Grant List
Represents Grant table in the DB
GET /v1/grants?page%5Bnumber%5D=1405&sort=-award_amount
{ "links": { "first": "https://cic-apps.datascience.columbia.edu/v1/grants?page%5Bnumber%5D=1&sort=-award_amount", "last": "https://cic-apps.datascience.columbia.edu/v1/grants?page%5Bnumber%5D=1424&sort=-award_amount", "next": "https://cic-apps.datascience.columbia.edu/v1/grants?page%5Bnumber%5D=1406&sort=-award_amount", "prev": "https://cic-apps.datascience.columbia.edu/v1/grants?page%5Bnumber%5D=1404&sort=-award_amount" }, "data": [ { "type": "Grant", "id": "14256", "attributes": { "award_id": "5I01HX003571-02", "title": "Maintaining Preventive Care during Public Health Emergencies through Effective Coordination", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2022-10-01", "end_date": "2024-09-30", "award_amount": null, "principal_investigator": { "id": 26865, "first_name": "SYLVIA J.", "last_name": "HYSONG", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] }, "other_investigators": [], "awardee_organization": { "id": 1685, "ror": "", "name": "MICHAEL E DEBAKEY VA MEDICAL CENTER", "address": "", "city": "", "state": "TX", "zip": "", "country": "United States", "approved": true }, "abstract": "BACKGROUND. Screening lies at the heart of preventive care. However, COVID-19 has dramatically disrupted routine screening efforts, resulting in excess veteran mortality not directly attributable to COVID-19. Screening rates at VA during COVID have varied markedly by facility and clinical condition. This is illustrated in cancer and mental health screening; cross-facility variability exists for each, suggesting susceptibilities in the capacity and workflow of the screening and referral process. To better understand these susceptibilities and identify new practices to mitigate interrupted care, we propose a qualitative study comparing facilities that exhibited high, low, and highly variable performance (respectively) in screening rates before and during the pandemic. SIGNIFICANCE. Disruptions to preventive screening lead to excess veteran mortality. Therefore, caring for veterans’ regular primary care (PC) needs while fulfilling our Fourth Mission (emergency preparedness) requires top-notch coordination and nimble teamwork from all clinical personnel. Our study will identify the systematic strategies and coordination patterns between primary and specialty care that differentiate successful facilities from struggling ones. Our findings will help design new or adapt existing workflows and interventions for coordination, shaping how screening and preventive care is delivered during and beyond COVID-19. Our study directly addresses: a) this solicitation’s goals; b) HSR&D’s clinical priorities; c) VA’s strategic plan goals for highly reliable care; and d) ORD real-world research impact priorities. SPECIFIC AIMS. Using cancer and mental health screening rates as exemplars, we propose to (1) Compare how PACTs from VHA facilities of varying screening performance patterns (high, low, improving, plummeting, variable) during the COVID-19 pandemic coordinated (a) as a team to conduct screening services, and (b) with specialty care teams at their facility to conduct screening services; and (2) Compare team, facility, and system- based barriers, facilitators, and strategies for continuing screening services during the COVID-19 pandemic amongst PACTs from VHA facilities of varying screening performance patterns during that period. METHOD. Design and Participants. This multi-method study consists of qualitative analysis of interviews and focus groups with primary care personnel, leadership, and patients at 10 VA Medical Centers (VAMCs). Site Selection. We will select study sites using a purposive stratified approach based on site rurality, COVID-19 caseload at the beginning of the pandemic, and performance on five outpatient clinical performance indicators of cancer and mental health screening. Sites will be categorized into one of five screening performance groups: high performers, low performers, improvers, plummeters, and highly variable. Procedure. Using data from prior research by the PI, we will create process maps for each performance measure to create a baseline for comparison to the process used since the pandemic began. We will interview the ACOS for primary care at each site to update the map to reflect the currently used process. We will conduct focus groups with PC and relevant specialty care clinicians to elicit themes regarding clinician coordination patterns (e.g., handoffs), strategies, and barriers/facilitators to screening during COVID (Aims 1- 3). We will also conduct patient interviews to examine their screening experience during this period, for context. Data Analysis: All interview and focus groups will be audio-recorded, transcribed, and enhanced by field notes. We will analyze clinician focus group transcripts and field notes using iterative, rapid analysis. Patient semi- structured interviews will be analyzed using inductive/deductive content analysis. NEXT STEPS/IMPLEMENTATION. We will share our findings, including site-specific recommendations, locally with key stakeholders at participating sites, and nationally through the Office of Primary Care-Mental Health Integration program and the VA National Women Veterans Oncology System of Excellence.", "keywords": [ "Accountability", "Address", "Adopted", "American", "Behavior", "Breast Cancer Detection", "COVID-19", "COVID-19 pandemic", "Caring", "Categories", "Cause of Death", "Cervical Cancer Screening", "Chronic Disease", "Clinic", "Clinical", "Complex", "Country", "Data", "Data Analyses", "Detection", "Diagnosis", "Disease", "Disease Management", "Drops", "Early treatment", "Emergency Situation", "Ensure", "Exhibits", "Focus Groups", "Future", "Genetic Transcription", "Goals", "Health", "Health Personnel", "Healthcare", "Heart", "Human Resources", "Individual", "Interruption", "Intervention", "Interview", "Lead", "Leadership", "Malignant Neoplasms", "Maps", "Measures", "Medical center", "Mental Depression", "Mental Health", "Mental Health Services", "Mental disorders", "Methods", "Mission", "Modeling", "Oncology", "Outcome", "Outpatients", "Participant", "Patients", "Pattern", "Performance", "Persons", "Post-Traumatic Stress Disorders", "Predisposition", "Prevention", "Preventive care", "Preventive screening", "Preventive service", "Primary Care", "Procedures", "Process", "Public Health", "Quality of Care", "Recommendation", "Research", "Resources", "Role", "Screening for cancer", "Services", "Shapes", "Site", "Specialist", "Strategic Planning", "Structure", "Symptoms", "System", "Testing", "Time", "Touch sensation", "Transcript", "Update", "Variant", "Veterans", "Woman", "Work", "colon cancer screening", "coronavirus disease", "design", "emergency preparedness", "exhaust", "experience", "improved", "medical specialties", "mortality", "notch protein", "pandemic disease", "poor health outcome", "post-pandemic", "prevent", "primary care team", "programs", "public health emergency", "routine screening", "rurality", "screening", "screening services", "telehealth", "tv watching" ], "approved": true } }, { "type": "Grant", "id": "14259", "attributes": { "award_id": "5I01BX006008-02", "title": "Host Genetic and Epigenetic Factors of the Progression, Comorbidities and Outcomes of Viral Infection", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2022-10-01", "end_date": "2026-09-30", "award_amount": null, "principal_investigator": { "id": 26780, "first_name": "Vincent Charles", "last_name": "Marconi", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] }, "other_investigators": [], "awardee_organization": { "id": 