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Nina Sperber

Associate Professor in Population Health Sciences
Population Health Sciences

Selected Publications


Pharmacogenetic testing in primary care could bolster depression treatment: A value proposition.

Journal Article Clin Transl Sci · June 2024 Pharmacogenetic testing could reduce the time to identify a safe and effective medication for depression; however, it is underutilized in practice. Major depression constitutes the most common mental disorder in the US, and while antidepressant therapy can ... Full text Link to item Cite

Workforce readiness for pharmacogenomics and key elements for sustainment within the Veterans Health Administration.

Journal Article Pharmacogenomics · February 2024 Aim: Understanding barriers and facilitators to pharmacogenomics (PGx) implementation and how to structure a clinical program with the Veterans Health Administration (VA). Materials & methods: Healthcare provider (HCP) survey at 20 VA facilities assessing ... Full text Open Access Link to item Cite

Evaluation of strategies to support implementation of a hospital walking program: protocol for a type III effectiveness-implementation hybrid trial.

Journal Article Implement Sci Commun · January 12, 2024 BACKGROUND: STRIDE is a supervised walking program designed to address the negative consequences of immobility during hospitalization for older adults. In an 8-hospital stepped wedge randomized controlled trial, STRIDE was associated with reduced odds of h ... Full text Link to item Cite

"I've been doing this for years": the COVID-19 pandemic and family caregiver isolation and loneliness.

Journal Article Front Aging · 2024 BACKGROUND: Family caregivers are family members or friends of care recipients who assist with activities of daily living, medication management, transportation, and help with finances among other activities. As a result of their caregiving, family caregiv ... 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

Group physical therapy for knee osteoarthritis: protocol for a hybrid type III effectiveness-implementation trial.

Journal Article Implement Sci Commun · October 12, 2023 BACKGROUND: Knee osteoarthritis (OA) is a leading cause of chronic pain and disability and one of the most common conditions treated in outpatient physical therapy (PT). Because of the high and growing prevalence of knee OA, there is a need for efficient a ... Full text Open Access Link to item Cite

Patient Perspectives of Barriers and Facilitators for the Uptake of Pharmacogenomic Testing in Veterans Affairs' Pharmacogenomic Testing for the Veterans (PHASER) Program.

Journal Article J Pers Med · September 9, 2023 We applied implementation science frameworks to identify barriers and facilitators to veterans' acceptance of pharmacogenomic testing (PGx), which was made available as a part of clinical care at 25 VA medical centers. We conducted 30 min interviews with v ... Full text Link to item Cite

Implementation intensification to disseminate a skills-based caregiver training program: protocol for a type III effectiveness-implementation hybrid trial.

Journal Article Implement Sci Commun · August 16, 2023 BACKGROUND: Family caregiver training decreases caregiver psychological burden and improves caregiver depressive symptoms and health-related quality of life. Caregivers FIRST is an evidence-based group skills training curriculum for family caregivers and w ... Full text Link to item Cite

Ready, set, go! The role of organizational readiness to predict adoption of a family caregiver training program using the Rogers' diffusion of innovation theory.

Journal Article Implement Sci Commun · June 19, 2023 BACKGROUND: Caregivers FIRST is an evidence-based program addressing gaps in caregivers' skills. In 2020, the Veterans Health Administration Caregiver Support Program (CSP) nationally endorsed Caregivers FIRST, offering credit in leadership performance pla ... Full text Open Access Link to item Cite

Effects of Implementation of a Supervised Walking Program in Veterans Affairs Hospitals : A Stepped-Wedge, Cluster Randomized Trial.

Journal Article Ann Intern Med · June 2023 BACKGROUND: In trials, hospital walking programs have been shown to improve functional ability after discharge, but little evidence exists about their effectiveness under routine practice conditions. OBJECTIVE: To evaluate the effect of implementation of a ... Full text Link to item Cite

A Cluster Randomized Trial of a Family Health History Platform to Identify and Manage Patients at Increased Risk for Colorectal Cancer.

