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Recent News

November 2017 CHERP Bulletin

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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