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Megan E Shepherd-Banigan

Assistant Professor in Population Health Sciences
Population Health Sciences
215 Morris Street, DUMC Box 104023, Durham, NC 27701

Selected Publications


Impact of SARS-CoV-2 Infection on Long-Term Depression Symptoms among Veterans.

Journal Article J Gen Intern Med · April 16, 2024 BACKGROUND: Prior research demonstrates that SARS-COV-2 infection can be associated with a broad range of mental health outcomes including depression symptoms. Veterans, in particular, may be at elevated risk of increased depression following SARS-COV-2 in ... Full text Link to item Cite

Comprehensive Caregiver Supports and Ascertainment and Treatment of Veteran Pain.

Journal Article Med Care Res Rev · April 2024 Disabled Veterans commonly experience pain. The Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides training, a stipend, and services to family caregivers of eligible Veterans to support their caregiving role. We compared ascertainme ... Full text Link to item Cite

Risk of Suicide-Related Outcomes After SARS-COV-2 Infection: Results from a Nationwide Observational Matched Cohort of US Veterans.

Journal Article J Gen Intern Med · March 2024 BACKGROUND: Negative mental health-related effects of SARS-COV-2 infection are increasingly evident. However, the impact on suicide-related outcomes is poorly understood, especially among populations at elevated risk. OBJECTIVE: To determine risk of suicid ... Full text Link to item Cite

Association between results of an amyloid PET scan and healthcare utilization in individuals with cognitive impairment.

Journal Article Journal of the American Geriatrics Society · March 2024 BackgroundThe Imaging Dementia Evidence for Amyloid Scanning (IDEAS) study reports that amyloid PET scans help providers diagnose and manage Alzheimer's disease and related dementias (ADRD). Using CARE-IDEAS, an IDEAS supplemental study, we examin ... Full text Cite

Changes in Outpatient Health Care Use After COVID-19 Infection Among Veterans.

Journal Article JAMA Netw Open · February 5, 2024 IMPORTANCE: The association of COVID-19 infection with outpatient care utilization is unclear. Many studies reported population surveillance studies rather than comparing outpatient health care use between COVID-19-infected and uninfected cohorts. OBJECTIV ... Full text Link to item Cite

Feasibility of a family-involved intervention to increase engagement in evidenced-based psychotherapies for posttraumatic stress disorder: A pilot study.

Journal Article Psychol Trauma · January 18, 2024 OBJECTIVE: To assess the feasibility of a family-involved intervention, family support in mental health recovery (FAMILIAR), for veterans with posttraumatic stress disorder (PTSD) seeking psychotherapy at a single Veterans Administration Health System. MET ... Full text Link to item Cite

Strategies for enhancing the representation of women in clinical trials: an evidence map.

Journal Article Syst Rev · January 2, 2024 BACKGROUND: Equitable sex- and gender-based representation in clinical trials is an essential step to ensuring evidence-based care for women. While multi-institutional actions have led to significant improvements in the inclusion of women in trials, inequi ... Full text Link to item Cite

Veteran Caretaker Perspectives of the Need for Childcare Assistance During Health Care Appointments.

Journal Article Womens Health Issues · 2024 PURPOSE: In 2020, Congress passed legislation to establish the national Veterans Child Care Assistance Program (VCAP) targeting eligible veterans receiving care through the Veterans Health Administration (VA). This needs assessment describes the childcare ... Full text Link to item Cite

Elevated Amyloid-β PET Scan and Cognitive and Functional Decline in Mild Cognitive Impairment and Dementia of Uncertain Etiology.

Journal Article J Alzheimers Dis · 2024 BACKGROUND: Elevated amyloid-β (Aβ) on positron emission tomography (PET) scan is used to aid diagnosis of Alzheimer's disease (AD), but many prior studies have focused on patients with a typical AD phenotype such as amnestic mild cognitive impairment (MCI ... Full text Link to item Cite

Implementation of NCCARE360, a Digital Statewide Closed-Loop Referral Platform to Improve Health and Social Care Coordination: Evidence from the North Carolina COVID-19 Support Services Program

Journal Article North Carolina Medical Journal · January 1, 2024 introduction Efforts to improve population health by being responsive to patients’ social and economic conditions will benefit from care models and technologies that assess and address unmet social needs. In 2019, NCCARE360 launched in North Carolina as th ... Full text Cite

Qualitative Analysis of Implementation Factors of an Embedded Caregiver Support Intervention into Adult Day Services.

Journal Article J Alzheimers Dis · 2024 BACKGROUND: Adult day services (ADS) are an important and often underutilized support resource for older adults. For persons living with dementia (PLWD), ADS is an optimal access point to not only receive therapeutic and rehabilitative activities, but as a ... Full text Link to item Cite

Informing a home time measure reflective of quality of life: A data driven investigation of time frames and settings of health care utilization.

Journal Article Health Serv Res · December 2023 OBJECTIVE: To evaluate short- and long-term measures of health care utilization-days in the emergency department (ED), inpatient (IP) care, and rehabilitation in a post-acute care (PAC) facility-to understand how home time (i.e., days alive and not in an a ... Full text Link to item Cite

Mental health therapy for veterans with PTSD as a family affair: A qualitative inquiry into how family support and social norms influence veteran engagement in care.

