Establishing a Veterans Advisory Council to Empower Patients and Inform VA Health Services Research
Friday 10:30 – 1:45 Breakout A1
Presentor: Sarah Ono
Travis Lovejoy, Ph.D., MPH, Center to Improve Veteran Involvement in Care, VA Portland Health Care System; Sarah Ono, Ph.D., Center to Improve Veteran Involvement in Care, VA Portland Health Care System; Kathleen Carlson, Ph.D., Center to Improve Veteran Involvement in Care, VA Portland Health Care System; Erika Cottrell, Ph.D., MPP, Center to Improve Veteran Involvement in Care, VA Portland Health Care System; Maya O’Neil, Ph.D., MCR, Center to Improve Veteran Involvement in Care, VA Portland Health Care System
In 2013, VA Health Services Research & Development funded 19 Centers of Innovation (COINs), each with unique research foci and each forming partnerships between researchers and clinical and operations leaders. The goal of these partnerships is to conduct timely, relevant, and rigorous research that can be implemented quickly and efficiently to improve health outcomes. The VA Portland Health Care System’s COIN, The Center to Improve Veteran Involvement in Care (CIVIC), emphasizes community based participatory research principles and patient engagement in research at all stages. Recently, CIVIC instituted a program to involve not only clinical and operations leaders, but also veteran patients in all phases of the research process. As part of this program, CIVIC established a Veterans Advisory Council composed of veteran patients. We sought to assemble a diverse group of patients across sex, race/ethnicity, mental health history, and military service era. The Council offers feedback to CIVIC investigators on design and conduct of studies and the interpretation and dissemination of results. This presentation describes processes of creating the Council and addresses issues germane to participatory research in VA and non-VA settings, such as ensuring a representative Council composition, navigating IRB, compensation for Council members, and maintaining sound research ethics.
Convening and Consulting a Patient-Stakeholder Panel to Optimize Implementation Planning in a Complex Healthcare Setting
Friday 10:30 – 1:45 Breakout A1
Presentor: Eve B. Carlson
Eve B. Carlson, National Center for PTSD, VA Palo Alto Health Care System; David A. Spain, Stanford University School of Medicine
Implementation of evidence-based practices is fostered when the perspectives of patients, providers, and other stakeholders are taken into account. These perspectives are especially critical to success in settings where stakeholders with a variety of different types of training, responsibilities, and interests cooperate to provide healthcare. In the context of planning a hybrid effectiveness-implementation study of a risk screening and referral system for traumatically-injured hospital patients, we convened a patient-stakeholder panel to obtain input on implementation factors and research and services planning. Most of hospitalized trauma patients recover without intervention, but 10-20% develop PTSD or depression and very few seek treatment on their own. After developing a screen for risk of psychological disorder, we brought together patients, family members, trauma surgeons, trauma nurses, social workers, and psychologists and sought their input on a patient preferences survey and a system for risk screening, providing risk information, and referral. We will share our experiences and address issues such as who needs to be included, how to recruit panel members who will be most engaged, how to explain the purpose and tasks of the panel, and how to insure that patients and family members are not intimidated by a roomful of health care professionals.
Building Patient-Practitioner Partnerships in Community Medical Settings to Sustainably Implement EBPs for Anxious and Depressed Cancer Survivors
Friday 10:30 – 1:45 Breakout A1
Presentor: Joanna J. Arch
Joanna J. Arch, University of Colorado Boulder; Jill Mitchell, Rocky Mountain Cancer Centers-Boulder
Many cancer survivors with anxiety and depression symptoms are treated in medical settings that are ill equipped to recognize or treat such symptoms or to offer EBPs. To address these unmet needs, over the past several years we have built a collaboration with the administrators, practitioners, and patients at a local community oncology care network. Together, we have implemented an empirically-based screening system for assessing anxiety and depression symptoms among cancer survivors at seminal office visits (n = 200+ screened to date). We next partnered to refine and assess an EBP intervention offered onsite for the cancer survivors who screen positively on the screener (n = 51 participants to date), which led to moderate to large effect size improvements on relevant mental health outcomes. Currently, we are in the process of implementing this EBP intervention at community oncology sites throughout the state and adapting it to meet additional patient needs. In summary, our work demonstrates how a partnership with a local community cancer care network led to the successful uptake of EBP in a novel and high-needs context.