1477, "ror": "https://ror.org/05eq41471", "name": "Veterans Health Administration", "address": "", "city": "", "state": "MI", "zip": "", "country": "United States", "approved": true }, "abstract": "Viral infections including Human immunodeficiency virus (HIV), hepatitis C virus (HCV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have placed a substantial strain on human health and the health care system. These infections have specifically had broad impacts on veteran health in the US. Host factors influence how humans respond to infectious agents and develop adverse health outcomes after infection. Although previous genome-wide association studies (GWAS) have identified loci associated with susceptibility and progression for several infections, understanding the role of host genetic and epigenetic factors on chronic disease comorbidities, aging, and long-term outcomes in the setting of viral infections has been hampered by sample size, heterogeneous populations, and discordant measurements/definitions of key phenotypes. Recent epigenome-wide association studies (EWAS) have uncovered DNA methylation markers associated with noncommunicable diseases (NCDs, such as coronary heart disease, diabetes, heart failure, chronic kidney disease), as well as HIV infection. However, the epigenetic predictors for incident NCDs and mortality are largely unknown among people with viral infections. Viral infections (e.g., HIV) can have a substantial impact on epigenetics, which may affect long-term health outcomes. Additionally, acceleration of the epigenetic clock or age has emerged as a novel biomarker of biological aging and can predict disease outcomes and mortality. Therefore, we will systematically investigate genetic and epigenetic predictors of NCDs and mortality in the following Aims. 1) To identify genetic and epigenetic predictors of age-related morbidity and mortality as well as modification effect of HIV infection among multi-ethnic veterans; 2) To identify genetic and epigenetic factors associated with morbidity and mortality among multi- ethnic veterans with HCV infection; 3) To identify genetic and epigenetic factors of long-term comorbidities, accelerated aging and mortality, as well as mediation effect of COVID-19 among multi-ethnic veterans. Impact: Viral infections including HIV, HCV and SARS-CoV-2 broadly affects veteran’s health and reduces the quality of life (healthspan) and life expectancy (lifespan) through a range of comorbidities. The molecular mechanisms underlying the morbidity and mortality after viral infections of HIV, HCV and SARS-CoV-2 are largely unknown. The proposed genetic and epigenetic study can reveal the genetic and epigenetic factors linking viral infection (acute, chronic, and resolved) and major NCD outcomes and mortality among multi-ethnic veterans, shed lights on potential targets for new prevention and intervention, provide insights into the comorbidity and aging process for all people, and develop systematic and precision medicine strategies to improve veteran’s health.", "keywords": [ "2019-nCoV", "Acceleration", "Acute", "Affect", "Age", "Aging", "Algorithms", "Antiviral Therapy", "Biological Aging", "COVID-19 impact", "Chronic", "Chronic Disease", "Chronic Kidney Failure", "Communicable Diseases", "Congestive Heart Failure", "Coronary heart disease", "DNA Methylation", "Data", "Diabetes Mellitus", "Diagnostic", "Disease", "Disease Outcome", "Disease Progression", "Electronic Health Record", "Epigenetic Process", "Ethnic Population", "General Population", "Genetic", "Genetic Markers", "Genetic Predisposition to Disease", "HIV", "HIV Infections", "Health", "Healthcare Systems", "Heart failure", "Hepatitis C", "Hepatitis C virus", "Human", "Human Genetics", "Human Genome", "Immune", "Immune response", "Immune system", "Immunologics", "Individual", "Infection", "Infectious Agent", "Inflammatory", "Integration Host Factors", "Intervention", "Life Expectancy", "Link", "Liver Cirrhosis", "Liver Fibrosis", "Longevity", "Measurement", "Mediation", "Mendelian randomization", "Modeling", "Modification", "Molecular", "Morbidity - disease rate", "Multiomic Data", "Organ", "Outcome", "Pathway interactions", "Persons", "Phenotype", "Population Heterogeneity", "Predisposition", "Prevention", "Process", "Prognosis", "Quality of life", "Risk Factors", "Role", "SARS-CoV-2 infection", "Sample Size", "Site", "Stroke", "System", "Therapeutic", "Veterans", "Virus Diseases", "advanced analytics", "age related", "chronic liver disease", "comorbidity", "disorder risk", "epigenetic marker", "epigenome-wide association studies", "genetic variant", "genome wide association study", "genomic locus", "healthspan", "improved", "insight", "longitudinal analysis", "methylation biomarker", "mortality", "multi-ethnic", "multiple chronic conditions", "novel marker", "pathogen", "precision medicine", "programs", "response" ], "approved": true } }, { "type": "Grant", "id": "14267", "attributes": { "award_id": "3I01HX003401-01A1S1", "title": "COVID-19 Impact on Pain management: Highlighting, Explaining, and Realigning services (CIPHER)", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2022-10-01", "end_date": "2024-09-30", "award_amount": null, "principal_investigator": { "id": 23769, "first_name": "Marianne", "last_name": "Matthias", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1636, "ror": "", "name": "RLR VA MEDICAL CENTER", "address": "", "city": "", "state": "IN", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [ { "id": 23770, "first_name": "Alan Benjamin", "last_name": "McGuire", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] } ], "awardee_organization": { "id": 1636, "ror": "", "name": "RLR VA MEDICAL CENTER", "address": "", "city": "", "state": "IN", "zip": "", "country": "United States", "approved": true }, "abstract": "Background: Transgender and gender diverse (TGD) Veterans are a priority population at greater risk of harm following disruptions in chronic pain care, with higher rates of chronic pain conditions and of physical and mental health comorbidities associated with prescription opioid use and overdose risk. Moreover, TGD Veterans avoid medical care due to negative experiences rooted in stigma, reporting “insensitivity, harassment, and violence” and “a general lack of knowledge about transgender patients and care among providers.” Significance: Both the higher rates of chronic pain conditions and the increased prevalence of SUD and overdose risk underscore that consistent chronic pain care and close oversight of care plans are essential for TGD Veterans, and interruptions may have dire consequences. The need to better understand and develop strategies to improve chronic pain care for TGD Veterans is critical and urgent to support wellbeing, manage pain, ameliorate discriminatory treatment rooted in provider biases, and prevent opioid-related crises. Innovation and Impact: Identity Development Evaluation and Sharing (IDEAS) is an innovative, evidence- supported methodology in which qualitative data are presented via theatricalized, filmed monologues. Studies have shown that viewing an IDEAS performance significantly reduces stigma beliefs, and literature suggests IDEAS may facilitate translation of qualitative findings into actionable recommendations for optimizing future care because data are presented in deeply contextualized ways – embedded in Veterans’ life experiences. Specific Aims: The proposed work will supplement an existing VA-funded study, CIPHER, which focuses on 1) understanding changes in Veterans’ chronic low-back pain care after COVID-19 and their associated