Journal Article J Gen Intern Med · May 2023 BACKGROUND: Obtaining comprehensive family health history (FHH) to inform colorectal cancer (CRC) risk management in primary care settings is challenging. OBJECTIVE: To examine the effectiveness of a patient-facing FHH platform to identify and manage patie ... Full text Link to item Cite

Patient experiences of a care transition intervention for Veterans to reduce emergency department visits.

Journal Article Acad Emerg Med · April 2023 OBJECTIVES: Care transition interventions (CTIs) are used to improve outcomes after an emergency department (ED) visit. A recent randomized controlled trial of a Veterans Health Administration (VHA) CTI titled Discharge Information and Support for Patients ... Full text Link to item Cite

Mandated Caregiver Training in the Veterans Health Administration: Caregiver Inquiry Informs National Dissemination.

Journal Article Gerontologist · March 21, 2023 BACKGROUND AND OBJECTIVES: A minority of family caregivers receive training, with implications for their own and their recipient's outcomes. Federal policy has supported the implementation and expansion of caregiver training and support. The Department of ... Full text Open Access 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

Self-Organization of Interprofessional Staff to Improve Mobility of Hospitalized Patients with STRIDE: a Complexity Science-Informed Qualitative Study.

Journal Article J Gen Intern Med · December 2022 BACKGROUND: Inpatient mobility programs can help older adults maintain function during hospitalization. Changing hospital practice can be complex and require engagement of various staff levels and disciplines; however, we know little about how interprofess ... Full text Link to item Cite

Determinants of inter-organizational implementation success: A mixed-methods evaluation of Veteran Directed Care.

Journal Article Healthc (Amst) · December 2022 BACKGROUND: Veteran Directed Care (VDC) aims to keep Veterans at risk for nursing home placement in their communities. VA medical centers (VAMCs) purchase VDC from third-party organizational providers who then partner with them during implementation. Exper ... Full text Link to item Cite

COVID-19 vaccination intention and activation among health care system employees: A mixed methods study.

Journal Article Vaccine · August 19, 2022 BACKGROUND: Achieving high COVID-19 vaccination rates among employees is necessary to prevent outbreaks in health care settings. The goal of the study was to produce actionable and timely evidence about factors underlying the intention and decisions to obt ... Full text Open Access Link to item Cite

A Mixed-Methods Protocol to Identify Best Practices for Implementing Pharmacogenetic Testing in Clinical Settings.

Journal Article J Pers Med · August 13, 2022 Using a patient's genetic information to inform medication prescriptions can be clinically effective; however, the practice has not been widely implemented. Health systems need guidance on how to engage with providers to improve pharmacogenetic test utiliz ... Full text Link to item Cite

Adapting to CONNECT: modifying a nursing home-based team-building intervention to improve hospital care team interactions, functioning, and implementation readiness.

Journal Article BMC Health Serv Res · July 29, 2022 BACKGROUND: Clinical interventions often need to be adapted from their original design when they are applied to new settings. There is a growing literature describing frameworks and approaches to deploying and documenting adaptations of evidence-based prac ... Full text Open Access 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

Pharmacogenetic testing in primary care could bolster depression treatment: A value proposition.

Journal Article Clin Transl Sci · June 2024 Pharmacogenetic testing could reduce the time to identify a safe and effective medication for depression; however, it is underutilized in practice. Major depression constitutes the most common mental disorder in the US, and while antidepressant therapy can ... Full text Link to item Cite

Workforce readiness for pharmacogenomics and key elements for sustainment within the Veterans Health Administration.

Journal Article Pharmacogenomics · February 2024 Aim: Understanding barriers and facilitators to pharmacogenomics (PGx) implementation and how to structure a clinical program with the Veterans Health Administration (VA). Materials & methods: Healthcare provider (HCP) survey at 20 VA facilities assessing ... Full text Open Access Link to item Cite

Evaluation of strategies to support implementation of a hospital walking program: protocol for a type III effectiveness-implementation hybrid trial.

Journal Article Implement Sci Commun · January 12, 2024 BACKGROUND: STRIDE is a supervised walking program designed to address the negative consequences of immobility during hospitalization for older adults. In an 8-hospital stepped wedge randomized controlled trial, STRIDE was associated with reduced odds of h ... Full text Link to item Cite

"I've been doing this for years": the COVID-19 pandemic and family caregiver isolation and loneliness.

