

New Evidence Reflecting VA’s Commitment to Achieve Health and Health Care Equity for All Veterans
Co-Editors in Chief Said A. Ibrahim, MD, MPH, MBA, Leonard E. Egede, MD, MS, and Michael J. Fine, MD, MSc

Harnessing Implementation Science to Increase the Impact of Health Equity Research
Chinman, Matthew PhD; Woodward, Eva N. PhD; Curran, Geoffrey M. PhD; Hausmann, Leslie R.M. PhD

Associations Between Perceived Race-based Discrimination and Contraceptive Use Among Women Veterans in the ECUUN Study
MacDonald, Serena BS; Hausmann, Leslie R.M. PhD; Sileanu, Florentina E. MS; Zhao, Xinhua PhD; Mor, Maria K. PhD; Borrero, Sonya MD, MS

Creating a Toolkit to Reduce Disparities in Patient Engagement
Keddem, Shimrit MS; Agha, Aneeza Z. MA; Long, Judith A. MD; Werner, Rachel M. MD, PhD*; Shea, Judy A. PhD

Will Veterans Answer Sexual Orientation and Gender Identity Questions?
Ruben, Mollie A. PhD; Blosnich, John R. PhD, MPH; Dichter, Melissa E. PhD, MSW; Luscri, Lorry MPH; Shipherd, Jillian C. PhD

Exploring Rural Disparities in Medical Diagnoses Among Veterans With Transgender-related Diagnoses Utilizing Veterans Health Administration Care
Bukowski, Leigh A. MPH; Blosnich, John PhD, MPH; Shipherd, Jillian C. PhD; Kauth, Michael R. PhD; Brown, George R. MD; Gordon, Adam J. MD, MPH



Read more on the VA Health Services Research and Development site.

The contents of this web site do not necessarily reflect the views of the US Government or the Department of Veterans Affairs.

 



July 2017 Bulletin

 

CHERP Investigators' Presence at the 2017 HSR&D/QUERI National Conference

Sherrie Aspinall, PharmD, MSc was moderator of the Paper Session on Pain Management.  She also presented a poster, Trends in Opioid and Nonsteroidal Anti-inflammatory Drug Prescriptions and Adverse Events before and after an Opioid Safety Initiative in Veterans

Effect of Peer Support on Emergency Room Usage in Relation to Primary Care in a High-Risk Veteran Population is the title of the oral presentation by Chantele Mitchell-Miland, MPH. 


Carolyn Thorpe, PhD, MPH presented on Effect of Dual Use of Veterans Affairs (VA) and Medicare Part D Drug Benefits on Chronic Disease Refill Adherence in Veterans with Dementia.


Melissa Dichter, PhD, MSW gave a talk on Impacts of Intimate and Sexual Violence Experiences on Women Veterans' Housing Stability.


A poster presentation by Leslie Hausmann, PhD was titled A Randomized, Controlled Study of a Positive Psychological Intervention to Improve Pain, Functioning, and Wellbeing in Veterans with Osteoarthritis. 


Elaine Lasky presented a poster on Timely Evaluation for Veterans New to Mental Health: Findings from the My VA Access Chart Reviews. 

 


PODCAST

Women Veterans: Housing Instability and Intimate Partner Violence
Listen to:  Melissa Dichter, PhD, MSW, and Ann Elizabeth Montgomery, PhD, MPA, MSW, both with HSR&D's Center for Health Equity Research & Promotion in Pittsburgh, PA, discuss the relationship between housing instability women Veterans experiences with intimate partner violence.

VISN 4 Competitive Pilot Project Funding

Congratulations to two CHERP Career Development Awardees on their new funding from the VISN4 Competitive Pilot Project Fund (CPPF).  Mitesh Patel, MD, MBA, MS  -- “A Randomized Trial of Social and Financial Incentives to Increase Physical Activity Among Overweight and Obese Veterans. ” John Blosnich, PhD--“Using electronic health records to identify social determinants of health among VISN4 Veterans” The goal of the CPPF is to provide initial funding for clearly delineated research projects to develop preliminary data so that the investigator can apply successfully for competitive, external, peer-reviewed grant support at a later date. 

