A5103168921- Musculoskeletal pain and rehabilitation
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Posttraumatic Stress Disorder Research
- Healthcare professionals’ stress and burnout
- Primary Care and Health Outcomes
- Pain Management and Placebo Effect
- HIV/AIDS Research and Interventions
- Occupational Health and Performance
- Adolescent Sexual and Reproductive Health
- Healthcare Policy and Management
- Opioid Use Disorder Treatment
- Intimate Partner and Family Violence
- Pediatric Pain Management Techniques
- HIV, Drug Use, Sexual Risk
- Health Systems, Economic Evaluations, Quality of Life
- Health Policy Implementation Science
- Pain Management and Opioid Use
- Suicide and Self-Harm Studies
- Global Maternal and Child Health
- Global Health Workforce Issues
- Mindfulness and Compassion Interventions
- Patient Satisfaction in Healthcare
- Hepatitis C virus research
- Nursing Roles and Practices
- Health, psychology, and well-being
VA Connecticut Healthcare System
2016-2025
Yale University
2016-2025
Health Services Research & Development
2017-2022
Hudson Institute
2018
Boston University
2016
VA Boston Healthcare System
2016
Rush University Medical Center
2015
University of Illinois Hospital & Health Sciences System
2015
Illinois Department of Public Health
2010-2015
Centers for Disease Control and Prevention
2014
<h3>Importance</h3> Cognitive behavioral therapy for chronic pain (CBT-CP) is a safe and effective alternative to opioid analgesics. Because CBT-CP requires multiple sessions therapists are scarce, many patients have limited access or fail complete treatment. <h3>Objectives</h3> To determine if program that personalizes patient treatment using reinforcement learning, field of artificial intelligence (AI), interactive voice response (IVR) calls noninferior standard telephone saves therapist...
Abstract Musculoskeletal disorders (MSDs) are highly prevalent, painful, and costly disorders. The MSD Cohort was created to characterize variation in pain, comorbidities, treatment, outcomes among patients with receiving Veterans Health Administration care across demographic groups, geographic regions, facilities. We searched electronic health records identify treated who had ICD-9-CM codes for diagnoses including, but not limited to, joint, back, neck disorders, osteoarthritis. inclusion...
Recommendations for chronic pain treatment emphasize multimodal approaches, including nonpharmacologic interventions to enhance self-management. Cognitive behavioral therapy (CBT) is an evidence-based that facilitates management of and improves outcomes, but access barriers persist. delivery assisted by health technology can obviate the need in-person visits, effectiveness this alternative standard unknown. The Cooperative Pain Education Self-management (COPES) trial was a randomized,...
The high prevalence and societal burden of chronic pain, its undertreatment, disparities in management have contributed to the acknowledgment pain as a serious public-health concern. concurrent opioid epidemic, increasing concern about overreliance on therapy despite evidence limited benefit harms, has heightened attention this problem. biopsychosocial model emerged primary conceptual framework for understanding complex experience informing models care. prominence psychological processes...
A social-ecological framework for resilience underscores the importance of conceptualizing individuals embedded within their context when evaluating a person's vulnerability and adaptation to stress. Despite high level trauma exposure, most veterans exhibit psychological following traumatic event. Interpersonal is associated with poorer outcomes than noninterpersonal experienced more frequently across lifespan by women as compared men. In present study, we examined gender differences in...
ABSTRACT Introduction This study reports rates of comorbid chronic pain and post-traumatic stress disorder (PTSD) among U.S. military veterans psychiatric comorbidities those with both PTSD. Materials Methods utilized National Veterans Affairs (VA) administrative data to identify all treated for or PTSD in 2023. Multivariable logistic regression models determined the likelihood each comorbidity relative only separately only, after adjusting demographic variables other comorbidities. Results...
We examined whether Cognitive Behavioral Therapy for chronic pain (CBT-CP) driven by artificial intelligence (i.e., AI-CBT-CP) increased its effectiveness through patient interactions. Data included 11,133 interactions with 168 patients receiving 10 weeks of AI-CBT-CP as part a comparative trial. Each week each patient, selected among three treatment recommendations: 45-minute or 15-minute "live" therapy session, asynchronous therapist feedback delivered via an interactive voice response...