Journal Article Front Aging · 2024 BACKGROUND: Family caregivers are family members or friends of care recipients who assist with activities of daily living, medication management, transportation, and help with finances among other activities. As a result of their caregiving, family caregiv ... 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

Group physical therapy for knee osteoarthritis: protocol for a hybrid type III effectiveness-implementation trial.

Journal Article Implement Sci Commun · October 12, 2023 BACKGROUND: Knee osteoarthritis (OA) is a leading cause of chronic pain and disability and one of the most common conditions treated in outpatient physical therapy (PT). Because of the high and growing prevalence of knee OA, there is a need for efficient a ... Full text Open Access Link to item Cite

Patient Perspectives of Barriers and Facilitators for the Uptake of Pharmacogenomic Testing in Veterans Affairs' Pharmacogenomic Testing for the Veterans (PHASER) Program.

Journal Article J Pers Med · September 9, 2023 We applied implementation science frameworks to identify barriers and facilitators to veterans' acceptance of pharmacogenomic testing (PGx), which was made available as a part of clinical care at 25 VA medical centers. We conducted 30 min interviews with v ... Full text Link to item Cite

Implementation intensification to disseminate a skills-based caregiver training program: protocol for a type III effectiveness-implementation hybrid trial.

Journal Article Implement Sci Commun · August 16, 2023 BACKGROUND: Family caregiver training decreases caregiver psychological burden and improves caregiver depressive symptoms and health-related quality of life. Caregivers FIRST is an evidence-based group skills training curriculum for family caregivers and w ... Full text Link to item Cite

Ready, set, go! The role of organizational readiness to predict adoption of a family caregiver training program using the Rogers' diffusion of innovation theory.

Journal Article Implement Sci Commun · June 19, 2023 BACKGROUND: Caregivers FIRST is an evidence-based program addressing gaps in caregivers' skills. In 2020, the Veterans Health Administration Caregiver Support Program (CSP) nationally endorsed Caregivers FIRST, offering credit in leadership performance pla ... Full text Open Access Link to item Cite

Effects of Implementation of a Supervised Walking Program in Veterans Affairs Hospitals : A Stepped-Wedge, Cluster Randomized Trial.

Journal Article Ann Intern Med · June 2023 BACKGROUND: In trials, hospital walking programs have been shown to improve functional ability after discharge, but little evidence exists about their effectiveness under routine practice conditions. OBJECTIVE: To evaluate the effect of implementation of a ... Full text Link to item Cite

A Cluster Randomized Trial of a Family Health History Platform to Identify and Manage Patients at Increased Risk for Colorectal Cancer.

Journal Article J Gen Intern Med · May 2023 BACKGROUND: Obtaining comprehensive family health history (FHH) to inform colorectal cancer (CRC) risk management in primary care settings is challenging. OBJECTIVE: To examine the effectiveness of a patient-facing FHH platform to identify and manage patie ... Full text Link to item Cite

Patient experiences of a care transition intervention for Veterans to reduce emergency department visits.

Journal Article Acad Emerg Med · April 2023 OBJECTIVES: Care transition interventions (CTIs) are used to improve outcomes after an emergency department (ED) visit. A recent randomized controlled trial of a Veterans Health Administration (VHA) CTI titled Discharge Information and Support for Patients ... Full text Link to item Cite

Mandated Caregiver Training in the Veterans Health Administration: Caregiver Inquiry Informs National Dissemination.

Journal Article Gerontologist · March 21, 2023 BACKGROUND AND OBJECTIVES: A minority of family caregivers receive training, with implications for their own and their recipient's outcomes. Federal policy has supported the implementation and expansion of caregiver training and support. The Department of ... Full text Open Access 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

Self-Organization of Interprofessional Staff to Improve Mobility of Hospitalized Patients with STRIDE: a Complexity Science-Informed Qualitative Study.