 

Selected recent publications


Cost and contribution margin of transcatheter versus surgical aortic valve replacement.  McCarthy FH, Savino DC, Brown CR, Bavaria JE, Kini V, Spragan DD, Dibble TR, Herrmann HC, Anwaruddin S, Giri J, Szeto WY, Groeneveld PW, Desai ND. J Thorac Cardiovasc Surg. 2017 Jun 21. pii: S0022-5223(17)31230-8. doi: 10.1016/j.jtcvs.2017.06.020.


Outcomes, readmissions, and costs in transfemoral and alterative access transcatheter aortic valve replacement in the US Medicare population. McCarthy FH, Spragan DD, Savino D, Dibble T, Hoedt AC, McDermott KM, Bavaria JE, Herrmann HC, Anwaruddin S, Giri J, Szeto WY, Groeneveld PW, Desai ND.J Thorac Cardiovasc Surg. 2017 Jun 16. pii: S0022-5223(17)31227-8.


Dichter ME, Haywood TN, Butler AE, Bellamy SL, Iverson KM. Intimate Partner Violence Screening in the Veterans Health Administration: Demographic and Military Service Characteristics. American journal of preventive medicine. 2017 Jun 1; 52(6):761-768. IIR 15-142 CDA 10-202


Bowen ME, Rowe M, Ersek M, Ibrahim S, Shea JA. The Physical and Cognitive Performance Test for Residents in Assisted Living Facilities. Journal of the American Geriatrics Society. 2017 Jul 1; 65(7):1543-1548. LIP 72-074


Hausmann LR, Youk AO, Kwoh CK, Ibrahim SA, Hannon M, Weiner DK, Gallagher RM, Parks A. Testing a Positive Psychological Intervention for Osteoarthritis. Pain medicine (Malden, Mass.). 2017 Jun 27. IIR 13-080


McCarthy FH, Savino DC, Brown CR, Bavaria JE, Kini V, Spragan DD, Dibble TR, Herrmann HC, Anwaruddin S, Giri J, Szeto WY, Groeneveld PW, Desai ND. Cost and contribution margin of transcatheter versus surgical aortic valve replacement. The Journal of Thoracic and Cardiovascular Surgery. 2017 Jun 21 RCD 04-417. IIR 14-077 IIR 10-352


McCarthy FH, Spragan DD, Savino D, Dibble T, Hoedt AC, McDermott KM, Bavaria JE, Herrmann HC, Anwaruddin S, Giri J, Szeto WY, Groeneveld PW, Desai ND. Outcomes, readmissions, and costs in transfemoral and alterative access transcatheter aortic valve replacement in the US Medicare population. The Journal of Thoracic and Cardiovascular Surgery. 2017 Jun 16. IIR 14-077 IIR 10-352


Hausmann LR, Youk AO, Kwoh CK, Ibrahim SA, Hannon M, Weiner DK, Gallagher RM, Parks A. Testing a Positive Psychological Intervention for Osteoarthritis. Pain medicine (Malden, Mass.). 2017 Jun 27. IIR 13-080


Ibrahim SA. Decision Aids and Elective Joint Replacement - How Knowledge Affects Utilization. The New England journal of medicine. 2017 Jun 29; 376(26):2509-2511. IIR 05-234


Jayadevappa R, Cook R, Chhatre S. Important Difference to Infer Changes in Health Related Quality of Life-A Systematic Review. Journal of clinical epidemiology. 2017 Jul 1. CIN 13-405


Liao JM, Schapira MS, Navathe AS, Mitra N, Weissman A, Asch DA. The Effect of Emphasizing Patient, Societal, and Institutional Harms of Inappropriate Antibiotic Prescribing on Physician Support of Financial Penalties: A Randomized Trial. Annals of internal medicine. 2017 Jun 20. XNV 72-237


Navathe AS, Song Z, Emanuel EJ. The Next Generation of Episode-Based Payments. JAMA : the journal of the American Medical Association. 2017 Jun 20; 317(23):2371-2372. XNV 72-240 XNV 72-235


Patel MS, Volpp KG, Small DS, Wynne C, Zhu J, Yang L, Honeywell S, Day SC. Using Active Choice Within the Electronic Health Record to Increase Influenza Vaccination Rates. Journal of general internal medicine. 2017 Jul 1; 32(7):790-795. XNV 72-211