Journal Article Psychol Serv · November 2023 Social support is important for posttraumatic stress disorder (PTSD) recovery and emerging literature indicate that social support could increase engagement in PTSD therapy. However, there is a need to understand how and why family involvement can increase ... Full text Link to item Cite

Prevalence and incidence of depressive symptoms and diagnosis of depression as associated with elevated amyloid among Medicare beneficiaries with cognitive impairment.

Journal Article J Affect Disord · August 1, 2023 BACKGROUND: Depression and cognitive impairment commonly co-occur, and it has been hypothesized that the two share pathological processes. Our objective for this study was to determine the relationship between elevated β-amyloid level and the prevalence an ... Full text Link to item Cite

Exploring the importance of predisposing, enabling, and need factors for promoting Veteran engagement in mental health therapy for post-traumatic stress: a multiple methods study.

Journal Article BMC Psychiatry · May 27, 2023 PURPOSE: This study explored Veteran and family member perspectives on factors that drive post-traumatic stress disorder (PTSD) therapy engagement within constructs of the Andersen model of behavioral health service utilization. Despite efforts by the Depa ... Full text Link to item Cite

Use of high cost care among Veterans with comorbid mental illness and Alzheimer's Disease and related dementias

Conference PLoS ONE · May 1, 2023 Introduction/Objective Alzheimer's Disease and Other Related Dementias (AD/ADRD) leads to frequent emergency department (ED) and inpatient use. Mental health symptoms among persons with AD/ADRD increases cognitive and functional disabilities and could cont ... Full text Cite

Racial inequality in functional trajectories between Black and White U.S. veterans.

Journal Article J Am Geriatr Soc · April 2023 BACKGROUND: Racial inequality in functional trajectories has been well documented in the U.S. civilian population but has not been explored among Veterans. Our objectives were to: (1) assess how functional trajectories differed for Black and White Veterans ... Full text Link to item Cite

Training Health Care Practitioners to Include Family Caregivers With Web-Based Learning Modules.

Journal Article Perm J · March 15, 2023 Background Caregivers play a key role in supporting patient health; however, they have largely been excluded from participating in health care teams. This paper describes development and evaluation of web-based training for health care professionals about ... Full text Link to item Cite

Impact of SARS-CoV-2 Infection on Long-Term Depression Symptoms among Veterans.

Journal Article J Gen Intern Med · April 16, 2024 BACKGROUND: Prior research demonstrates that SARS-COV-2 infection can be associated with a broad range of mental health outcomes including depression symptoms. Veterans, in particular, may be at elevated risk of increased depression following SARS-COV-2 in ... Full text Link to item Cite

Comprehensive Caregiver Supports and Ascertainment and Treatment of Veteran Pain.

Journal Article Med Care Res Rev · April 2024 Disabled Veterans commonly experience pain. The Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides training, a stipend, and services to family caregivers of eligible Veterans to support their caregiving role. We compared ascertainme ... Full text Link to item Cite

Risk of Suicide-Related Outcomes After SARS-COV-2 Infection: Results from a Nationwide Observational Matched Cohort of US Veterans.

Journal Article J Gen Intern Med · March 2024 BACKGROUND: Negative mental health-related effects of SARS-COV-2 infection are increasingly evident. However, the impact on suicide-related outcomes is poorly understood, especially among populations at elevated risk. OBJECTIVE: To determine risk of suicid ... Full text Link to item Cite

Association between results of an amyloid PET scan and healthcare utilization in individuals with cognitive impairment.

Journal Article Journal of the American Geriatrics Society · March 2024 BackgroundThe Imaging Dementia Evidence for Amyloid Scanning (IDEAS) study reports that amyloid PET scans help providers diagnose and manage Alzheimer's disease and related dementias (ADRD). Using CARE-IDEAS, an IDEAS supplemental study, we examin ... Full text Cite

Changes in Outpatient Health Care Use After COVID-19 Infection Among Veterans.

Journal Article JAMA Netw Open · February 5, 2024 IMPORTANCE: The association of COVID-19 infection with outpatient care utilization is unclear. Many studies reported population surveillance studies rather than comparing outpatient health care use between COVID-19-infected and uninfected cohorts. OBJECTIV ... Full text Link to item Cite

Feasibility of a family-involved intervention to increase engagement in evidenced-based psychotherapies for posttraumatic stress disorder: A pilot study.

Journal Article Psychol Trauma · January 18, 2024 OBJECTIVE: To assess the feasibility of a family-involved intervention, family support in mental health recovery (FAMILIAR), for veterans with posttraumatic stress disorder (PTSD) seeking psychotherapy at a single Veterans Administration Health System. MET ... Full text Link to item Cite

Strategies for enhancing the representation of women in clinical trials: an evidence map.