Journal Article J Gen Intern Med · December 2022 BACKGROUND: Inpatient mobility programs can help older adults maintain function during hospitalization. Changing hospital practice can be complex and require engagement of various staff levels and disciplines; however, we know little about how interprofess ... Full text Link to item Cite

Determinants of inter-organizational implementation success: A mixed-methods evaluation of Veteran Directed Care.

Journal Article Healthc (Amst) · December 2022 BACKGROUND: Veteran Directed Care (VDC) aims to keep Veterans at risk for nursing home placement in their communities. VA medical centers (VAMCs) purchase VDC from third-party organizational providers who then partner with them during implementation. Exper ... Full text Link to item Cite

COVID-19 vaccination intention and activation among health care system employees: A mixed methods study.

Journal Article Vaccine · August 19, 2022 BACKGROUND: Achieving high COVID-19 vaccination rates among employees is necessary to prevent outbreaks in health care settings. The goal of the study was to produce actionable and timely evidence about factors underlying the intention and decisions to obt ... Full text Open Access Link to item Cite

A Mixed-Methods Protocol to Identify Best Practices for Implementing Pharmacogenetic Testing in Clinical Settings.

Journal Article J Pers Med · August 13, 2022 Using a patient's genetic information to inform medication prescriptions can be clinically effective; however, the practice has not been widely implemented. Health systems need guidance on how to engage with providers to improve pharmacogenetic test utiliz ... Full text Link to item Cite

Adapting to CONNECT: modifying a nursing home-based team-building intervention to improve hospital care team interactions, functioning, and implementation readiness.

Journal Article BMC Health Serv Res · July 29, 2022 BACKGROUND: Clinical interventions often need to be adapted from their original design when they are applied to new settings. There is a growing literature describing frameworks and approaches to deploying and documenting adaptations of evidence-based prac ... Full text Open Access 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

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

Patient experiences with a phone-based cardiovascular risk reduction intervention: Are there differences between women and men?

Journal Article Patient Educ Couns · November 2021 OBJECTIVES: To explore gender-based differences in experiences with a telehealth-delivered intervention for reduction of cardiovascular risk. METHODS: We conducted 23 semi-structured qualitative interviews by telephone with 11 women and 12 men who received ... Full text Open Access 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

Evaluation of the Veterans Affairs Pharmacogenomic Testing for Veterans (PHASER) clinical program at initial test sites.

Journal Article Pharmacogenomics · November 2021 Aim: The first Plan-Do-Study-Act cycle for the Veterans Affairs Pharmacogenomic Testing for Veterans pharmacogenomic clinical testing program is described. Materials & methods: Surveys evaluating implementation resources and processes were distributed to i ... 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

Strategies to Integrate Genomic Medicine into Clinical Care: Evidence from the IGNITE Network.

Journal Article J Pers Med · July 8, 2021 The complexity of genomic medicine can be streamlined by implementing some form of clinical decision support (CDS) to guide clinicians in how to use and interpret personalized data; however, it is not yet clear which strategies are best suited for this pur ... Full text Link to item Cite

'The face of the programme': How local clinicians shape decisions about eligibility for a national caregiver support programme in the USA.

Journal Article J Health Serv Res Policy · July 2021 OBJECTIVE: To examine the causes of variation for determining clinical eligibility for a national caregiver programme in the US Veterans Health Administration (VHA) and so help inform standardization of clinical eligibility assessment for support and estab ... Full text Link to item Cite

Establishing the value of genomics in medicine: the IGNITE Pragmatic Trials Network.

Journal Article Genet Med · July 2021 PURPOSE: A critical gap in the adoption of genomic medicine into medical practice is the need for the rigorous evaluation of the utility of genomic medicine interventions. METHODS: The Implementing Genomics in Practice Pragmatic Trials Network (IGNITE PTN) ... Full text Open Access 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

Coincidence analysis: a new method for causal inference in implementation science.

Journal Article Implement Sci · December 11, 2020 BACKGROUND: Implementation of multifaceted interventions typically involves many diverse elements working together in interrelated ways, including intervention components, implementation strategies, and features of local context. Given this real-world comp ... Full text Link to item Cite

Advancing the science of population-based measures of home-time.