Chee W, Lee Y, Im EO, Chee E, Tsai HM, Nishigaki M, Yeo SA, Schapira MM, Mao JJ. A culturally tailored Internet cancer support group for Asian American breast cancer survivors: A randomized controlled pilot intervention study. Journal of telemedicine and telecare. 2017 Jul 1; 23(6):618-626. CIN 13-405


Weintraub D, Chiang C, Kim HM, Wilkinson J, Marras C, Stanislawski B, Mamikonyan E, Kales HC. Antipsychotic Use and Physical Morbidity in Parkinson Disease. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2017 Jul 1; 25(7):697-705. IIR 12-144


Konetzka RT, Werner RM. Relationships between Acute and Postacute Care Providers: Measurement and Estimation. Health services research. 2017 Jun 5. R01 HS024266
 


 

Daniel Hall, MD, MDiv, MHSc, published an article in JAMA Surgery about study findings that frailty screening of preoperative patients is feasible, and may be an effective and scalable tool for improving surgical outcomes for aging and increasingly frail U.S. and Veteran populations.   Hall D, Arya S, Schmid K, et al. Association of Frailty Screening Initiative with Post-Operative Survival at 30, 180 and 365 days. JAMA Surgery. November 30, 2016;e-pub ahead of print.

The Pittsburgh Post-Gazette featured an article about this important work:  http://www.post-gazette.com/aging-edge/aging-edge-reports/2016/11/30/Frailty-screening-brings-better-results-after-surgery-study-says/stories/201611300172

 

Peter Groeneveld, MD, MS 

Peter Groeneveld, MD, MS published an article in JAMA Cardiology looking at trends in cardiac stress testing in patients younger than 65 years old.  Using a database of commercially insured patients they noted an overall increase in stress testing of 3% from 2015 to 215. Whether appropriate or not, rates rose by 59% among those 25-34 years old as did rates of use of certain modalities such as stress echo (Up 28%).  These findings are in contrast to other studies which have had noted declines in the use of stress testing in Medicare beneficiaries. Pete argues that “trends in stress testing may be driven more by characteristics of health systems and populations than by efforts to reduce overuse of testing.”  http://jamanetwork.com/journals/jamacardiology/fullarticle/2583458

.

Selected recent publications

Naples JG, Gellad WF, Hanlon JT. The Role of Opioid Analgesics in Geriatric Pain Management. Clinics in geriatric medicine. 2016 Nov 1; 32(4):725-735
Kangovi S, Mitra N, Turr L, Huo H, Grande D, Long JA. A randomized controlled trial of a community health worker intervention in a population of patients with multiple chronic diseases: Study design and protocol. Contemporary clinical trials. 2016 Dec 10.
Mavandadi S, Patel S, Benson A, DiFilippo S, Streim J, Oslin D. Correlates of Caregiver Participation in a Brief, Community-Based Dementia Care Management Program. The Gerontologist. 2016 Dec 7.
Metraux S, Manjelievskaia J, Treglia D, Hoffman R, Culhane DP, Ku BS. Posthumously Assessing a Homeless Population: Services Use and Characteristics. Psychiatric services (Washington, D.C.). 2016 Dec 1; 67(12):1334-1339.
Navathe AS, Emanuel EJ. Physician Peer Comparisons as a Nonfinancial Strategy to Improve the Value of Care. JAMA : the journal of the American Medical Association. 2016 Nov 1; 316(17):1759-1760.
Schapira MM, Aggarwal C, Akers S, Aysola J, Imbert D, Langer C, Simone CB, Strittmatter E, Vachani A, Fraenkel L. How Patients View Lung Cancer Screening. The Role of Uncertainty in Medical Decision Making. Annals of the American Thoracic Society. 2016 Nov 1; 13(11):1969-1976.
Neuman MD, Silber JH, Passarella MR, Werner RM. Comparing the Contributions of Acute and Postacute Care Facility Characteristics to Outcomes After Hospitalization for Hip Fracture. Medical care. 2016 Nov 2.

 

Recent Funding Announcement

Congratulations to CHERP PI Yu-Xiao Yang MD  on his HSR&D Merit Review Award, “Comparative Effectiveness of Split-dose Colonoscopy Bowel Preparations Regimens.”