Journal Article Syst Rev · January 2, 2024 BACKGROUND: Equitable sex- and gender-based representation in clinical trials is an essential step to ensuring evidence-based care for women. While multi-institutional actions have led to significant improvements in the inclusion of women in trials, inequi ... Full text Link to item Cite

Veteran Caretaker Perspectives of the Need for Childcare Assistance During Health Care Appointments.

Journal Article Womens Health Issues · 2024 PURPOSE: In 2020, Congress passed legislation to establish the national Veterans Child Care Assistance Program (VCAP) targeting eligible veterans receiving care through the Veterans Health Administration (VA). This needs assessment describes the childcare ... Full text Link to item Cite

Elevated Amyloid-β PET Scan and Cognitive and Functional Decline in Mild Cognitive Impairment and Dementia of Uncertain Etiology.

Journal Article J Alzheimers Dis · 2024 BACKGROUND: Elevated amyloid-β (Aβ) on positron emission tomography (PET) scan is used to aid diagnosis of Alzheimer's disease (AD), but many prior studies have focused on patients with a typical AD phenotype such as amnestic mild cognitive impairment (MCI ... Full text Link to item Cite

Implementation of NCCARE360, a Digital Statewide Closed-Loop Referral Platform to Improve Health and Social Care Coordination: Evidence from the North Carolina COVID-19 Support Services Program

Journal Article North Carolina Medical Journal · January 1, 2024 introduction Efforts to improve population health by being responsive to patients’ social and economic conditions will benefit from care models and technologies that assess and address unmet social needs. In 2019, NCCARE360 launched in North Carolina as th ... Full text Cite

Qualitative Analysis of Implementation Factors of an Embedded Caregiver Support Intervention into Adult Day Services.

Journal Article J Alzheimers Dis · 2024 BACKGROUND: Adult day services (ADS) are an important and often underutilized support resource for older adults. For persons living with dementia (PLWD), ADS is an optimal access point to not only receive therapeutic and rehabilitative activities, but as a ... Full text Link to item Cite

Informing a home time measure reflective of quality of life: A data driven investigation of time frames and settings of health care utilization.

Journal Article Health Serv Res · December 2023 OBJECTIVE: To evaluate short- and long-term measures of health care utilization-days in the emergency department (ED), inpatient (IP) care, and rehabilitation in a post-acute care (PAC) facility-to understand how home time (i.e., days alive and not in an a ... Full text Link to item Cite

Mental health therapy for veterans with PTSD as a family affair: A qualitative inquiry into how family support and social norms influence veteran engagement in care.

Journal Article Psychol Serv · November 2023 Social support is important for posttraumatic stress disorder (PTSD) recovery and emerging literature indicate that social support could increase engagement in PTSD therapy. However, there is a need to understand how and why family involvement can increase ... Full text Link to item Cite

Prevalence and incidence of depressive symptoms and diagnosis of depression as associated with elevated amyloid among Medicare beneficiaries with cognitive impairment.

Journal Article J Affect Disord · August 1, 2023 BACKGROUND: Depression and cognitive impairment commonly co-occur, and it has been hypothesized that the two share pathological processes. Our objective for this study was to determine the relationship between elevated β-amyloid level and the prevalence an ... Full text Link to item Cite

Exploring the importance of predisposing, enabling, and need factors for promoting Veteran engagement in mental health therapy for post-traumatic stress: a multiple methods study.

Journal Article BMC Psychiatry · May 27, 2023 PURPOSE: This study explored Veteran and family member perspectives on factors that drive post-traumatic stress disorder (PTSD) therapy engagement within constructs of the Andersen model of behavioral health service utilization. Despite efforts by the Depa ... Full text Link to item Cite

Use of high cost care among Veterans with comorbid mental illness and Alzheimer's Disease and related dementias

Conference PLoS ONE · May 1, 2023 Introduction/Objective Alzheimer's Disease and Other Related Dementias (AD/ADRD) leads to frequent emergency department (ED) and inpatient use. Mental health symptoms among persons with AD/ADRD increases cognitive and functional disabilities and could cont ... Full text Cite

Racial inequality in functional trajectories between Black and White U.S. veterans.

Journal Article J Am Geriatr Soc · April 2023 BACKGROUND: Racial inequality in functional trajectories has been well documented in the U.S. civilian population but has not been explored among Veterans. Our objectives were to: (1) assess how functional trajectories differed for Black and White Veterans ... Full text Link to item Cite

Training Health Care Practitioners to Include Family Caregivers With Web-Based Learning Modules.

Journal Article Perm J · March 15, 2023 Background Caregivers play a key role in supporting patient health; however, they have largely been excluded from participating in health care teams. This paper describes development and evaluation of web-based training for health care professionals about ... Full text Link to item Cite

Reactions to Amyloid PET Scan Results and Levels of Anxious and Depressive Symptoms: CARE IDEAS Study.

Journal Article Gerontologist · January 24, 2023 BACKGROUND AND OBJECTIVES: Few studies have examined care partners' reactions to their loved ones receiving amyloid-β positron emission tomography (PET) scan results, which can be indicative of Alzheimer's disease. We explored care partners' reactions qual ... Full text Link to item Cite

Continuity of care (COC) and amyloid-β PET scan: the CARE-IDEAS study.

