A5075145993- Mobile Health and mHealth Applications
- Sleep and related disorders
- Health Policy Implementation Science
- Homelessness and Social Issues
- Primary Care and Health Outcomes
- Digital Mental Health Interventions
- Healthcare Policy and Management
- Geriatric Care and Nursing Homes
- Vaccine Coverage and Hesitancy
- Sleep and Work-Related Fatigue
- Healthcare Systems and Technology
- Sleep and Wakefulness Research
- ICT in Developing Communities
- Electronic Health Records Systems
- Posttraumatic Stress Disorder Research
- Mental Health and Patient Involvement
- Pharmaceutical Practices and Patient Outcomes
- Health Sciences Research and Education
- Atrial Fibrillation Management and Outcomes
- Medication Adherence and Compliance
- Evaluation and Performance Assessment
- Food Security and Health in Diverse Populations
- Venous Thromboembolism Diagnosis and Management
- Global Health Workforce Issues
- Diabetes Management and Education
VA New England Healthcare System
2021-2024
Boston University
2024
Bedford VA Research Corporation
2012-2022
United States Department of Veterans Affairs
2012-2021
Edith Nourse Rogers Memorial Veterans Hospital
2014-2019
Health Services Research & Development
2017
Center for Innovation
2014
Providence VA Medical Center
2014
Quality Enhancement Research Initiative
2013
Objectives. We examined the feasibility of using mobile phone text messaging with homeless veterans to increase their engagement in care and reduce appointment no-shows. Methods. sent 2 message reminders participants (n = 20) before each outpatient appointments at an urban Veterans Affairs medical center. Evaluation included pre- postsurvey questionnaires, open-ended questions, review records. estimated costs savings large-scale implementation. Results. Participants were satisfied...
Addressing the health needs of homeless veterans is a priority in United States, and, although information technologies can potentially improve access to and engagement care, little known about this population's use or their willingness communicate with healthcare providers systems.This study fills gap through survey veterans' attitudes using these assist accessing needed services.Among 106 surveyed, 89% had mobile phone (one-third were smartphones), 76% used Internet. Among those phone, 71%...
We sought to understand how patients and primary care teams use secure messaging (SM) communicate with one another by analyzing message threads from 2 Department of Veterans Affairs facilities.We coded 1000 SM communication sampled 40 teams.Most (94.5%) were initiated (90.4%) or caregivers (4.1%); only 5.5% team members proactively reaching out patients. Medication renewals refills (47.2%), scheduling requests (17.6%), medication issues (12.9%), health (12.7%) the most common...
Contextual elements have significant impact on uptake of health care innovations. While existing conceptual frameworks in implementation science suggest contextual interact with each other, little research has described how this might look practice. To bridge gap, study identifies the interconnected patterns among that influence an anticoagulation clinic improvement initiative. We completed 51 semi-structured interviews and ethnographic observations across five case sites involved...
Although COVID-19 vaccines have been available to many U.S. Veterans Affairs (VA) healthcare system employees and Veteran patients since early 2021, vaccine receipt data indicates some groups are not receiving them. Our objective was conduct a rapid qualitative assessment of Veterans' VA employees' views on vaccination inform clinical leaders' ongoing efforts increase uptake across the VA. We employed semi-structured interviews focus group involving as part quality improvement project...
A decade ago, Congress passed the U.S. Civil Service Reform Act of 1978 (CSRA). The merit pay provisions reforms were hailed as a means for making federal managers and their organizations more responsive, efficient, effective. Merit proved instead to be demoralizing counterproductive. Among its shortcomings inadequate funding, inequities between nonmanagers, invalid performance appraisals.1 sought remedy these problems in 1984 by creating Performance Management Recognition System (PMRS),...
Sleep disturbance is a major health concern among US veterans who have served since 2001 in combat theater Iraq or Afghanistan. We report subjective and objective sleep results from pilot trial assessing self-management-guided use of mobile app (CBT-i Coach, which based on cognitive behavioral therapy for insomnia) as an intervention insomnia military veterans.The primary aim this study was to evaluate changes outcomes pre postintervention.Subjective included the Insomnia Severity Index,...
Objective Anticoagulation clinics ( ACC s) can improve anticoagulation control and prevent adverse events. However, s vary widely in their performance on control. Our objective was to compare the organization management of top‐performing with that bottom‐performing s. Data Sources/Study Setting Three high outlier three low V eterans H ealth A dministration VA ). Study Design Site visits qualitative data collection analysis. Collection/Extraction Methods We conducted semi‐structured...