Colorectal cancer (CRC) is the second leading cause of cancer-related death in the US. Colonoscopy can effectively reduce CRC incidence and mortality.  Preliminary data from our group also indicated that nearly half of the scheduled colonoscopies at the VA were not completed due to cancellations, no-shows and inadequate preparation quality.  If the alternative bowel preparation regimen is found to be superior to the current standard in this pragmatic trial, it would provide sufficient reason to offer this option to our veterans to improve patient satisfaction, reduce colorectal cancer risk and promote more efficient use of VA endoscopy resources.



The VA Healthcare Network – VISN 4 invites VISN 4 investigators to apply for support via the Competitive Pilot Project Fund (CPPF) Program for fiscal year 2018.  The goal of the CPPF is to provide initial funding for clearly delineated research projects to develop preliminary data so that the investigator can apply successfully for competitive, external, peer-reviewed grant support at a later date. Please go to the full announcement which includes the CPPF program overview and provides specific details and instructions for submitting an application. 

 

Exploring precision medicine for depression

VA Health Services Research and Development (HSR&D) and Genomic Medicine Implementation programs recently funded a groundbreaking study, entitled PRIME Care (PRecision medicine In MEntal health Care) to David Oslin, MD and a multidisciplinary team of investigators throughout the VA.  The study will be hosted at the Corporal Michael J. Crescenz VA Medical Center in Philadelphia, PA where Dr. Oslin is Director of the VISN 4 Mental Illness Research, Education and Clinical Center and Core Investigator with the HSRD Center for Health Equity Research and Promotion (CHERP).

PRIME Care is based on ORD’s Clinical Precision Medicine in Mental Health initiative and is in response to the VA Quality Enhancement Research Initiative (QUERI) Evidence Synthesis Program Scientific Review which strongly suggested the need for more research on genomic testing implementation in the clinical care setting.   HSR&D awarded funding to PRIME Care, which began in October 2016, to break new ground by determining optimal approaches to using genomic information to better treat depression in Veterans. PRIME Care focuses on the effectiveness of pharmacogenomics – how genes personally affect a person’s response to treatment, and may help shorten time to optimal treatment by predicting how well an individual will tolerate or respond to an antidepressant.
- See more at: http://www.cherp.research.va.gov/features/Exploring_precision_medicine_for_depression.asp#sthash.P8Lt1wqb.dpuf


Health disparities among LGBT Veterans


Dr. John R. Blosnich is a research health scientist with the Center for Health Equity Research and Promotion at the VA Pittsburgh Health Care System, and an adjunct assistant professor at the University of Pittsburgh Graduate School of Public Health. His research focuses on interpersonal and self-directed violence among lesbian, gay, bisexual, and transgender (LGBT) people. His VA work focuses on LGBT Veterans, with particular attention to suicide risk...
http://www.mirecc.va.gov/visn19/education/media/#podcast_lgbt_blosnich


Funding News


Dan Hall, MD, MDiv, MHS received notification of intent to fund his HSR&D pilot project, “Pilot Testing Prehabilitation Services Aimed at Improving Outcomes of Frail Veterans Following Major Abdominal Surgery”


Melissa Dichter, PhD, MSW secured a pilot award from National Center for Homelessness Among Veterans to examine the intersection of intimate partner violence and housing instability among women Veterans


Selected Recent Publications

Kini V, McCarthy FH, Dayoub E, Bradley SM, Masoudi FA, Ho PM, Groeneveld PW. Cardiac Stress Test Trends Among US Patients Younger Than 65 Years, 2005-2012. JAMA cardiology. 2016 Nov 15.

Varley, P. R., Feske, U., Gao, S., Stone, R. A., Zhang, S., Monte, R., . . . Hall, D. E. (2016). Time required to review research protocols at 10 Veterans Affairs Institutional Review Boards. Journal of Surgical Research, 204, 481-489. doi:10.1016/j.jss.2016.06.004


Kutney-Lee A, Germack H, Hatfield L, Kelly S, Maguire P, Dierkes A, Del Guidice M, Aiken LH. Nurse Engagement in Shared Governance and Patient and Nurse Outcomes. The Journal of nursing administration


Metraux S, Treglia D, O'Toole TP. Migration by Veterans Who Received Homeless Services From the Department of Veterans Affairs.


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