Journal Article Alzheimers Res Ther · January 7, 2023 BACKGROUND: High continuity of care (COC) is associated with better clinical outcomes among older adults. The impact of amyloid-β PET scan on COC among adults with mild cognitive impairment (MCI) or dementia of uncertain etiology is unknown. METHODS: We li ... Full text Link to item Cite

Use of high cost care among Veterans with comorbid mental illness and Alzheimer's Disease and related dementias.

Journal Article PLoS One · 2023 INTRODUCTION/OBJECTIVE: Alzheimer's Disease and Other Related Dementias (AD/ADRD) leads to frequent emergency department (ED) and inpatient use. Mental health symptoms among persons with AD/ADRD increases cognitive and functional disabilities and could con ... Full text Open Access Link to item Cite

Optimizing the Equitable Deployment of Virtual Care for Women: Protocol for a Qualitative Evidence Synthesis Examining Patient and Provider Perspectives Supplemented with Primary Qualitative Data.

Journal Article Health Equity · 2023 INTRODUCTION: Women experience numerous barriers to patient-centered health care (e.g., lack of continuity). Such barriers are amplified for women from marginalized communities. Virtual care may improve equitable access. We are conducting a partner-engaged ... Full text Open Access Link to item Cite

Adapting a family-involved intervention to increase initiation and completion of evidenced-based psychotherapy for posttraumatic stress disorder.

Journal Article SSM Ment Health · December 2022 Posttraumatic stress disorder (PTSD) is disabling condition among United States Veterans. Training programs for evidenced-based therapies have been rolled out nationally in the Veterans Health Administration (VHA), but provider adoption of these treatments ... Full text Link to item Cite

Association between Gentrification and Health and Healthcare Utilization.

Journal Article J Urban Health · December 2022 There is tremendous interest in understanding how neighborhoods impact health by linking extant social and environmental drivers of health (SDOH) data with electronic health record (EHR) data. Studies quantifying such associations often use static neighbor ... Full text Link to item Cite

Advance directives among cognitively impaired persons who had an amyloid PET scan and their care partners: a mixed-methods study.

Journal Article BMC Palliat Care · November 6, 2022 BACKGROUND: Little research exists on the role of β-amyloid PET scans as part of Alzheimer's diagnostic tests and documentation of end-of-life preferences for persons with cognitive impairment. The study objectives were to examine the association of amyloi ... Full text Link to item Cite

How can equitable video visit access be delivered in primary care? A qualitative study among rural primary care teams and patients.

Journal Article BMJ Open · August 5, 2022 OBJECTIVE: The COVID-19 pandemic sparked exponential growth in video visit use in primary care. The rapid shift to virtual from in-person care exacerbated digital access disparities across racial groups and rural populations. Moving forward, it is critical ... Full text Open Access Link to item Cite

Individual and program Characteristics May Drive Variability in Outcomes After Caregivers Participate in a Tailored Support Intervention.

Journal Article J Appl Gerontol · August 2022 Critically needed programs designed to support family caregivers have shown inconsistent reductions in stress and burden. To explore drivers of improvement in caregiver outcomes after participation in a support intervention we analyzed data from a one-on-o ... Full text Open Access Link to item Cite

Predictors of discharge from the VA Caregiver Support Program.

Journal Article Am J Manag Care · August 1, 2022 OBJECTIVES: The Department of Veterans Affairs (VA) Program of Comprehensive Assistance for Family Caregivers (PCAFC) is a clinical program providing training, a monthly stipend, and other services to caregivers of qualifying post-9/11 veterans with servic ... Full text Link to item Cite

Identifying Family and Unpaid Caregivers in Electronic Health Records: Descriptive Analysis.

Journal Article JMIR Form Res · July 18, 2022 BACKGROUND: Most efforts to identify caregivers for research use passive approaches such as self-nomination. We describe an approach in which electronic health records (EHRs) can help identify, recruit, and increase diverse representations of family and ot ... Full text Open Access Link to item Cite

Making the Informal Formal: Discussing and Completing Advance Care Plans in Care Dyads with Cognitive Impairment.

Journal Article J Palliat Care · July 2022 Background: Discussing advance care planning (ACP) with care partners may be a steppingstone to the completion of advance directives (ADs) for persons with cognitive impairment (PwCIs). Objectives: To examine whether PwCI-reported occurrence of and PwCI-ca ... Full text Link to item Cite

Family Caregivers of Veterans Experience Clinically Significant Levels of Distress Prepandemic and During Pandemic: Implications for Caregiver Support Services.

Journal Article Med Care · July 1, 2022 BACKGROUND: Of the 26.4 million family caregivers in the United States, nearly 40% report high levels of emotional strain and subjective burden. However, for the 5 million caregivers of Veterans, little is known about the experiences of caregivers of Veter ... Full text Link to item Cite

Psychological distress among medically complex veterans with a recent emergency department visit.

