A5087977132- Patient Satisfaction in Healthcare
- Primary Care and Health Outcomes
- Patient-Provider Communication in Healthcare
- Health Policy Implementation Science
- Global Cancer Incidence and Screening
- Mental Health and Patient Involvement
- Empathy and Medical Education
- Health, psychology, and well-being
- Healthcare Systems and Technology
- Musculoskeletal pain and rehabilitation
- Palliative Care and End-of-Life Issues
- Health Literacy and Information Accessibility
- Healthcare Policy and Management
- Cardiac Health and Mental Health
- Electronic Health Records Systems
- Mental Health Treatment and Access
- Telemedicine and Telehealth Implementation
- Ethics in Clinical Research
- Posttraumatic Stress Disorder Research
- COVID-19 and healthcare impacts
- Patient Dignity and Privacy
- Education and Military Integration
- Blood Pressure and Hypertension Studies
- Art Therapy and Mental Health
- Advances in Oncology and Radiotherapy
VA New England Healthcare System
2021-2024
VA Boston Healthcare System
2019-2024
United States Navy
2023
Medical College of Wisconsin
2023
Center for the Study of Healthcare Provider Behavior
2023
United States Department of the Navy
2023
Milwaukee VA Medical Center
2023
Bedford VA Research Corporation
2020-2021
Bedford Research Foundation
2019
Edith Nourse Rogers Memorial Veterans Hospital
2018-2019
Healthcare organizations increasingly are focused on providing care which is patient-centered rather than disease-focused. Yet little known about how best to transform the culture of in these organizations. We sought understand key organizational factors for implementing cultural transformation through an examination efforts US Department Veterans Affairs. conducted multi-day site visits at four Affairs medical centers designated as leaders care. qualitative semi-structured interviews with...
To describe how a partnered evaluation of the Whole Health (WH) system care-comprised WH pathway, clinical care, and well-being programs-produced patient outcomes findings, which informed Veterans Administration (VA) policy change.Electronic health records (EHR)-based cohort 1,368,413 patients longitudinal survey receiving care at 18 pilot medical centers.In partnership with VA operations, we focused on impact services utilization Veterans' (1) use opioids (2) experiences, engagement,...
Veterans Healthcare Administration (VHA) conducted a large demonstration project of holistic Whole Health approach to care in 18 medical centers, which included making complementary and integrative health (CIH) therapies more widely available. This evaluation examines patterns service use among with chronic pain, comparing those without PTSD.We assessed the services cohort co-occurring pain PTSD (n = 1698; 28.9%), them musculoskeletal only 4170; 71.1%). Data was gathered from VA electronic...
Patient access to clinical information represents a means improve the transparency and delivery of health care as well interactions between patients providers. We examine movement toward augmenting patient using technology. Our analysis focuses on "Blue Button," tool that many organizations are implementing part their Web-based portals.We present framework for evaluating effects technology-assisted may have stakeholder experiences, processes care, outcomes.A case study United States...
Background: As information and communication technology is becoming more widely implemented across health care organizations, patient-provider email or asynchronous electronic secure messaging has the potential to support patient-centered communication. Within medical home model of Veterans Health Administration (VA), envisioned as a means enhance access strengthen relationships between veterans their team members. However, despite previous studies that have examined content messages...
Co-design provides a meaningful way to engage patients in research. However, there is limited practical guidance. We used our co-design project identify strategies for other researchers. An ethnographic case study design was used. Data included participant observation of meetings, meeting minutes, analytic fieldnotes, qualitative patient interviews, and research team member self-reflections. Additionally, we got external feedback. analyzed data iteratively. Our 5 6 identified 3 include...
Objectives: Veterans often suffer from multiple chronic illnesses, including mental health disorders, diabetes, obesity, and cardiovascular disease. The improvement of engagement in their own care is critical for enhanced well-being overall health. Peer-led group programs may be an important tool to provide support skill development. We conducted a pilot study explore the impact peer-led group-based program that teaches become empowered engage through mindful awareness practices, self-care...
