Background: Learning Health Systems strive to continuously integrate innovations and evidence-based practices (EBPs) into routine care settings. Few models provide a specified pathway accelerate adoption spread of EBPs across diverse Objective: The US Department Veterans Affairs Quality Enhancement Research Initiative (QUERI) Implementation Roadmap facilitates uptake in practice by aligning research health system priorities. Methods: is based on earlier iterations the QUERI translational...

Persons with serious mental illness (SMI) are disproportionately burdened by premature mortality. This disparity is exacerbated poor continuity of care the health system. The Veterans Health Administration (VA) developed Re-Engage, an effective population-based outreach program to identify veterans SMI lost and reconnect them VA services. However, such programs often encounter barriers getting implemented into routine care. Adaptive designs needed when implementation intervention requires...

Journal Article Psychosocial Outcomes for Adult Children of Parents with Severe Mental Illnesses: Demographic and Clinical History Predictors Get access Carol T. Mowbray, Mowbray Search other works by this author on: Oxford Academic PubMed Google Scholar Deborah Bybee, Bybee Daphna Oyserman, Oyserman Peter MacFarlane, MacFarlane Nicholas Bowersox Health & Social Work, Volume 31, Issue 2, May 2006, Pages 99–108, https://doi.org/10.1093/hsw/31.2.99 Published: 01 2006 history Received: 21...

Objective: To evaluate factors associated with suicide mortality among Veterans Health Administration (VHA) patients bipolar disorder.

Abstract Objectives The U.S. Department of Veterans Affairs (VA) has been a national leader in Learning Health System (LHS) implementation due to its combined mission research, education, clinical care, and emergency preparedness. We describe the current VA LHS training ecosystem within Administration's Office Academic Affiliations (OAA), Research Development (ORD), ORD's Services (HSR&D) program, Innovation Ecosystem (IE), including lessons learned regarding their sustainment. Methods...

Few implementation strategies have been empirically tested for their effectiveness in improving uptake of evidence-based treatments or programs. This study compared the an immediate versus delayed enhanced strategy (Enhanced Replicating Effective Programs (REP)) providers at Veterans Health Administration (VA) outpatient facilities (sites) on improved outreach program (Re-Engage) among sites not initially responding to a standard strategy. One mental health provider from each U.S. VA site (N...

This study compared effectiveness of an enhanced versus standard implementation strategy (Replicating Effective Programs [REP]) on site-level uptake Re-Engage, a national program for veterans with serious mental illness.Mental health providers at 158 Veterans Affairs (VA) facilities were given REP-based manuals and training in which involved identifying who had not been seen VA care least one year, documenting their clinical status, coordinating further care. After six months, responding to...

US health care systems face a growing demand to incorporate innovations that improve patient outcomes at lower cost. Funding agencies increasingly must demonstrate the impact of research investments on public health. The Learning Health System promotes continuous institutional innovation, yet specific processes develop for further and implementation into real-world settings maximize impacts have not been specified.We describe Research Lifecycle how it leverages priorities support translation...

It is important to ensure that veterans who have experienced military sexual trauma (MST) and posttraumatic stress disorder (PTSD) access trauma-focused treatment. For with serious mental illness (SMI), prior work documents decreased likelihood receive care. This study focused on evaluating the engagement of Veterans Health Administration (VHA) patients diagnosed PTSD MST in specialty care, as well how this differs for SMI. Using VHA administrative data, all screened positive fiscal year...

A model of the process seeking treatment for mental health problems is presented that explicates much previous research in this area. comprising seven steps proposed (recognize there a problem, decide problem related, change needed, make efforts to effect change, professional help needed seek help, and help). Activities or decisions interrupt process, barriers encountered at each step, variations sequence, experience social support across are presented. Implications improving access proposed.

This study used factor analysis of a Veterans Health Administration (VHA) survey to identify factors that measure satisfaction with inpatient treatment and examine the factors' utility in evaluating participation following discharge.The Survey Healthcare Experiences Patients (inpatient version) (I-SHEP) was mailed 34,237 veterans who were discharged from outpatient care VHA during fiscal year 2009 completed by 7,408 patients. A responses identified underlying I-SHEP evaluated relationships...

OBJECTIVES Assertive community treatment (ACT) programs may improve patients' outcomes, in part by increasing adherence to antipsychotic medication. This study assessed the association between ACT enrollment and subsequent adherence. METHODS The authors identified a national sample of 763 Veterans Affairs (VA) patients with schizophrenia who were newly enrolled fiscal years 2001 2004 had valid medication possession ratios (MPRs) for five sequential six-month periods, first occurring before...

Objective Assess whether neighborhood characteristics predict patient‐reported outcomes for depression. Data Sources VA electronic medical record data and U.S. census data. Study Design Retrospective longitudinal cohort. Extraction Methods Neighborhood individual of patients (N = 4,269) with a unipolar depressive disorder diagnosis an initial Patient Health Questionnaire (PHQ‐9) score ≥10 were used to 50 percent improvement in 4‐8‐month PHQ‐9 scores. Principal Findings The proportion...

The objective was to assess the prevalence and impact of anxiety disorders on service utilization among Veterans Health Administration (VHA) patients with schizophrenia.This cross-sectional study examined diagnostic, utilization, medication records included in VHA National Psychosis Registry. Relationships between schizophrenia were evaluated along demographic dimensions.During fiscal year 2011, 23.8% (N=20,722) 87,006 diagnosed as having a comorbid disorder; 15.2% sample had posttraumatic...

Objectives . Persons with mental disorders experience functional impairments and premature mortality. Limited continuity of care may contribute to disparities in this group. We describe the replication an evidence-based outreach program (Re-Engage) reconnect Veterans into who have dropped out services. Methods Using Enhanced Replicating Effective Programs framework, population-based registries were used identify lost-to-care, providers information determine Veteran disposition need for care....