Journal Article Psychol Serv · May 2022 Medical complexity and psychological distress are associated with frequent emergency department (ED) use. Despite this known association, our understanding is limited about which patients are at risk for persistent psychological distress and what patterns ... Full text Link to item Cite

Primary Care Engagement Among Individuals with Experiences of Homelessness and Serious Mental Illness: an Evidence Map.

Journal Article J Gen Intern Med · May 2022 BACKGROUND: Experiences of homelessness and serious mental illness (SMI) negatively impact health and receipt of healthcare. Interventions that promote the use of primary care services for people with both SMI and homelessness may improve health outcomes, ... Full text Link to item Cite

Prioritizing Support Offered to Caregivers by Examining the Status Quo and Opportunities for Enhancement When Using Web-Based Self-reported Health Questionnaires: Descriptive Qualitative Study.

Journal Article JMIR Form Res · April 8, 2022 BACKGROUND: The Rosalynn Carter Institute for Caregivers (RCI) offers evidence-based interventions to promote caregivers' health and well-being. Trained coaches regularly meet with caregivers to offer education and instructions to improve caregiver health, ... Full text Link to item Cite

Informal Caregiver Support Policies Change Use of Vocational Assistance Services for Individuals With Disabilities.

Journal Article Med Care Res Rev · April 2022 Support policies for caregivers improves care-recipient access to care and effects may generalize to nonhealth services. Using administrative data from the U.S. Department of Veterans Affairs (VA) for veterans <55 years, we assessed the association between ... Full text Link to item Cite

Use of motivational techniques to enhance unpaid caregiver engagement in a tailored skills training intervention.

Journal Article Aging Ment Health · February 2022 OBJECTIVES: The Helping Invested Families Improve Veterans' Experiences Study (HI-FIVES) evaluated a skills training program to support family caregivers of cognitively or functionally impaired persons. HI-FIVES demonstrated sustained improvements in careg ... Full text Link to item Cite

Amyloid-β PET Scan Results Disclosure and Care-Partner Emotional Well-Being Over Time.

Journal Article J Alzheimers Dis · 2022 BACKGROUND: Diagnostic tests, such as amyloid-β positron emission tomography (PET) scans, can increase appropriate therapeutic management for the underlying causes of cognitive decline. To evaluate the full utility of this diagnostic tool, information is n ... Full text Link to item Cite

Caregiving in U.S. Gulf States During Natural Disasters and COVID-19.

Journal Article Gerontol Geriatr Med · 2022 OBJECTIVES: To ascertain common experiences and needs of a diverse group of caregivers challenged by hurricanes/floods and COVID-19. METHODS: In-depth interviews with unpaid caregivers in U.S. Southeast/Gulf Coast states who had experienced caregiving duri ... Full text Link to item Cite

Developing a person-centered, population based measure of "home time": Perspectives of older patients and unpaid caregivers.

Journal Article Healthc (Amst) · December 2021 Measuring "home time," number of days not in facility-based care, with medical claims is a promising approach to assess person-centered outcomes on a population level. Generally, spending more time at home matches long-term care preferences and improves qu ... Full text Link to item Cite

Family Caregiver and Provider Perspectives on Inclusive Care: Aligning Needs and Expectations.

Journal Article Med Care · November 1, 2021 BACKGROUND: Home-based and community-based health care for individuals with complex medical conditions is often provided by family caregivers. Yet caregivers often are not meaningfully included in interactions with clinical health care teams. Inclusive car ... Full text Link to item Cite

Inclusion of Caregivers in Veterans' Care: A Critical Literature Review.

Journal Article Med Care Res Rev · October 2021 More direct inclusion of informal caregivers (i.e., family, friends) in patients' care will make care more patient- and family-centered and has the potential to improve overall quality of care for patients. We need to understand what potentially comprises ... Full text Link to item Cite

Drivers of Long-Term Care Considerations by Persons With Cognitive Impairment.

Journal Article J Appl Gerontol · June 2021 Consideration of place of care is the first step in long-term care (LTC) planning and is critical for patients diagnosed with Alzheimer's disease; yet, drivers of consideration of place of care are unknown. We apply machine learning algorithms to cross-sec ... Full text Link to item Cite

Experiences of VA vocational and education training and assistance services: Facilitators and barriers reported by veterans with disabilities.

Journal Article Psychiatr Rehabil J · June 2021 OBJECTIVE: To understand the experiences of veterans with disabilities and caregiving needs who use Department of Veterans Affairs (VA) vocational and education services, including Supported Employment, the Post-9/11 GI Bill, and Vocational Rehabilitation ... Full text Link to item Cite

Replicating an effective VA program to train and support family caregivers: a hybrid type III effectiveness-implementation design.

Journal Article BMC Health Serv Res · May 6, 2021 BACKGROUND: Caring for a growing aging population using existing long-term care resources while simultaneously supporting and educating family caregivers, is a public health challenge. We describe the application of the Replicating Effective Programs (REP) ... Full text Open Access Link to item Cite

Sex differences in predictors of recurrent major depression among current-era military veterans.