impacts; and 2) using these data to develop strategies to optimize future delivery of VA pain services. Aim 1 of the proposed work will enhance CIPHER by elucidating chronic pain care experiences of a high priority population, TGD Veterans. In aim 2 of the proposed work we will apply findings from Aim 1 to develop a novel, interactive intervention to support equitable TGD Veteran care, advancing CIPHER’s aim of developing short and long-term strategies to optimize equitable delivery of pain management services post-COVID-19. Methodology: In aim 1 we will purposefully sample TGD Veterans from CIPHER’s cohort of Veterans with chronic low back pain use ICD-10 Gender Identity Disorder codes. We will conduct narrative interviews to learn about TGD Veterans’ chronic pain care experiences prior to and following the onset of the pandemic. We will identify key messages via thematic analysis of interview transcripts, focusing especially on areas for future care optimization. In aim 2 we will apply IDEAS to produce a 25-minute film with professional actors portraying key messages from aim 1 findings. We will share the film with CIPHER stakeholders and primary care providers during a 1-hour meeting in which TGD Veteran panelists join for a 15-minute PI-moderated post-film panel conversation. Stakeholders and providers will complete a pre/post Acceptance and Action Questionnaire – Stigma, which provides a composite score with lower scores indicating reduced enacted stigma. An unadjusted two sample paired t-test will be used to assess the difference in matched pre-post AAQ-S survey scores. To assess whether IDEAS feasibly and acceptably shares qualitative data to facilitate actionable change, we will distribute the Acceptability of Intervention Measure (AIM) and the Feasibility of Intervention Measure (FIM) anonymously via an online survey that will include space for open-ended responses with each item, asking respondents to describe if/how IDEAS facilitates actionable change. We will use explanatory sequential mixed methods to expand quantitative AIM/FIM findings with qualitative feedback. Next steps/Implementation: The proposed work will result in an IDEAS film depicting chronic pain care experiences of TGD Veterans that can be disseminated by CIPHER stakeholders, as well as data on pre/post change in provider stigma and stakeholders’ perceptions of IDEAS feasibility and acceptability.", "keywords": [ "Area", "Attitude", "Belief", "COVID-19", "COVID-19 impact", "COVID-19 pandemic", "Caring", "Chronic low back pain", "Code", "Cognitive", "Cognitive Science", "Collaborations", "Communities", "Data", "Development", "Environment", "Equity", "Evaluation", "Event", "Feedback", "Film", "Funding", "Future", "Gender identity disorder", "Goals", "Healthcare", "Healthcare Systems", "High Prevalence", "Hour", "Indiana", "International Statistical Classification of Diseases and Related Health Problems Tenth Revision (ICD-10)", "Interruption", "Intervention", "Interview", "Knowledge", "Learning", "Lesbian Gay Bisexual Transgender Queer", "Life Experience", "Literature", "Low Back Pain", "Measures", "Medical", "Mental Health", "Methodology", "Methods", "Neurologic", "Opioid", "Pain", "Pain management", "Patients", "Perception", "Performance", "Personal Satisfaction", "Persons", "Play", "Population", "Prevalence", "Provider", "Questionnaires", "Recommendation", "Reporting", "Research Personnel", "Resistance", "Respondent", "Risk", "Sampling", "Services", "Substance Use Disorder", "Surveys", "Testing", "Transcript", "Translating", "Translations", "Universities", "Veterans", "Violence", "Work", "acceptability and feasibility", "catalyst", "chronic pain", "chronic painful condition", "cisgender", "cohort", "comorbidity", "disorder risk", "experience", "gender diversity", "health care disparity", "improved", "innovation", "meetings", "member", "novel", "opioid overdose", "opioid use", "overdose risk", "pandemic disease", "physical conditioning", "post-COVID-19", "prescription opioid", "prevent", "primary care provider", "programs", "response", "social stigma", "transgender" ], "approved": true } }, { "type": "Grant", "id": "14271", "attributes": { "award_id": "5I01RX003656-02", "title": "INDIVIDUAL PLACEMENT AND SUPPORT FOR VETERANS WITH OPIOID USE DISORDER: A MIXED METHODS STUDY", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2022-10-01", "end_date": "2026-09-30", "award_amount": null, "principal_investigator": { "id": 25523, "first_name": "LORI L.", "last_name": "DAVIS", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] }, "other_investigators": [ { "id": 24118, "first_name": "Mercy N", "last_name": "Mumba", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1699, "ror": "", "name": "TUSCALOOSA VETERANS AFFAIRS MEDICAL CTR", "address": "", "city": "", "state": "AL", "zip": "", "country": "United States", "approved": true } ] } ], "awardee_organization": { "id": 1699, "ror": "", "name": "TUSCALOOSA VETERANS AFFAIRS MEDICAL CTR", "address": "", "city": "", "state": "AL", "zip": "", "country": "United States", "approved": true }, "abstract": "Background: Living with an opioid use disorder (OUD) can make finding and sustaining employment a significant challenge and is only getting worse in the COVID-19 environment. With states reporting unemployment rates as high as 15-20%, the negative effects of unemployment on OUD treatment outcomes are expected to deteriorate. The COVID-19 pandemic has further resulted in treatment disruptions that are exacerbating poor outcomes, because of unemployment, social isolation, interrupted access to medication for OUD treatment (MOUD), and interference of daily routines that provide the necessary structure for many people with OUD. Our group has conducted research that shows Individual Placement and Support (IPS) is efficacious in yielding more weeks worked and higher steady employment rates for Veterans with posttraumatic stress disorder and Veterans diagnosed with a broad range of mental conditions (including substance use) being treated in a primary care setting; however, little is known about its efficacy in Veterans with OUD. Only one small study in civilians (n=45) with OUD has been conducted, in which 50% of the participants assigned to IPS gained employment compared to 5% of waitlist control at 6 months follow-up (p<0.001). A systematic review of effectiveness of IPS with conditions other than serious psychiatric mental illness revealed major limitations in many studies, including small sample sizes, major modifications to IPS model, weak control, and short follow-up periods. A larger randomized controlled trial of IPS for Veterans recovering from OUD with longer follow-up period, strong treatment control, and strict adherence to IPS fidelity, such as the one we propose, is warranted. Methods: This is a prospective, multi-site, randomized controlled trial to determine the efficacy of IPS compared to non-IPS Treatment-as-Usual Vocational Rehabilitation (TAU-VR) in a sample of 120 Veterans recovering from OUD (Aim 1). Investigators hypothesize that Veterans with OUD randomized to IPS will work significantly more weeks in a competitive job over 15 months compared to the non-IPS TAU-VR group. Additionally, compared to non-IPS TAU-VR, IPS recipients will earn significantly more income from competitive jobs and be significantly more likely to achieve steady employment. The investigators will also evaluate self-report measures of resilience, quality of life, perceived stress, community engagement, depression, anxiety, abstinence self-efficacy and suicide risk. As Aim 2, using a Community Based Participatory Research (CBRP) approach, the investigators will identify the contextual barriers to and facilitators of implementing vocational services for Veterans in both the IPS and non-IPS TAU-VR study arms, including evaluation of employment challenges, optimal occupational functioning, and OUD treatment adherence, with specific emphasis on the impact of COVID-19 and social distancing. To address Aim 2, the investigators will conduct semi-structured interviews with Veterans with OUD randomized to IPS or non-IPS TAU-VR. These interviews will be supplemented by qualitative findings from an ongoing Rehabilitation R&D pilot study that includes qualitative interviews on the same topic with IPS specialists, providers, unemployed veterans with OUD, and potential employers. Working with a CBPR Steering Committee, findings will be aggregated to reach consensus on best practices for IPS implementation in this new population. In an Exploratory Aim 3, the impact of IPS will be compared to non-IPS TAU-VR on participants’ adherence to MOUD and rates of OUD relapse. Significance: This study seeks to find the best intervention for successful recovery and functional reintegration for Veterans recovering from OUD. This study is especially timely given the societal impact of the COVID-19 pandemic on employment and mental health problems of the general population, and Veterans specifically. Additionally, with the new VHA plan to expand supported employment services to Veterans with substance use disorders in the coming years, our study is timely and can significantly contribute to the evidence required to successfully implement and sustain supported employment services in this new priority population.", "keywords": [ "Abstinence", "Address", "Adherence", "Anxiety", "Area", "Back", "COVID-19", "COVID-19 impact", "COVID-19 pandemic", "COVID-19 pandemic effects", "Communities", "Consensus", "Control Groups", "Data", "Deterioration", "Diagnosis", "Economic Burden", "Economics", "Effectiveness", "Employment", "Environment", "Evaluation", "Feeling hopeless", "General Population", "Goals", "Homelessness", "Income", "Individual", "Interruption", "Intervention", "Interview", "Link", "Measures", "Mental Depression", "Mental Health", "Mental disorders", "Methods", "Modeling", "Modification", "Occupational", "Occupations", "Outcome", "Participant", "Patient Self-Report", "Persons", "Pilot Projects", "Population", "Post-Traumatic Stress Disorders", "Poverty", "Prevention", "Process", "Productivity", "Provider", "Psyche structure", "Public Health", "Publishing", "Quality of life", "Randomized", "Randomized Controlled Trials", "Recovery", "Rehabilitation therapy", "Relapse", "Reporting", "Research", "Research Personnel", "Research Support", "Resources", "Sample Size", "Sampling", "Self Efficacy", "Services", "Site", "Social Distance", "Social isolation", "Socialization", "Specialist", "Structure", "Substance Use Disorder", "Supported Employment", "Symptoms", "Treatment outcome", "Unemployment", "Veterans", "Vocation", "Vocational rehabilitation", "Waiting Lists", "Work", "arm", "community based participatory research", "community engagement", "design", "effectiveness evaluation", "efficacy evaluation", "efficacy testing", "evidence base", "experience", "follow-up", "functional independence", "implementation evaluation", "implementation facilitators", "improved", "interest", "medication for opioid use disorder", "methadone treatment", "opioid epidemic", "opioid use disorder", "patient population", "perceived stress", "primary care setting", "prospective", "rehabilitation service", "relapse prevention", "research and development", "resilience", "rural area", "substance use", "success", "suicidal risk", "systematic review", "treatment adherence", "treatment as usual" ], "approved": true } }, { "type": "Grant", "id": "14278", "attributes": { "award_id": "5I01HX003565-02", "title": "COVID-19 Preventive Health Inventory: Evaluating a primary care approach to catching-up on needed chronic and preventive care for Veterans", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2022-10-01", "end_date": "2024-09-30", "award_amount": null, "principal_investigator": { "id": 26866, "first_name": "Ashok", "last_name": "Reddy", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] }, "other_investigators": [], "awardee_organization": { "id": 1512, "ror": "", "name": "VA PUGET SOUND HEALTHCARE SYSTEM", "address": "", "city": "", "state": "WA", "zip": "", "country": "United States", "approved": true }, "abstract": "Background: Chronic disease and preventive care that occurs within primary care was delayed or deferred in the acute COVID-19 crisis, which is expected to have profound impacts on the health of VA patients. In response, the VHA Office of Primary Care (OPC) launched the Preventative Health Initiative (PHI) on March 1st, 2021 to support primary care in delivering needed primary care services. This innovative care coordination intervention leverages three main components: 1) development of an electronic dashboard utilizing 10 common chronic and preventive care quality measures; 2) using nurse care managers for proactive virtual care visits; and 3) the use of structured electronic health record note template to complete needed care. Our current work has shown substantial PHI use and diffusion; however, little is known about implementation and outcomes from PHI uptake. Our proposal will address these knowledge gaps and provide needed evidence on mitigation strategies being supported by the OPC. Significance/Impact: This study will build on ongoing collaborations between VA’s OPC and health services researchers and provide needed evidence that the VA health system can use to better serve Veterans in ongoing pandemic response and recovery. A key component of our work will assess whether national efforts to mitigate effects of the pandemic were effective in reducing adverse health impacts. Innovation: Our work will be the first to evaluate the implementation of a multi-component care coordination intervention to support chronic and preventive care after the disruption to primary care delivery caused by the pandemic. Specific Aims: Aim 1: Identify key factors associated with use of PHI at 1 year as a care coordination intervention to improve coordination of chronic and preventive disease in primary care Aim 2: Understand implementation of the PHI to deliver chronic and preventive care from the perspectives of a) clinic frontline staff (leaders, PCPs, and nurse care managers) and b) Veterans who received the PHI. Aim 3: Examine impact of PHI tool on primary care quality (diabetes, hypertension, and colon cancer screening) and potentially preventable utilization. Methodology: This rapid-cycle evaluation will use both quantitative and qualitative approaches to understanding the implementation and outcomes from the OPC’s PHI intervention. Aim 1: We will use a multi- level modeling approach to examine patient-level variation in rates of PHI-use to identify the extent to which Veteran, provider, or clinic-factors explain this variation. Aim 2: We will conduct semi-structured interviews among clinic staff to understand the implementation of PHI and Veteran experience of PHI-directed care. Aim 3: We will conduct a propensity scored matched analysis, matching patients who received PHI intervention to a comparison group who did not receive PHI to estimate the impacts on quality and utilization measures using a series of difference-in-differences regression models. Implementation/Next Steps: Together, work from these aims will provide key evidence for VA policymakers on the impact of a large-scale care coordination intervention