Background: The use of telemental health via videoconferencing (TMH-V) became critical during the Coronavirus disease 2019 (COVID-19) pandemic due to restriction non-urgent in-person appointments. current brief report demonstrates rapid growth in TMH-V appointments weeks following declaration within Department Veterans Affairs (VA), largest healthcare system United States. Methods: COVID-19 changes were captured six World Health Organization's (March 11, 2020-April 22, 2020). Pre-COVID-19...

Meterko, Mark PhD; Baker, Errol Stolzmann, Kelly L. MS; Hendricks, Ann M. Cicerone, Keith D. PhD, ABPP-Cn; Lew, Henry MD, PhDEditor(s): Caplan, Bruce ABPP; Bogner, Jennifer ABPP Author Information

Survey response rate is regarded as a key data-quality indicator, yet not necessarily predictive of nonresponse bias. Our study objective was to use high-response-rate survey assess bias across successive waves. This healthcare leaders utilized web-based, self-report format with an initial invitation and four nonrespondent follow-ups. Across five waves, comparisons were made for demographic facility characteristics, proportion items completed, distribution three question types: factual...

With the use of Veterans Health Administration and Department Defense databases veterans who completed a Affairs comprehensive traumatic brain injury (TBI) evaluation, objectives this study were to (1) identify co-occurrence self-reported auditory, visual, vestibular impairment, referred as multisensory impairment (MSI), (2) examine demographic, deployment-related, mental health characteristics that potentially predictive MSI. Our sample included 13,746 with either history deployment-related...

The current study examined patient and provider differences in use of phone, video, in-person mental health (MH) services. Participants included patients who completed ≥ 1 MH appointment within the Department Veterans Affairs (VA) from 10/1/17-7/10/20 providers 100 VA appointments 10/1/17-7/10/20. Adjusted odds ratios (aORs) are reported providers: (a) completing ≥1 video pre-COVID (10/1/17-3/10/20) COVID (3/11/20-7/10/20) periods; (b) majority visits via or during COVID. sample 2,480,119...

To describe the prevalence of self-reported rates auditory, visual, and dual sensory impairment (DSI) in Afghanistan Iraq war Veterans receiving traumatic brain injury (TBI) evaluations.Retrospective medical chart review.Thirty-six thousand nine hundred nineteen who received a TBI evaluation between October 2007 June 2009. Final sample included 12,521 subjects judged to have deployment-related comparison group 9106 participants with no evidence TBI.Self-reported auditory visual...

Background: VHA screens for traumatic brain injury (TBI) among patients formerly deployed to Afghanistan or Iraq, referring those who screen positive a Comprehensive TBI Evaluation (CTBIE).

Outcome for mental health conditions is suboptimal, and care fragmented. Evidence from controlled trials indicates that collaborative chronic models (CCMs) can improve outcomes in a broad array of conditions. US Department Veterans Affairs leadership launched nationwide initiative to establish multidisciplinary teams general clinics all medical centers. As part this effort, partnered with implementation researchers develop program evaluation protocol provide rigorous scientific data address...

There is great interest in leveraging technology, including cell phones and computers, to improve healthcare. A range of e-health applications pertaining mental health such as messaging for prescription refill or mobile device videoconferencing are becoming more available, but little known about the patient's using these newer applications.We mailed a survey 300 patients seen general clinic local Veterans Affairs Medical Center. Survey questions focused on use phones, tablets, other...

IMPORTANCECollaborative chronic care models (CCMs) have extensive randomized clinical trial evidence for effectiveness in serious mental illnesses, but little exists regarding their feasibility or effect typical practice conditions.OBJECTIVE To determine the of implementation facilitation establishing CCM health teams and impact on outcomes team-treated individuals. DESIGN, SETTING, AND PARTICIPANTSThis quasi-experimental, stepped-wedge was conducted from February 2016 through 2018,...

To assess physical activity and disability in chronic obstructive pulmonary disease (COPD), we evaluated the use of an accelerometer checklist to measure free-living activity. Seventeen males with stable COPD completed a daily for 14 days. Ten subjects concurrently wore Actiped (FitSense, Southborough, Massachussetts) that records steps per day. Regression models assessed relationships between day, number activities performed, clinical measures status. The average day ranged from 406 4,856....

Women physicians must consider many conflicting issues when timing childbirth. We characterized maternity leave, breast-feeding practices and satisfaction associated with pregnancy in women urologists.A 114-item anonymous survey including questions on leave duration for firstborn children, workplace policies, attitudes was mailed to all 365 American board certified urologists May July 2007. Logistic regression used identify factors greater satisfaction.A total of 243 (69%) responded, whom...

In recent years, hospitals and payers have increased their efforts to improve the quality of patient care by encouraging provider adherence evidence-based practices. Although individual is certainly essential in delivery appropriate care, a team perspective important when examining variation quality. present study, authors modeled relationship between measure aggregate job satisfaction for members primary teams objective measures based on process indicators intermediate outcomes. Multilevel...

Objective. To test the utility of a two-dimensional model organizational climate for explaining variation in diabetes care between primary clinics. Data Sources/Study Setting. Secondary data were obtained from 223 clinics Department Veterans Affairs health system. Study Design. Organizational was defined using dimensions task and relational climate. The association processes intermediate outcomes estimated 4,539 patients cross-sectional study. Collection/Extraction Methods. All collected...

To examine the relations among demographic characteristics, traumatic brain injury (TBI) history, suspected psychiatric conditions, current neurobehavioral health symptoms, and employment status in Veterans evaluated for TBI Department of Affairs.Retrospective cross-sectional database review comprehensive evaluations documented between October 2007 June 2009.Operation Enduring Freedom/Operation Iraqi Freedom (n = 11 683) who completed a evaluation.Veterans Affairs clinicians use to obtain...

Although respiratory dysfunction is common in chronic spinal cord injury (SCI), determinants of longitudinal change FEV(1) and FVC have not been assessed.Determine factors that influence lung function decline SCI.A total 174 male participants (mean age 49 17 yr after injury) completed a questionnaire underwent spirometry over an average follow-up 7.5 years (range, 4-14 yr).In multivariate models, was significantly related to continued smoking, persistent wheeze, increase body mass index,...

Thousands of women Veterans experience intimate partner violence (IPV) each year. The Health Administration (VHA) has encouraged IPV screening in Affairs medical centers (VAMCs) since 2014. Through retrospective analysis VHA administrative data from fiscal year (FY) 2014 into FY2020, we examined implementation outcomes reach and adoption, as well screen-positive rates using descriptive multivariate linear regression analyses. We overall a function childbearing age (18-44 vs. 45+ years). In...

Background Sustaining healthcare interventions once they have been implemented is a pivotal public health endeavor. Achieving sustainability requires context-sensitive adaptations to evidence-based practices (EBPs) or the implementation strategies used ensure their adoption. For replicability of beyond specific setting in question, underlying logic needs be clearly described, and themselves need plainly documented. The goal this project was describe process by which facilitation adapted...