Journal Article Psychol Serv · May 2021 Although major depressive disorder (MDD) is a frequent diagnosis among women seeking care in the Veterans Health Administration, little is known about its course. For example, recurrence of MDD and its predictors have been investigated in civilians, but no ... Full text Link to item Cite

Family Caregivers of Veterans Experience High Levels of Burden, Distress, and Financial Strain.

Journal Article J Am Geriatr Soc · November 2020 BACKGROUND/OBJECTIVES: To describe the caregiving experiences and physical and emotional needs of family members and friends who provide care to veterans with mental, physical, and cognitive comorbidities. DESIGN: Cross-sectional study. SETTING: National t ... Full text Link to item Cite

Comprehensive support of family caregivers: Are there health system cost offsets?

Journal Article Health Serv Res · October 2020 OBJECTIVES: To examine the effect of the Department of Veterans Affairs' (VA) Program of Comprehensive Assistance for Caregivers (PCAFC) on total VA health care costs for Veterans. DATA SOURCES: VA claims. STUDY DESIGN: Using a pre-post cohort design with ... Full text Link to item Cite

Mechanisms Through Which a Family Caregiver Coaching Intervention Might Reduce Anxiety Among Children in Military Households.

Journal Article Matern Child Health J · October 2020 OBJECTIVES: Children of injured or disabled veterans and service members may be at risk for mental health and adjustment problems due to household stress. Yet, there are few widely available interventions to address the needs of this population. Reducing d ... Full text Link to item Cite

Measurement Properties of the CAPACITY Instrument to Assess Perceived Communication With the Health Care Team Among Care Partners of Patients With Cognitive Impairment.

Journal Article Med Care · September 2020 BACKGROUND: The CAregiver Perceptions About CommunIcaTion with Clinical Team members (CAPACITY) instrument measures how care partners perceive themselves to be supported by the patient's health care team and their experiences communicating with the team. O ... Full text Link to item Cite

Connecting Caregivers to Support: Lessons Learned From the VA Caregiver Support Program.

Journal Article J Appl Gerontol · April 2020 Development and evaluation of supportive caregiver interventions has become a national priority. This study's aim was to evaluate how caregivers participating in the Department of Veterans Affairs (VA) Caregiver Support Program (CSP) use and value supporti ... Full text Link to item Cite

Identifying treatment effects of an informal caregiver education intervention to increase days in the community and decrease caregiver distress: a machine-learning secondary analysis of subgroup effects in the HI-FIVES randomized clinical trial.

Journal Article Trials · February 14, 2020 BACKGROUND: Informal caregivers report substantial burden and depressive symptoms which predict higher rates of patient institutionalization. While caregiver education interventions may reduce caregiver distress and decrease the use of long-term institutio ... Full text Open Access Link to item Cite

Adaptation and Implementation of a Family Caregiver Skills Training Program: From Single Site RCT to Multisite Pragmatic Intervention.

Journal Article J Nurs Scholarsh · January 2020 PURPOSE: We describe an approach to rapidly adapt and implement an education and skills improvement intervention to address the needs of family caregivers of functionally impaired veterans-Helping Invested Families Improve Veterans' Experience Study (HI-FI ... Full text Link to item Cite

Leveraging institutional support for family caregivers to meet the health and vocational needs of persons with disabilities.

Journal Article Nurs Outlook · 2020 BACKGROUND: Family caregivers might enhance veteran engagement in health and nonhealth services (i.e., vocational/educational assistance). PURPOSE: To describe how veterans with disabilities perceive their recovery needs, identify types of social support f ... Full text Link to item Cite

How Accurately Do Patients and Their Care Partners Report Results of Amyloid-β PET Scans for Alzheimer's Disease Assessment?

Journal Article J Alzheimers Dis · 2020 BACKGROUND: Amyloid-β PET scans will likely become an integral part of the diagnostic evaluation for Alzheimer's disease if Medicare approves reimbursement for the scans. However, little is known about patients' and their care partners' interpretation of s ... Full text Link to item Cite

Family Caregiver Skills Training to Improve Experiences of Care: a Randomized Clinical Trial.

Journal Article J Gen Intern Med · October 2019 OBJECTIVE: To evaluate the effectiveness of Helping Invested Families Improve Veterans' Experiences Study (HI-FIVES), a skills training program for caregivers of persons with functional or cognitive impairments. DESIGN: A two-arm RCT. SETTING: Single Veter ... Full text Link to item Cite

Emergency Department Interventions for Older Adults: A Systematic Review.

Journal Article J Am Geriatr Soc · July 2019 OBJECTIVES: To evaluate the effect of emergency department (ED) interventions on clinical, utilization, and care experience outcomes for older adults. DESIGN: A conceptual model informed, protocol-based systematic review. SETTING: Emergency Department (ED) ... Full text Link to item Cite

Pain Intensity and Pain Interference in Male and Female Iraq/Afghanistan-era Veterans.

Journal Article Womens Health Issues · June 25, 2019 BACKGROUND: Chronic pain conditions are common among both male and female Iraq/Afghanistan-era veterans and can have substantial negative impacts on quality of life and function. Although in general women tend to report higher levels of pain intensity than ... Full text Link to item Cite

Including Family Caregivers In Seriously Ill Veterans' Care: A Mixed-Methods Study.