on mitigating the impact COVID-19 on chronic and preventive care.", "keywords": [ "Acute", "Address", "Adoption", "Blood Pressure", "COVID-19", "COVID-19 impact", "COVID-19 pandemic", "Care given by nurses", "Caring", "Case Manager", "Chronic", "Chronic Care", "Chronic Disease", "Clinic", "Collaborations", "Data", "Development", "Diabetes Mellitus", "Diffusion", "Disease", "Disease Management", "Early Diagnosis", "Effectiveness", "Electronic Health Record", "Electronics", "Emergency department visit", "Equipment and supply inventories", "Evaluation", "Frontline worker", "Glycosylated hemoglobin A", "Health", "Health Services", "Health system", "Hospitalization", "Hypertension", "Infrastructure", "Intervention", "Interview", "Knowledge", "Licensing", "Managed Care", "Measurement", "Measures", "Methodology", "Modeling", "Monitor", "Morbidity - disease rate", "Outcome", "Patients", "Policy Maker", "Prevention", "Preventive", "Preventive care", "Preventive healthcare", "Primary Care", "Provider", "Quality of Care", "Quasi-experiment", "Recovery", "Research Design", "Research Personnel", "Screening for cancer", "Series", "Services", "Structure", "Team Nursing", "Telephone", "Testing", "United States Department of Veterans Affairs", "Variant", "Veterans", "Veterans Health Administration", "Visit", "Work", "care coordination", "care delivery", "cohort", "colon cancer screening", "colorectal cancer screening", "comparison group", "dashboard", "electronic structure", "experience", "implementation evaluation", "improved", "improved outcome", "innovation", "insight", "member", "mortality", "multilevel analysis", "pandemic disease", "pandemic impact", "pandemic response", "patient centered medical home", "primary care clinic", "primary care patient", "primary care services", "primary care team", "programs", "response", "screening", "service delivery", "tool", "uptake", "video visit", "virtual", "virtual delivery", "virtual healthcare" ], "approved": true } }, { "type": "Grant", "id": "14279", "attributes": { "award_id": "5I01RX003639-02", "title": "Home-Based Exercise Tele-Rehabilitation in High-Risk Veterans: Impact of COVID-19 Exposure and Socioeconomic Factors", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2022-10-01", "end_date": "2026-09-30", "award_amount": null, "principal_investigator": { "id": 26753, "first_name": "KRISANN K", "last_name": "OURSLER", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] }, "other_investigators": [ { "id": 26754, "first_name": "ALICE S.", "last_name": "RYAN", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] } ], "awardee_organization": { "id": 1532, "ror": "https://ror.org/036a0e562", "name": "Baltimore VA Medical Center", "address": "", "city": "", "state": "MD", "zip": "", "country": "United States", "approved": true }, "abstract": "The Coronavirus Disease 2019 (COVID-19) pandemic is widespread throughout the world despite multiple strategic efforts and precautions to impede its transmission. Comorbid conditions, especially hypertension, diabetes and chronic lung and cardiac disease are risk factors for hospitalization and death. Veterans have a high prevalence of these conditions and are at increased risk for complications and poor recovery. The development and successful implementation of rehabilitative strategies for Veterans during and post COVID-19 should be a high clinical research priority. The long-term impact of COVID-19 on cardiopulmonary and physical function is uncertain; and further, rehabilitation strategies to target impairments must be feasible within constraints of social distancing. Pertinent knowledge gaps regarding the post-recovery physiologic trajectory in patients with pulmonary and cardiometabolic conditions also need to be addressed to tailor effective exercise rehabilitation strategies. The objective of this exercise trial is to investigate the effect of a home-based exercise tele-rehabilitation on these outcomes and to evaluate five individual World Health Organization’s International Classification of Functioning, Disability and Health (ICF) components identified for research in COVID-19 survivors. Our central hypothesis is that home-based exercise with a group component (COVID Tele-EX) improves cardiopulmonary and physical function in Veterans post COVID-19. The study design includes an investigative team who have a track record of VA rehabilitation collaboration and will allow the exploration of healthcare disparities related to COVID-19, which are associated with functional decline and may affect sustainability of exercise rehabilitation strategies deployed under social distancing restrictions. Veterans from the Baltimore VAMC and surrounding Community Based Outpatient Clinics (CBOCs) will participate from home in the 12-week exercise intervention which will consist of virtual group exercise classes in VA Video Connect (VVC). Procedures before and after the intervention will include cardiopulmonary exercise test, pulmonary function test, physical function, and questionnaires targeted at exercise self-efficacy. Our study of cardiopulmonary and physical function in Veterans recovered from COVID-19 will provide critical and novel information on “Long COVID” or Post-Acute Sequelae of SARS-Co-V-2 infection. Findings from this trial will provide evidence to implement this tele-home group exercise program across VA centers that can extend beyond the COVID-19 pandemic and has vital implications for improving and creating a new standard of rehabilitative care for Veterans.", "keywords": [ "2019-nCoV", "Address", "Adherence", "Admission activity", "Adult", "Affect", "Ambulatory Care Facilities", "Area", "Award", "Baltimore", "Black race", "COVID-19", "COVID-19 impact", "COVID-19 mortality", "COVID-19 pandemic", "COVID-19 patient", "COVID-19 survivors", "Cardiopulmonary", "Cardiovascular Diseases", "Cessation of life", "Chronic", "Chronic Kidney Failure", "Chronic Obstructive Pulmonary Disease", "Chronic lung disease", "Classification", "Clinical Research", "Collaborations", "Communicable Diseases", "Communities", "Coronavirus", "Databases", "Development", "Diabetes Mellitus", "Dyspnea", "Epidemic", "Ethnic Origin", "Exercise", "Exercise Physiology", "Exercise Test", "Fatigue", "Future", "Geographic Locations", "Group Homes", "Guidelines", "HIV Infections", "Hand Strength", "Health", "Healthcare", "Healthcare Systems", "High Prevalence", "Hispanic", "Home", "Hospitalization", "Hypertension", "Impairment", "Individual", "Infection", "Inflammatory", "Inflammatory Response", "Intervention", "Knowledge", "Long COVID", "Lung", "Maryland", "Muscle Weakness", "Not Hispanic or Latino", "Organ", "Outcome", "Patients", "Physical Function", "Physical Performance", "Physical activity", "Physiological", "Post-Acute Sequelae of SARS-CoV-2 Infection", "Procedures", "Pulmonary function tests", "Questionnaires", "Race", "Recovery", "Rehabilitation therapy", "Research", "Research Design", "Research Priority", "Risk", "Risk Factors", "Rural Community", "SARS-CoV-2 exposure", "SARS-CoV-2 negative", "SARS-CoV-2 positive", "Seasons", "Self Efficacy", "Social Distance", "Socioeconomic Factors", "Socioeconomic Status", "Source", "Step Tests", "Support Groups", "Symptoms", "Syndrome", "Testing", "United States", "Urban Community", "Vaccines", "Variant", "Veterans", "Veterans Health Administration", "Viral", "World Health Organization", "cardiometabolism", "cardiorespiratory fitness", "clinical practice", "comorbidity", "coronavirus disease", "disability", "disability risk", "ethnic disparity", "exercise intensity", "exercise intervention", "exercise program", "exercise rehabilitation", "exercise