Journal Article Healthc (Amst) · December 2020 The "home time" measure is gaining appeal in evaluating outcomes for multiple patient populations including post-surgery or intervention and the last 6 months of life. Advancing the science of home time measures will require obtaining the perspectives of p ... Full text Link to item Cite

Implementation of a stepped wedge cluster randomized trial to evaluate a hospital mobility program.

Journal Article Trials · October 16, 2020 BACKGROUND: Stepped wedge cluster randomized trials (SW-CRT) are increasingly used to evaluate new clinical programs, yet there is limited guidance on practical aspects of applying this design. We report our early experiences conducting a SW-CRT to examine ... Full text Open Access Link to item Cite

Correction: Developing a common framework for evaluating the implementation of genomic medicine interventions in clinical care: the IGNITE Network's Common Measures Working Group.

Journal Article Genet Med · October 2020 An amendment to this paper has been published and can be accessed via a link at the top of the paper. ... 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

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

Interorganizational Context When Implementing Multisector Partnered Programs: A Qualitative Analysis of Veteran Directed Care.

Journal Article J Gerontol Soc Work · 2020 As the number of Veterans enrolled in the Veterans Health Administration (VHA) and at risk for needing Long Term Services and Supports increases, VHA is shifting from institutional to Home and Community Based Services, such as the Veteran-Directed Care (VD ... Full text Link to item Cite

Women Veterans Experience with the VA MOVE! Weight Management Program.

Journal Article Womens Health Rep (New Rochelle) · 2020 UNLABELLED: Background: Obesity prevalence is higher in women veterans overall than their civilian counterparts considering 44% of women veterans are obese. Thus, there is a critical need to understand the facilitators and barriers to women veterans' parti ... Full text Open Access Link to item Cite

An electronic family health history tool to identify and manage patients at increased risk for colorectal cancer: protocol for a randomized controlled trial.

Journal Article Trials · October 7, 2019 BACKGROUND: Colorectal cancer is the fourth most commonly diagnosed cancer in the United States. Approximately 3-10% of the population has an increased risk for colorectal cancer due to family history and warrants more frequent or intensive screening. Yet, ... Full text Link to item Cite

Qualitative study of system-level factors related to genomic implementation.

Journal Article Genet Med · July 2019 PURPOSE: Research on genomic medicine integration has focused on applications at the individual level, with less attention paid to implementation within clinical settings. Therefore, we conducted a qualitative study using the Consolidated Framework for Imp ... 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

Effect of Sociodemographic Factors on Uptake of a Patient-Facing Information Technology Family Health History Risk Assessment Platform.

Journal Article Appl Clin Inform · March 2019 OBJECTIVE: Investigate sociodemographic differences in the use of a patient-facing family health history (FHH)-based risk assessment platform. METHODS: In this large multisite trial with a diverse patient population, we evaluated the relationship between s ... 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

Implementation, adoption, and utility of family health history risk assessment in diverse care settings: evaluating implementation processes and impact with an implementation framework.

Journal Article Genet Med · February 2019 PURPOSE: This paper describes the implementation outcomes associated with integrating a family health history-based risk assessment and clinical decision support platform within primary care clinics at four diverse healthcare systems. METHODS: A type III h ... Full text Link to item Cite

Implementing a Mandated Program Across a Regional Health Care System: A Rapid Qualitative Assessment to Evaluate Early Implementation Strategies.

Journal Article Qual Manag Health Care · 2019 BACKGROUND: Rapid qualitative assessment was used to describe early strategies to implement an evidence-based walking program for hospitalized older adults, assiSTed eaRly mobIlity for hospitalizeD older vEterans (STRIDE), mandated by a regional Department ... 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

Developing a common framework for evaluating the implementation of genomic medicine interventions in clinical care: the IGNITE Network's Common Measures Working Group.

Journal Article Genet Med · June 2018 PurposeImplementation research provides a structure for evaluating the clinical integration of genomic medicine interventions. This paper describes the Implementing Genomics in Practice (IGNITE) Network's efforts to promote (i) a broader understanding of g ... Full text Link to item Cite

Supporting teams to optimize function and independence in Veterans: a multi-study program and mixed methods protocol.