Abstract Background Women are more likely to experience multiple overlapping pain conditions (MOPCs) relative men. Post‐traumatic stress disorder can negatively impact the severity and trajectory of chronic its treatment. Specific associations between gender, post‐traumatic (PTSD), MOPCs require further examination. Methods A cohort all Veterans in 2021 who met criteria for one or 12 types was created using national Health Administration administrative data. were defined as number which each...
Women veterans have a higher prevalence of chronic pain relative to men. One hypothesis is that differential combat and traumatic sexual experiences attenuated levels social support between men women may differentially contribute the development perpetuation pain. This investigation examined [1] gender differences in trauma, support, family conflict among with pain, [2] whether were associated severity, interference, depressive symptom severity as function gender.Participants included 460...
Rates of pain among veterans are as high 60%; rates approach 80% in women seeking Department Veterans Affairs (VA) care. Prior studies examined experiences managing community samples, with gender disparities observed. As the largest national integrated health care system country, VA offers a unique environment to a) study perceptions men and b) contrast using an setting prior observations private sector.A purposive sample chronic patients was recruited qualitatively describe explore...
Pain and smoking are highly prevalent among Veterans. Studies in non-Veteran populations have reported higher pain intensity current smokers compared with nonsmokers former smokers. We examined the association of status Veterans Operations Enduring Freedom, Iraqi New Dawn (OEF/OIF/OND). The sample consisted OEF/OIF/OND who had at least one visit to Affairs (2001–2012) information electronic medical record for concurrent intensity. primary outcome measure was intensity, categorized as none...
The infertility associated with primary ovarian insufficiency (POI) presents significant emotional challenges requiring psychosocial adjustment. Few investigations have explored the longitudinal process of adaptation to POI. This investigation tests a model adjustment POI that includes separate vulnerability and resilience resource factors. Among 102 women POI, personal attributes reflective were assessed at baseline. Coping strategies 4 months later measures distress well-being 12 later. As...
In response to clusters of carbapenem-resistant Enterobacteriaceae (CRE) in Illinois, USA, the Illinois Department Public Health and Centers for Disease Control Prevention Chicago Epicenter launched a statewide Web-based registry designed bidirectional data exchange among health care facilities. CRE occurrences are entered searchable system, enabling interfacility communication patient information. For rapid notification facilities, admission feeds automated. During first 12 months...
ABSTRACT Introduction The aim is to elucidate approaches care for comorbid chronic pain and PTSD (CP + PTSD) in the Veterans Administration (VA). These conditions are co-magnifying highly but traditionally treated separate clinical settings. Materials Methods This multimethod analysis examined CP via administrative data analyses qualitative interviews of VA-served veterans. Results All participants with diagnoses 2021 were identified using VA (N = 456,544). Visits during following year...
Background Trauma is a significant public health issue that affects both mental and physical health. Healthcare delivery based on trauma-informed care (TIC) principles designed to mitigate the risk of re-traumatization in healthcare settings improve patient outcomes. Chronic pain common comorbidity trauma reason people seek healthcare, including chiropractic care. The extent which TIC training integrated into education Doctor Chiropractic Programs (DCPs) remains unclear. Objective This study...
Abstract Purpose In the context of increased access to multidisciplinary pain team care in veterans health administration (VHA) recent years, current study sought determine whether continuity clinic varied for rural compared urban veterans, following an initial visit. Specifically, frequency general visits and psychology were contrasted between 2015 2022. Methods National VHA administrative data used build two cohorts with visit or Number number year calculated. Multivariable regression...
Abstract Objective To examine the relationship between body mass index (BMI) and pain intensity among veterans with musculoskeletal disorder diagnoses (MSDs; nontraumatic joint disorder; osteoarthritis; low back, neck pain). Setting Administrative electronic health record data from Veterans Health Administration (VHA). Subjects A national cohort of US military MSDs in VHA care during 2001–2012 (N = 1,759,338). Methods These cross-sectional were analyzed using hurdle negative binomial models...