training", "fitness", "functional decline", "functional improvement", "health care disparity", "heart disease risk", "high risk", "hospitalization rates", "human old age (65+)", "improved", "international health organization", "long term consequences of COVID-19", "long-ter" ], "approved": true } }, { "type": "Grant", "id": "14285", "attributes": { "award_id": "5I01HX002941-02", "title": "A web-based program to improve chronic illness self-management by engaging patients and informal caregivers", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2022-10-01", "end_date": "2027-03-31", "award_amount": null, "principal_investigator": { "id": 26867, "first_name": "Ranak", "last_name": "Trivedi", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] }, "other_investigators": [], "awardee_organization": { "id": 1497, "ror": "", "name": "VETERANS ADMIN PALO ALTO HEALTH CARE SYS", "address": "", "city": "", "state": "CA", "zip": "", "country": "United States", "approved": true }, "abstract": "Background: For the 80% of older Americans who have at least one chronic condition, sharing self- management responsibilities with caregivers (relatives or friends) predicts longevity, better health, better quality of life, and fewer hospitalizations. Caregivers often support patients in their self-management efforts. This can bring patients and caregivers closer but can also generate stress for both that can interfere with self- management. Yet, self-management programs rarely support the coping needs of patient-caregiver dyads. Significance: There are more than 5 million caregivers of Veterans; 75% of older Veterans receive some caregiver support. Caregivers incur individual financial and emotional costs even as they provide unpaid care. Having an effective self-management strategy that addresses the needs of both can improve outcomes and quality of life for millions of Veterans who suffer from chronic illnesses and their caregivers. This project addresses the priorities “Long-term care and Caregiving,” “Virtual Care/Telehealth,” and “Access to Care” and is consistent with the legislative goals of the MISSION Act. Innovation and Impact: This highly innovative proposal uses the novel concept that strengthening the interpersonal relationships between Veterans and caregivers can improve the self-management of chronic conditions. It challenges current clinical paradigms by addressing the collective stress coping needs of dyads. It is methodologically innovative because unlike many behavioral intervention trials, it assesses barriers and facilitators to plan for future implementation. Our focus on technology-enabled tools is timely given how COVID19 has transformed care delivery. This project takes advantage of the unique capabilities of the VA health system to explore questions including robust caregiver support and virtual care programs. Specific Aims: With investments from VA HSR&D, we have developed and successfully pilot tested a new theoretically-derived technology called Web-based Self-care Using Collaborative Coping EnhancEment in Diseases (web-SUCCEED). We propose to conduct a randomized clinical trial comparing web-SUCCEED to an enhanced usual care (EUC) control. We will conduct a formative evaluation guided by the Consolidated Framework of Implementation Research (CFIR) to accelerate future implementation. 1. Assess whether web-SUCCEED improves Veteran outcomes of self-management compared to EUC, 4 weeks and 6 months following randomization. 2a. Assess whether web-SUCCEED improves patient stress and quality of life. 2b. Assess whether web-SUCCEED improves caregiver stress, quality of life and caregiver burden. 2c. Examine communication, dyadic coping, mutuality, and relationship quality as mediators of primary and secondary outcomes (Aims 1, 2a, 2b). 3. Guided by CFIR, conduct a formative evaluation involving key stakeholder interviews to understand barriers and facilitators of future implementation. Methodology: We will recruit 280 cognitively intact Veterans from VA Palo Alto Health Care System who are managing at least one common chronic condition, and their caregivers. Veteran-caregiver dyads will be randomized 1:1 to web-SUCCEED or EUC. Veteran and caregiver assessments will take place at baseline, then again at 4 weeks and 6 months. The formative evaluation will be guided by CFIR and involve semi- structured interviews with clinical staff, providers, and facility leaders in Year 4. Next Steps: Our formative evaluation will set us up for implementation studies to evaluate web-SUCCEED in a wider array of clinical settings and facilities. Existing operational partnerships will facilitate wider clinical implementation and moving research into practice. Our innovative project, strong investigative team and operational partnerships will ensure a successful study that has the potential to shift clinical paradigms.", "keywords": [ "Acceleration", "Address", "Adult", "American", "Award", "Behavior Therapy", "Behavioral", "COVID-19", "Caregiver Burden", "Caregiver support", "Caregivers", "Caring", "Chronic", "Chronic Disease", "Chronically Ill", "Clinical", "Cognitive", "Collaborations", "Communication", "Consolidated Framework for Implementation Research", "Data", "Diabetes Mellitus", "Diagnosis", "Disease", "Distress", "Educational process of instructing", "Eligibility Determination", "Emotional", "Ensure", "Equipment and supply inventories", "Family Caregiver", "Family member", "Friends", "Funding", "Gender", "Goals", "Grant", "Health", "Health Services Accessibility", "Health system", "Healthcare Systems", "Hospitalization", "Individual", "Internet", "Interpersonal Relations", "Intervention Trial", "Interview", "Investments", "Learning", "Life Style", "Long-Term Care", "Longevity", "Maintenance", "Measures", "Mediator", "Medication Management", "Mental Depression", "Methodology", "Myocardial Ischemia", "Online Systems", "Outcome", "Pain", "Patient Care", "Patients", "Persons", "Pilot Projects", "Practice Management", "Primary Care Physician", "Prognosis", "Provider", "Psychologist", "Quality of life", "Randomized", "Reporting", "Resources", "Scientist", "Self Care", "Self Management", "Services", "Specific qualifier value", "Stress", "Stress and Coping", "Structure", "Technology", "Telephone", "Testing", "Veterans", "Work", "acceptability and feasibility", "arm", "behavior change", "care delivery", "caregiver stress", "caregiving", "clinical implementation", "clinical practice", "coping", "cost", "design", "effectiveness evaluation", "experience", "follow-up", "formative assessment", "future implementation", "health care availability", "implementation study", "improved", "improved outcome", "informal caregiver", "innovation", "member", "mobile application", "novel", "patient engagement", "peer support", "pilot test", "positive emotional state", "primary outcome", "programs", "randomized clinical trials", "recruit", "research to practice", "retention rate", "rural area", "secondary outcome", "self-management program", "skills", "telehealth", "telephone based", "tool", "treatment as usual", "trial comparing", "trial planning", "usability", "user centered design", "virtual healthcare", "web site" ], "approved": true } }, { "type": "Grant", "id": "14289", "attributes": { "award_id": "3I01HX003479-01A2S1", "title": "Disparities in Trust: COVID-19's Impact on Minority Veterans' Healthcare Experiences", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2022-10-01", "end_date": "2024-09-30", "award_amount": null, "principal_investigator": { "id": 25688, "first_name": "SUSAN L.", "last_name": "ZICKMUND", "orcid": null, "emails": "[email