Journal Article Implement Sci · April 20, 2018 BACKGROUND: Successful implementation of new clinical programs depends on effectively establishing, reorganizing, or enhancing team structures and processes to coordinate the work of individuals who are interdependent in their tasks, manage relationships, ... Full text Open Access Link to item Cite

Comparison of Telephone and Televideo Modes for Delivery of Genetic Counseling: a Randomized Trial.

Journal Article J Genet Couns · April 2018 Telephone and televideo have yielded equivalent patient satisfaction and psychosocial outcomes when compared to in-person genetic counseling, yet little is known about how they compare to one another. In this randomized controlled trial, veterans received ... Full text 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

Innovation in a Learning Health Care System: Veteran-Directed Home- and Community-Based Services.

Journal Article J Am Geriatr Soc · November 2017 A path-breaking example of the interplay between geriatrics and learning healthcare systems is the Veterans Health Administration's (VHA's) planned roll-out of a program for providing participant-directed home- and community-based services to veterans with ... Full text Link to item Cite

Implementation evaluation of the Telephone Lifestyle Coaching (TLC) program: organizational factors associated with successful implementation.

Journal Article Transl Behav Med · June 2017 The Telephone Lifestyle Coaching (TLC) program provided telephone-based coaching for six lifestyle behaviors to 5321 Veterans at 24 Veterans Health Administration (VHA) medical facilities. The purpose of the study was to conduct an evaluation of the TLC pr ... Full text Link to item Cite

Challenges and strategies for implementing genomic services in diverse settings: experiences from the Implementing GeNomics In pracTicE (IGNITE) network.

Journal Article BMC Med Genomics · May 22, 2017 BACKGROUND: To realize potential public health benefits from genetic and genomic innovations, understanding how best to implement the innovations into clinical care is important. The objective of this study was to synthesize data on challenges identified b ... Full text Open Access Link to item Cite

How Can Adult Children Influence Parents' Long-Term Care Insurance Purchase Decisions?

Journal Article Gerontologist · April 1, 2017 PURPOSE OF THE STUDY: Long-term care (LTC) poses a significant strain on public health insurance financing. In response, there is policy interest in bolstering the private long-term care insurance (LTCI) market. Although families are central to LTC provisi ... Full text Link to item Cite

Implementation of Lung Cancer Screening in the Veterans Health Administration.

Journal Article JAMA Intern Med · March 1, 2017 IMPORTANCE: The US Preventive Services Task Force recommends annual lung cancer screening (LCS) with low-dose computed tomography for current and former heavy smokers aged 55 to 80 years. There is little published experience regarding implementing this rec ... Full text Link to item Cite

Patient perceptions of a comprehensive telemedicine intervention to address persistent poorly controlled diabetes.

Journal Article Patient Prefer Adherence · 2017 OBJECTIVE: We studied a telemedicine intervention for persistent poorly controlled diabetes mellitus (PPDM) that combined telemonitoring, self-management support, and medication management. The intervention was designed for practical delivery using existin ... Full text Open Access Link to item Cite

Understanding the Context for Long-Term Care Planning.

Journal Article Med Care Res Rev · June 2016 Evolving family structure and economic conditions may affect individuals' ability and willingness to plan for future long-term care (LTC) needs. We applied life course constructs to analyze focus group data from a study of family decision making about LTC ... Full text Open Access Link to item Cite

Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration.

Journal Article J Pers Med · April 28, 2016 We examined facilitators and barriers to adoption of genomic services for colorectal care, one of the first genomic medicine applications, within the Veterans Health Administration to shed light on areas for practice change. We conducted semi-structured in ... Full text Open Access Link to item Cite

Implementation of new clinical programs in the VHA healthcare system: the importance of early collaboration between clinical leadership and research.

Journal Article J Gen Intern Med · December 2014 Collaboration between policy, research, and clinical partners is crucial to achieving proven quality care. The Veterans Health Administration has expended great efforts towards fostering such collaborations. Through this, we have learned that an ideal coll ... Full text Link to item Cite

Scheduled telephone visits in the veterans health administration patient-centered medical home.