Vulnerable populations face difficulties accessing and using the internet personal health record (PHR) systems for health-related purposes. Populations disconnected from also tend to be care services.To develop evaluate an intervention increase skills in PHR use vulnerable with limited computer experience.Preevaluation postevaluation quantitative surveys, semistructured interviews, focus groups, ethnographic observation.Fourteen low-income Veterans receiving at Affairs medical centers human...
The transition to the community after incarceration presents challenges for returning citizens, including immediate need secure housing, employment, and income. Additionally, health care is essential this population due high rates of chronic physical mental problems substance use disorders. There growing recognition interventions that support citizens as they navigate reintegration while simultaneously tending behavioral needs. We developed pilot tested a peer intervention designed provide...
Acceptability of mobile phone text messaging as a means asynchronous communication between health care systems and patients is growing. The US Department Veterans Affairs (VA) has adopted an automated texting system (aTS) for national rollout. aTS allows providers to develop clinical protocols promote patient self-management teams monitor progress in-person visits. Texting-supported hepatitis C virus (HCV) treatment not been previously tested.Guided by the Practical, Robust Implementation...
Background. Homeless veterans have complex healthcare needs, but experience many barriers to treatment engagement. While information technologies (IT), especially mobile phones, are used engage patients in care, little is known about homeless veterans’ IT use. This study examines access and use of IT, attitudes toward health-related use, the context homelessness.Methods. Qualitative interviews were conducted with 30 different housing programs Boston, MA, ranging from emergency shelters...
Insomnia is a prevalent and debilitating disorder among veterans. Cognitive behavioral therapy for insomnia (CBTI) can be effective treating insomnia, although many cannot access this care. Technology-based solutions lifestyle changes, such as physical activity (PA), offer affordable accessible self-management alternatives to in-person CBTI.This study aims extend replicate prior pilot work examine whether the use of mobile app CBTI (cognitive coach [CBT-i Coach]) improves subjective...
Clinical pharmacists (CPs) with a scope of practice operate as direct care providers and health team members. Research often focuses on one role or the other; little is understood about dynamic relationship between roles in settings.To identify challenges CPs face balancing dual members implications for CP effectiveness quality care.Pharmacists were interviewed primary purpose informing an implementation effort. Besides implementation, there emergent themes regarding posed negotiating roles....
Military veterans involved in the criminal justice system are a vulnerable subpopulation that has extensive physical and behavioural health treatment needs. Like non-veteran populations, safe stable housing, employment social support critical for returning to society after incarceration. The challenges of reintegration immense, risk recidivism is high. U.S. Department Veteran Affairs (VA) developed specific programmes assist plan with reentry. While there have been successes, early mortality...
Importance Few evidence-based treatments are available for Gulf War illness (GWI). Behavioral that target factors known to maintain the disability from GWI, such as problem-solving impairment, may be beneficial. Problem-solving treatment (PST) targets impairment and is an other conditions. Objective To examine efficacy of PST reduce disability, physical symptoms in GWI. Design, Setting, Participants This multicenter randomized clinical trial conducted US Department Veterans Affairs compared...
Background 1.8 million Veterans are estimated to need legal services, such as for housing eviction prevention, discharge upgrades, and state federal benefits. While having one’s needs met is known improve health its social determinants, many Veterans’ remain unmet. Public Law 116–315 enacted in 2021 authorizes VA fund services (LSV) by awarding grants service providers including nonprofit organizations law schools’ assistance programs. This congressionally mandated LSV initiative will award...
Between 12,000 and 16,000 veterans leave incarceration annually. As is known to be the case for justice-involved populations in general, mental health disorders (MHDs) substance use (SUDs) are highly prevalent among incarcerated veterans, individuals with MHDs SUDs reentering community at increased risk of deteriorating recidivism. We sought identify opportunities better coordinate care/services across correctional, community, VA systems reentry SUDs.We interviewed 16 post-incarceration 22...
Improved anticoagulation control with warfarin reduces adverse events and represents a target for quality improvement. No previous study has described an effort to improve across health system.To describe the results of in New England region Veterans Health Administration (VA).Our intervention encompassed 8 VA sites managing more than 5000 patients (Veterans Integrated Service Network 1 [VISN 1]). We provided system measure processes care, along targeted audit feedback. focused on care...
The Veterans Health Administration (VHA) is deploying an automated texting system (aTS) to support patient self-management.We conducted a qualitative evaluation examine factors influencing national rollout of the aTS, guided by Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework, which intended novel technologies.Semistructured interviews were with 33 staff 38 patients who early adopters aTS. Data analyzed following deductive inductive approaches using priori...