Rationale: Shared decision-making (SDM) for lung cancer screening (LCS) is recommended in guidelines and required by Medicare, yet it seldom achieved practice. The best approach implementing SDM LCS remains unknown, the 2021 U.S. Preventive Services Task Force calls implementation research to increase uptake of LCS. Objectives: To develop a stakeholder-prioritized agenda outcomes advance Methods: American Thoracic Society VA Health Research Development Service convened multistakeholder...
Interventions are needed to overcome a key barrier patient-provider communication, namely that patients hesitate participate in clinical conversations because they believe their expected role is be passive. This expectation reinforced for veterans, who replicate experience of military hierarchy the relationship. Black moreover, encounter structural racism compounds this power imbalance. paper describes co-designed intervention empower veterans talk with providers, using shared...
Purpose While the value of art therapy is well-established and arts are increasingly leveraged to promote health wellbeing more broadly, little known about impacts non-clinical programs. In this preliminary investigation, we sought fill gap by exploring diverse stakeholders’ perspectives on programming Veterans receiving care at Health Administration (VA). Design Semi-structured qualitative interviews with Veterans, VA staff, community partners. Setting Interviewees were recruited from 7...
Background: Measuring patient well-being during clinical care may enhance patient-centered communication and treatment planning. The Veterans Health Administration (VHA) piloted the use of Well-Being Signs (WBS), a self-report measure psychosocial well-being, in care. Objective: To understand early WBS implementation health team member experiences with its before developing detailed support materials finalizing measure. Methods: We conducted mixed-methods evaluation pilot at 4 VHA...
The Veterans Health Administration (VHA) is building a Whole system of care that aspires to empower and equip each Veteran pursue personally meaningful vision health well-being. As part this effort, VHA has developed Taking Charge My Life (TCMLH), peer-led, group-based programme seeks support in setting pursuing well-being goals. Prior research showed TCMLH groups positively impact outcomes; yet, little known about Veterans' own experiences perspectives.We completed semi-structured telephone...
Objectives: Despite numerous interventions to address adherence antihypertensive medications, continued high rates of uncontrolled blood pressure (BP) suggest a need better understand patient factors beyond associated with BP control. We examined how patients’ BP-related beliefs, and aspects life context affect control, medication adherence.Methods: conducted cross-sectional telephone survey primary care patients hypertension between 2010 2011 (N=103; 93 had complete data on all variables...
Committed to implementing a person-centered, holistic (Whole Health) system of care, the Veterans Health Administration (VHA) developed peer-led, group-based, multi-session "Taking Charge My Life and Health" (TCMLH) program wherein reflect on values, set health well-being-related goals, provide mutual support. Prior work has demonstrated positive impact these groups. After face-to-face TCMLH groups were disrupted by COVID-19 pandemic, VHA facilities rapidly implemented virtual (video-based)...
Aims: Provide guidance for engaging military veterans in various research teams to help overcome veterans' lack of trust research. Methods: We draw from our combined experience present four case studies veteran on sensitive topics illustrate successful engagement with veterans. Results: For each example, we describe contributions at different phases then share practical realizing benefits and overcoming challenges phase. In experience, has built by aligning participants' own as Conclusion:...
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Abstract Background Since 2013, the Veterans Health Administration (VHA) has advanced a person-centered, Whole (WH) System of Care, shift from disease-oriented system to one that prioritizes “what matters most” patients in their lives. is predicated on patient-provider interactions marked by multi-level understanding health and trusted relationships promote well-being. Presently, WH implementation been focused largely primary care settings, yet goal effect system-wide transformation so...
Shared decision-making (SDM) for lung cancer screening (LCS) is recommended by multiple organizations, reflecting a larger movement toward patient-centered care. Yet SDM LCS does not routinely occur owing to barriers at levels. Moreover, how best implement into routine clinical practice remains unknown. There need novel approach overcome multilevel and ensure high-quality integrated practice. We present the protocol our U.S. Department of Veterans Affairs (VA)-funded study. Our designed...