Journal Article BMC Health Serv Res · April 1, 2014 BACKGROUND: The Veterans Health Administration (VHA) patient-centered medical home model, Patient Aligned Care Teams (PACT), includes telephone visits to improve care access and efficiency. Scheduled telephone visits can replace in-person care for some foc ... Full text Link to item Cite

The role of symptoms and self-efficacy in predicting physical activity change among older adults with arthritis.

Journal Article J Phys Act Health · March 2014 BACKGROUND: Physical and psychological symptoms limit physical activity for people with arthritis. This study examined if self-efficacy mediated a relationship between symptom and physical activity (PA) frequency change. METHODS: This was a secondary analy ... Full text Link to item Cite

Differences in effectiveness of the active living every day program for older adults with arthritis.

Journal Article J Aging Phys Act · October 2013 OBJECTIVE: The authors explored whether demographic and psychosocial variables predicted differences in physical activity for participants with arthritis in a trial of Active Living Every Day (ALED). METHOD: Participants (N = 280) from 17 community sites w ... Full text Link to item Cite

Spousal support in a behavior change intervention for cholesterol management.

Journal Article Patient Educ Couns · July 2013 OBJECTIVE: To evaluate spousal involvement in a nurse-led intervention for patients with high cholesterol in which patients set health goals and spouses learned support strategies. METHODS: Qualitative interviews were conducted with 29 patients and 26 spou ... Full text Link to item Cite

Differences in osteoarthritis self-management support intervention outcomes according to race and health literacy.

Journal Article Health Educ Res · June 2013 We explored whether the effects of a telephone-based osteoarthritis (OA) self-management support intervention differed by race and health literacy. Participants included 515 veterans with hip and/or knee OA. Linear mixed models assessed differential effect ... Full text Open Access Link to item Cite

Patient and provider interventions for managing osteoarthritis in primary care: protocols for two randomized controlled trials.

Journal Article BMC Musculoskelet Disord · April 24, 2012 BACKGROUND: Osteoarthritis (OA) of the hip and knee are among the most common chronic conditions, resulting in substantial pain and functional limitations. Adequate management of OA requires a combination of medical and behavioral strategies. However, some ... Full text Open Access Link to item Cite

Participant evaluation of a telephone-based osteoarthritis self-management program, 2006-2009.

Journal Article Prev Chronic Dis · 2012 INTRODUCTION: Self-management support interventions can help improve osteoarthritis outcomes but are underused. Little is known about how participants evaluate the helpfulness of these programs. We describe participants' evaluations of a telephone-based, o ... Open Access Link to item Cite

Influence of parent characteristics and disease outcome framing on HPV vaccine acceptability among rural, Southern women.

Journal Article Cancer Causes Control · February 2008 OBJECTIVE: A new prophylactic vaccine protects against infection with HPV types that cause many cervical cancers and genital warts. This study explored the impact of framing the vaccine's benefits, with respect to the disease outcome being prevented, on wo ... Full text Link to item Cite

Multilevel perspectives on diffusing a physical activity promotion program to reach diverse older adults.

Journal Article J Aging Phys Act · July 2006 Diffusing research-based physical activity programs in underserved communities could improve the health of ethnically diverse populations. We utilized a multilevel, community-based approach to determine attitudes, resources, needs, and barriers to physical ... Full text Link to item Cite

Diffusing a research-based physical activity promotion program for seniors into diverse communities: CHAMPS III.

Journal Article Prev Chronic Dis · April 2006 INTRODUCTION: Increasing the physical activity levels of older adults through diffusion of successful research-based programs into community settings is challenging because of differences between research and real-world settings. This project diffused the ... Link to item Cite

Diffusing a research-based physical activity promotion program for seniors into diverse communities: CHAMPS III

Journal Article Preventing Chronic Disease · January 1, 2006 Introduction: Increasing the physical activity levels of older adults through diffusion of successful research-based programs into community settings is challenging because of differences between research and real-world settings. This project diffused the ... Cite