protected]", "private_emails": null, "keywords": "[]", "approved": true, "websites": "[]", "desired_collaboration": "", "comments": "", "affiliations": [] }, "other_investigators": [], "awardee_organization": { "id": 1781, "ror": "https://ror.org/007fyq698", "name": "VA Salt Lake City Healthcare System", "address": "", "city": "", "state": "UT", "zip": "", "country": "United States", "approved": true }, "abstract": "Background: Patients who distrust their healthcare providers are less likely to seek care or comply with medical regimens, potentially exacerbating negative downstream impacts on overall health. Previous research on Veterans’ experiences of healthcare has found low trust and high perceived discrimination among Latinx Veterans. Nuances unique to Latinx populations have been understudied in the context of medical distrust. Given the demographic transformation of the US Armed Forces and increasing population of Latinx Veterans expected to seek VA care, it is important to better understand Latinx Veterans’ healthcare experiences and how those experiences may contribute to medical distrust. Significance/Impact: Research findings will provide evidence to support strategies for improved implementation of healthcare practices that are more sensitive to race and ethnicity and can reduce medical distrust and improve engagement with VA care by the already vulnerable, high-risk Latinx Veteran population. Innovation: While prior studies hint at factors contributing to medical distrust in patients overall, research has yet to investigate this phenomenon among Latinx patients specifically. We lack data that explores possible connections between medical distrust and specific health outcomes, and we need studies that comprehensively examine connections and contradictions between quantitative survey responses and qualitative interview remarks. This proposal’s conceptualization of medical distrust as central to our research question and mixed-methods approach makes the proposed study both novel and necessary. Specific Aims: Through this work we will better understand how medical distrust may influence health outcomes in Latinx Veterans, the extent to which knowledge and information about VA gained from social networks influences medical distrust, and Latinx Veterans’ definitions of medical distrust. Aim 1. Describe the association between medical distrust and health outcomes among Latinx patients. We will estimate the association between patient indication of medical distrust and self-reported health outcomes. Aim 2. Assess social network influence on medical distrust among Latinx Veterans. We will examine the extent to which positive and negative social network influence is associated with medical distrust by combining results from semi-structured interviews and quantitative close-ended surveys. Aim 3. Seek Latinx Veteran input on current measure of medical distrust and cultural sensitivity. We will also conduct semi-structured cognitive interviews with 25 Latinx Veterans participating in the parent study to learn patients’ perspectives on how medical distrust is currently measured. Methodology: Participating Veterans will complete a survey and semi-structured interview asking about their sources of medical distrust in 12 domains of health care. Findings from these surveys and interviews will be analyzed using quantitative methods (for close-ended survey responses) and qualitative methods (for open- ended responses from interviews (Aim 3)). A concurrent mixed-methods approach will also be employed to generate a more complete assessment of findings (Aims 1 & 2). Next Steps/Implementation: Study findings will inform a future VA Career Development Award proposal to develop strategies for implementation of healthcare practices that are more sensitive to race and ethnicity.", "keywords": [ "Address", "African American", "COVID-19 impact", "Caring", "Communities", "Cultural Sensitivity", "Data", "Disparity", "Ethnic Origin", "Family", "Fright", "Future", "Goals", "Health", "Health Disparities Research", "Health Personnel", "Healthcare", "Healthcare Systems", "Hearing", "Human Resources", "Individual", "Intervention", "Interview", "K-Series Research Career Programs", "Knowledge", "Latinx", "Latinx population", "Learning", "Measures", "Medical", "Medical Research", "Methodology", "Methods", "Minority", "Outcome", "Parents", "Pathway Analysis", "Pathway interactions", "Patient Self-Report", "Patients", "Persons", "Positioning Attribute", "Provider", "Qualitative Methods", "Race", "Regimen", "Research", "Sampling", "Scientist", "Shapes", "Social Network", "Societies", "Source", "Structure", "Subgroup", "Surveys", "System", "Training", "Trust", "Veterans", "Vulnerable Populations", "Work", "care seeking", "cognitive interview", "distrust", "experience", "health disparity", "high risk", "implementation strategy", "improved", "indexing", "innovation", "interest", "intergenerational", "marginalization", "marginalized population", "military veteran", "novel", "patient population", "patient response", "peer", "perceived discrimination", "response", "transmission process", "treatment adherence" ], "approved": true } }, { "type": "Grant", "id": "14303", "attributes": { "award_id": "5I21RX003880-02", "title": "Brief Enhanced Anxiety Sensitivity Treatment: A Pilot Study", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2022-09-01", "end_date": "2024-08-31", "award_amount": null, "principal_investigator": { "id": 26271, "first_name": "Nicholas Paul", "last_name": "Allan", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] }, "other_investigators": [], "awardee_organization": { "id": 1653, "ror": "", "name": "VETERANS AFFAIRS, UNITED STATES DEPARTMENT OF", "address": "", "city": "", "state": "NY", "zip": "", "country": "United States", "approved": true }, "abstract": "Veterans with elevated anxiety sensitivity are likely to suffer disproportionately and unnecessarily following the COVID-19 pandemic. Beyond the emotional suffering, this will likely manifest in functional impairment. Addressing this potential crisis requires dissemination of interventions targeting risk factors that maintain anxiety and functional impairment without overloading an already taxed mental health services pipeline. Anxiety sensitivity, or fear of anxiety sensations, is a transdiagnostic risk factor that exacerbates anxiety, results in functional impairment, and increases the strength of the relation between anxiety and functional impairment. Thus, anxiety sensitivity is an ideal target to restore functioning in Veterans with reporting functional impairment. Preliminary data by our group has demonstrated that functional impairment due to COVID-19 is common, enduring, and is predicted by levels of anxiety sensitivity, suggesting a critical need to intervene. Further, there is robust evidence that anxiety sensitivity is malleable using cognitive-behavioral therapy techniques, even when delivered in brief, one-session interventions. Our group has shown brief one- session interventions are efficacious and rated as acceptable by participants. The increased use of telehealth and mobile apps in the Veterans Healthcare Administration provides an opportunity for this brief evidence- based intervention to be disseminated broadly. The proposed study will be the first to adapt and test Brief Enhanced Anxiety Sensitivity Treatment (BEAST) for functional impairment in Veterans with elevated anxiety sensitivity. BEAST comprises a one-session intervention including psychoeducation about the nature of anxiety, identification and challenging of common maladaptive thoughts about anxiety sensations, and interoceptive exposure