Journal Article Health Aff (Millwood) · June 2019 Family caregivers often serve as unpaid members of the home and community-based care workforce for people with serious illness; as key partners in the home-clinic continuum, they should be included in health care teams. The Campaign for Inclusive Care is a ... Full text Link to item Cite

Is Maternal Income in Childhood Associated With Adolescent Health and Behavioral Outcomes?

Journal Article J Fam Issues · May 1, 2019 Maternal income increases immediate investment in children for food, child care, and health care, but whether maternal income influences longer term health and behavioral outcomes is unknown. Using data from the NICHD Study of Early Child Care and Youth De ... Full text Link to item Cite

Invisible partners in care: Snapshot of well-being among caregivers receiving comprehensive support from Veterans Affairs.

Journal Article Health Sci Rep · March 2019 BACKGROUND AND AIMS: Since May 2011, over 23 000 caregivers of Veterans seriously injured on or after September 11, 2001 have enrolled in the Program of Comprehensive Assistance for Family Caregivers (PCAFC). PCAFC provides caregivers training, a stipend, ... Full text Open Access Link to item Cite

Comprehensive Support for Family Caregivers: Impact on Veteran Health Care Utilization and Costs.

Journal Article Med Care Res Rev · February 2019 This study aimed to examine the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) on Veteran health care utilization and costs. A pre-post cohort design including a nonequivalent control group was used to understand how ... Full text Link to item Cite

Comprehensive Family Caregiver Support and Caregiver Well-Being: Preliminary Evidence From a Pre-post-survey Study With a Non-equivalent Control Group.

Journal Article Front Public Health · 2019 Introduction: In May 2010, the Caregivers and Veterans Omnibus Health Services Act of 2010, was signed into law in the United States, establishing the Program of Comprehensive Assistance for Family Caregivers (PCAFC) provided through the VA Caregiver Suppo ... Full text Open Access Link to item Cite

The Effect of Support and Training for Family Members on Access to Outpatient Services for Veterans with Posttraumatic Stress Disorder (PTSD).

Journal Article Adm Policy Ment Health · July 2018 The VA Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides landmark support for family caregivers of post-9/11 veterans. This study examines PCAFC support for veterans with and without PTSD and assesses whether program effect differs ... Full text Link to item Cite

Interventions That Support or Involve Caregivers or Families of Patients with Traumatic Injury: a Systematic Review.

Journal Article J Gen Intern Med · July 2018 BACKGROUND: Almost 40 million family caregivers care for a loved one with severe physical or cognitive impairments. The purpose of this review is to summarize evidence about the benefits of interventions to support or involve family members/caregivers of p ... Full text Link to item Cite

Systematic Review of Behavioral Weight Management Program MOVE! for Veterans.

Journal Article Am J Prev Med · May 2018 CONTEXT: Since 2006, the Veterans Health Administration has delivered a population-based behavioral weight management program (MOVE!) to Veterans, which numerous studies have examined. The purpose of this study was to systematically review these studies to ... Full text Link to item Cite

Management of Menopause Symptoms with Acupuncture: An Umbrella Systematic Review and Meta-Analysis.

Journal Article J Altern Complement Med · April 2018 OBJECTIVES: Vasomotor symptoms (VMSs) are the most common symptoms reported during menopause. Although hormone therapy is effective for reducing VMSs, its use is restricted in some women. Many women with VMSs thus seek nonhormonal, nonpharmacologic treatme ... Full text Link to item Cite

Comprehensive Support for Family Caregivers of Post-9/11 Veterans Increases Veteran Utilization of Long-term Services and Supports: A Propensity Score Analysis.

Journal Article Inquiry · 2018 Family caregivers are an important component of the long-term services and supports (LTSS) system. However, caregiving may have negative consequences for caregiver physical and emotional health. Connecting caregivers to formal short-term home- and communit ... Full text Open Access Link to item Cite

Family caregiver use and value of support services in the VA Program of Comprehensive Assistance for Family Caregivers

Journal Article Journal of Long-Term Care · January 1, 2018 Context: The US Congress in 2010 established the Program of Comprehensive Assistance for Family Caregivers (PCAFC) in the Department of Veterans Affairs’ (VA) healthcare system, expanding services for family caregivers of eligible veterans with injuries su ... Full text Cite

Paternal history of mental illness associated with posttraumatic stress disorder among veterans.

Journal Article Psychiatry Res · October 2017 This study examined the association between parent and family reported history of non-PTSD mental illness (MI), PTSD specifically, and substance use problems, and participant clinical diagnosis of PTSD. Participants were drawn from the US Department of Vet ... Full text Link to item Cite

Improving vasomotor symptoms; psychological symptoms; and health-related quality of life in peri- or post-menopausal women through yoga: An umbrella systematic review and meta-analysis.

Journal Article Complement Ther Med · October 2017 OBJECTIVES: Vasomotor symptoms (VMS), commonly reported during menopausal transition, negatively affect psychological health and health-related quality of life (HRQoL). While hormone therapy is an effective treatment, its use is limited by concerns about p ... Full text Link to item Cite

Self-Reported Pain in Male and Female Iraq/Afghanistan-Era Veterans: Associations with Psychiatric Symptoms and Functioning.

Journal Article Pain Med · September 1, 2017 OBJECTIVE: To examine pain symptoms and co-occurring psychiatric and functional indices in male and female Iraq/Afghanistan-era veterans. DESIGN: Self-reported data collection and interviews of Iraq/Afghanistan-era veterans who participated in a multisite ... Full text Link to item Cite

Use of mindfulness, meditation and relaxation to treat vasomotor symptoms.

Journal Article Climacteric · April 2017 Postmenopausal women with bothersome vasomotor symptoms (VMS) often seek alternatives to hormone-based treatment due to medication risks or personal preference. We sought to identify the effects of meditation, mindfulness, hypnosis and relaxation on VMS an ... Full text Link to item Cite

NONPHARMACOLOGIC TREATMENTS FOR MENOPAUSE-ASSOCIATED VASOMOTOR SYMPTOMS

Conference JOURNAL OF GENERAL INTERNAL MEDICINE · April 1, 2017 Link to item Cite

Mothers' Employment Attributes and Use of Preventive Child Health Services.

Journal Article Med Care Res Rev · April 2017 This study examines whether paid sick leave and hours worked per week are associated with receipt of recommended well-child visits, preventive dental care, influenza vaccines, obesity screening, and vision screening among U.S. children aged 0 to 17 years w ... Full text Link to item Cite

Do Maternity Care Coordination Services Encourage Use of Behavioral Health Treatment among Pregnant Women on Medicaid?

Journal Article Womens Health Issues · 2017 OBJECTIVE: Maternity care coordination (MCC) may provide an opportunity to enhance access to behavioral health treatment services. However, this relationship has not been examined extensively in the empirical literature. This study examines the effect of M ... Full text Link to item Cite

Nonpharmacologic, nonherbal management of menopause-associated vasomotor symptoms: an umbrella systematic review (protocol).

Journal Article Syst Rev · April 7, 2016 BACKGROUND: Vasomotor symptoms such as hot flashes and night sweats are a common concern of perimenopausal and postmenopausal women and are associated with a decreased quality of life. These symptoms can be effectively managed with hormone therapy, but saf ... Full text Open Access Link to item Cite

Workplace Stress and Working from Home Influence Depressive Symptoms Among Employed Women with Young Children.

Journal Article Int J Behav Med · February 2016 BACKGROUND: Poor balance between work and family can be a major stressor for women with young children and have a negative impact on emotional well-being. Family-friendly workplace attributes may reduce stress and depressive symptoms among this population. ... Full text Link to item Cite

Dental attendance among low-income women and their children following a brief motivational counseling intervention: A community randomized trial.

Journal Article Soc Sci Med · November 2015 UNLABELLED: This study tested a behavioral intervention to increase dental attendance among rural Oregonian low-income women and their children. It utilized a multi-site, single-blind, randomized trial design. Four hundred women were randomized into one of ... Full text Link to item Cite

"The Promotora Explained Everything": Participant Experiences During a Household-Level Diabetes Education Program.

Journal Article Diabetes Educ · July 2014 PURPOSE: The purpose of this study is to describe participant experiences of a household-level, community health worker-led intervention to improve diabetes-related health behaviors and outcomes. METHODS: The Home Health Parties (HHP) aimed to improve diab ... Full text Link to item Cite

Macro-activity patterns of farmworker and non-farmworker children living in an agricultural community.

Journal Article Environ Res · July 2014 BACKGROUND: Children of farmworkers have significantly higher exposure to pesticides than do other children living in the same agricultural communities, but there is limited information about how and where older farmworker children (>6) spend their time an ... Full text Link to item Cite

Paid leave benefits among a national sample of working mothers with infants in the United States.

Journal Article Matern Child Health J · January 2014 To describe a range of employment benefits, including maternity and other paid leave, afforded to working women with infants; and to examine the geographic, socio-demographic correlates of such benefits to inform the workplace policy agenda in the US. Usin ... Full text Link to item Cite

A tool for assessing management capacity at the decentralized level in a fragile state.

Journal Article Int J Health Plann Manage · 2012 Fragile states need assessment of decentralized management capabilities, not just of the central level, to design capacity-building efforts focused on improving management. Improving the management capacity of health departments at the provincial or distri ... Full text Link to item Cite

Rebuilding and strengthening health systems and providing basic health services in fragile states.

Journal Article Disasters · October 2011 The international community has compelling humanitarian, political, security and economic reasons to engage in rebuilding and strengthening health systems in fragile states. Improvements in health services and systems help to strengthen civil society and t ... Full text Link to item Cite

Rebuilding and strengthening health systems and providing basic health services in fragile states

Journal Article Disasters · January 1, 2011 The international community has compelling humanitarian, political, security and economic reasons to engage in rebuilding and strengthening health systems in fragile states. Improvements in health services and systems help to strengthen civil society and t ... Full text Cite