to demonstrate the benign nature of anxiety. BEAST also includes a two-week ecological momentary intervention component designed to provide ecologically valid opportunities to practice the skills acquired during the one session. The proposed aims in this pilot feasibility and acceptability trial are to 1) adapt BEAST to be delivered via telehealth and a mobile app working with stakeholders and the Center for Mobile Applications Research Resources & Services and 2) pilot test the intervention for acceptability and feasibility. This application is directly responsive to RR&D Small Projects in Rehabilitation Research (SPiRE) RFA RX-22-003. We target functional impairment in Veterans with elevated anxiety sensitivity, a common finding in people with anxiety disorders. Findings from this pilot trial will provide the necessary demonstration of acceptability, feasibility, and usability of BEAST and its constituent components. This will allow us to expeditiously conduct a fully powered randomized control trial to demonstrate efficacy of BEAST and then a dissemination trial. Disseminating a brief anxiety sensitivity intervention would represent a significant advance for treatment of a transdiagnostic component underlying anxiety and related conditions as well as impairment and could yield tremendous public health impact.", "keywords": [ "Address", "Adherence", "Anxiety", "Anxiety Disorders", "Award", "Behavior", "Benign", "COVID-19", "COVID-19 pandemic", "COVID-19 pandemic effects", "Client", "Cognitive", "Cognitive Therapy", "Data", "Diagnostic", "Distress", "Double Effect", "Effectiveness", "Emotional", "Environment", "Esthesia", "Evaluation", "Evidence based intervention", "Exercise", "Exposure to", "Feedback", "Fright", "Health Personnel", "Healthcare", "Impairment", "Individual", "Infrastructure", "Intervention", "Measures", "Mental Health", "Mental Health Services", "Methods", "Modification", "Monitor", "Moods", "Nature", "Occupational", "Participant", "Patient Outcomes Assessments", "Patient Recruitments", "Patients", "Persons", "Pilot Projects", "Process", "Public Health", "Randomized Controlled Trials", "Recovery of Function", "Reporting", "Research", "Resources", "Risk Factors", "Services", "Stimulus", "Stress", "Taxes", "Techniques", "Testing", "Thinking", "Time", "Training", "Treatment Efficacy", "Veterans", "Work", "acceptability and feasibility", "anxiety reduction", "anxiety sensitivity", "arm", "behavioral health", "bodily sensation", "brief intervention", "clinical care", "cost", "design", "dissemination trial", "efficacious intervention", "emotional distress", "emotional experience", "experience", "functional disability", "functional outcomes", "functional restoration", "health application", "improved", "intervention delivery", "meetings", "military veteran", "mobile application", "participant retention", "pilot test", "pilot trial", "programs", "psychoeducation", "psychoeducational", "rehabilitation research", "satisfaction", "self help", "skill acquisition", "skills", "social", "stressor", "telehealth", "treatment adherence", "uptake", "usability", "virtual", "virtual delivery", "virtual intervention" ], "approved": true } }, { "type": "Grant", "id": "14594", "attributes": { "award_id": "1I21HX003799-01A1", "title": "Systems Analysis of Healthcare-Associated Infection Prevention during the COVID-19 Pandemic", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2024-05-01", "end_date": "2025-10-31", "award_amount": null, "principal_investigator": { "id": 31260, "first_name": "Julie A", "last_name": "Keating", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] }, "other_investigators": [], "awardee_organization": { "id": 2247, "ror": "", "name": "WM S. MIDDLETON MEMORIAL VETERANS HOSP", "address": "", "city": "", "state": "WI", "zip": "", "country": "United States", "approved": true }, "abstract": "Background: Effective healthcare-associated infection (HAI) prevention requires multiple complex interventions (e.g., hand hygiene, environmental cleaning, personal protective equipment use, and evidence-based patient procedure protocols such as central line maintenance). The COVID-19 pandemic’s effects on healthcare (e.g., staffing shortages, supply chain disruptions, modified protocols to reduce exposure) also impacted HAI prevention. Retrospective analyses have found differential impacts on HAI rates during the pandemic, with some HAIs increasing and others decreasing. However, there has not yet been an assessment of how the COVID-19 pandemic specifically impacted guideline-concordant HAI prevention practices. Significance: This pilot project directly addresses HSR&D’s research priority to enhance the Quality and Safety of Health Care by gathering critical information regarding the implementation of HAI prevention practices during the COVID-19 pandemic. Information gathered here will inform the effective implementation of HAI prevention activities, including resuming guideline-concordant HAI prevention practices, to reduce HAIs across VA and increase the quality and safety of the healthcare received by Veterans. Innovation and Impact: We will conduct a work systems analysis using the Systems Engineering Initiative for Patient Safety (SEIPS) framework, which allows for the assessment of barriers and facilitators within and between each individual work system element (people, tools and technology, task, organization, and environment). This granular analysis allows for identifying and addressing specific barriers to implementation, which can be difficult to identify in complex work systems like those in HAI prevention. By addressing these barriers, we can develop implementation strategies to support the resuming of guideline-concordant HAI prevention practices in work systems that were or are continuing to be affected by COVID-19-related impacts. Specific Aims: In this pilot project, we aim to: 1. Conduct a work systems analysis of HAI prevention during the COVID-19 pandemic among acute inpatient care facilities in VISN12 to identify specific impacts of the pandemic on HAI prevention and HCW-reported needs for improved HAI prevention during the pandemic. 2. Identify barriers and facilitators to resuming IPC best practices in the COVID endemic era. Methodology: We will conduct semi-structured interviews with 1) 1-2 HAI prevention stakeholders and 2) up to 5 frontline nursing personnel at each of the 8 VA medical centers in VISN12. We will use interview guides structured around the CDC’s multidrug-resistant organism prevention strategies and the SEIPS framework to probe pandemic-related changes to HAI prevention practices as well as reasons behind these changes and barriers to resuming practices. We will use a rapid qualitative inquiry approach to analyze interview data, ultimately producing 1) a specific list of HAI prevention practices that were substantially modified during the COVID-19 pandemic and require additional implementation support to resuming practices; 2) work system element barriers and facilitators to conducting these practices during the pandemic; and 3) a logic model guiding the development of a larger research project on priority HAI prevention practices. Next Steps/Implementation: This pilot project will identify specific HAI prevention practices requiring additional implementation support, leading directly to a larger research project to gather VA-wide data on the implementation of these practices. We will also then develop and test implementation strategies to maximize effectiveness of the practice in reducing HAIs while minimizing burden on healthcare workers. 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