Co-designing a blueprint for spreading person-centered, Whole Health care to HIV specialty care settings: a mixed methods protocol.

Background: Since 2013, the Veterans Health Administration (VHA) has advanced a person-centered, Whole Health (WH) System of Care, a shift from a disease-oriented system to one that prioritizes "what matters most" to patients in their lives. Whole Health is predicated on patient-provider interactions marked by a multi-level understanding of health and trusted relationships that promote well-being. Presently, WH implementation has been focused largely in primary care settings, yet the goal is to effect a system-wide transformation of care so that Veterans receive WH across VHA clinical settings, including specialty care.

Needs for Successful Engagement in Telemedicine Among Rural Older US Veterans and Their Caregivers: Qualitative Study.

Background: Telemedicine is an important option for rural older adults who often must travel far distances to clinics or forgo essential care. In 2014, the Geriatric Research, Education, and Clinical Centers (GRECC) of the US Veterans Health Administration (VA) established a national telemedicine network called GRECC Connect. This network increased access to geriatric specialty care for the 1.

The Development and Use of a New Visual Tool (REVISIT) to Support Participant Recall: Web-Based Interview Study Among Older Adults.

Background: Qualitative health services research often relies on semistructured or in-depth interviews to develop a deeper understanding of patient experiences, motivations, and perspectives. The quality of data gathered is contingent upon a patient's recall capacity; yet, studies have shown that recall of medical information is low. Threats to generating rich and detailed interview data may be more prevalent when interviewing older adults.

The role of Department of Veterans Affairs community-based outpatient clinics in enhancing rural access to geriatrics telemedicine specialty care.

Background: Half of the 4.7 M veterans who reside in rural communities and rely on U.S.

Caregiver Support Role in Occupational Therapy Video Telehealth: A Scoping Review.

Caregiver involvement may facilitate patient participation in occupational therapy (OT) video telehealth. However, little is known about the extent to which caregivers participate and what they do. This scoping review aims to, 1) describe the caregiver role supporting patient participation in OT video telehealth, and, 2) identify barriers and facilitators to caregiver involvement.

Promoting Whole Health and Well-Being at Home: Veteran and Provider Perspectives on the Impact of Tele-Whole Health Services.

Background: The Veterans Health Administration (VA) is undergoing a transformation in how healthcare is organized and provided. This transformation to a Whole Health System of Care encompasses the integration of complementary and integrative health services, education, and Whole Health coaching to develop Veterans' self-care skills. During the COVID-19 pandemic, these services were provided via telehealth (tele-WH).

Perceived benefits of geriatric specialty telemedicine among rural patients and caregivers.

Objective: Explore the perceived benefits of a Veterans Health Administration (VHA) geriatric specialty telemedicine service (GRECC Connect) among rural, older patients and caregivers to contribute to an assessment of its quality and value.

Data Sources: In Spring 2021, we interviewed a geographically diverse sample of rural, older patients and their caregivers who participated in GRECC Connect telemedicine visits.

Study Design: A cross-sectional qualitative study focused on patient and caregiver experiences with telemedicine, including perceived benefits and challenges.

Integrating CFIR-ERIC and e-Delphi Methods to Increase Telegeriatrics Uptake.

Background And Objectives: Participatory implementation methods are needed in geriatric health care to improve care and services for a growing population of older adults. We describe an efficient participatory approach to improve uptake of Geriatric Research Education and Clinical Center (GRECC) Connect, a national geriatrics outpatient consultation service using telehealth technology to connect geriatric specialists to rural, older veterans though community-based clinics.

Research Design And Methods: We designed a three-phase participatory method to identify high-priority implementation strategies to support the uptake of GRECC Connect.

Innovative Approaches to Engaging Homeless and Marginally Housed Patients in Care: a Case Study of Hepatitis C.

Background: Homeless and marginally housed (HAMH) individuals experience significant health disparities compared to housed counterparts, including higher hepatitis C virus (HCV) rates. New direct-acting antiviral (DAA) medications dramatically increased screening and treatment rates for HCV overall, but inequities persist for HAMH populations.

Objective: This study examines the range of policies, practices, adaptations, and innovations implemented by Veteran Affairs Medical Centers (VAMCs) in response to Veterans Health Administration (VHA)'s 2016 HCV funding allocation to expand provision of HCV care.

Evaluating the Impacts of Patient Engagement on Health Services Research Teams: Lessons from the Veteran Consulting Network.

Background: Despite increasing commitment to patient engagement in research, evaluation of the impact of these efforts on research processes, products, and teams is limited.

Objective: To explore the impacts of engaging patients as consultants to research studies by examining the experiences, impacts, and lessons learned from a program facilitating patient engagement at a Veterans Health Administration research center.

Design: We developed a logic model to articulate the activities being implemented to support patient engagement and their anticipated outcomes.

Leaning Into Whole Health: Sustaining System Transformation While Supporting Patients and Employees During COVID-19.

Background: The US Veterans Health Administration (VA) is transforming its healthcare system to create a Whole Health System (WHS) of care. Akin to such reorganization efforts as creating patient-centered medical homes and primary care behavioral health integration, the WHS goes beyond by transforming the entire system to one that takes a proactive approach to support patient and employee health and wellness. The SARS-CoV-2 pandemic disrupted the VA's healthcare system and added stress for staff and patients, creating an exogenous shock for this transformation towards a WHS.

Assessing Patients' Perceptions of Clinician Communication: Acceptability of Brief Point-of-Care Surveys in Primary Care.

Background: Improving patient-centered (PC) communication is a priority in many healthcare organizations. Most PC communication metrics are distal to the care encounter and lack clear attribution, thereby reducing relevance for leaders and clinicians.

Objective: We assessed the acceptability of measuring PC communication at the point-of-care.

Incorporating patient input into the design of a disease management program for COPD.

In the era of value-based payment contracts, there is increasing emphasis on disease management as a strategy for improving care quality and reducing costs. To design effective disease management programs, healthcare systems should understand the day-to-day experience of living with particular health conditions, and ensure that evidence-based services and interventions are adapted to align with the realities of patients' lives and their priorities. For healthcare systems operating with limited resources, there is a need for practical and small-scale approaches for collecting and using patient input as part of program design and operations.

Facilitators and Barriers to Successful Engagement in a Complex Care Management Program: Patient and Care Manager Perspectives.

Complex care management (CCM) interventions have been developed across the United States to address the challenges of high-need, high-cost patients. Though their heterogeneity makes it challenging to determine their general effectiveness, there are calls in the literature to continue to implement and evaluate them. This article presents CCM patient and care manager perspectives on facilitators and barriers to success in such a program in a safety-net hospital.

Effectiveness of IMPACT:Ability to Improve Safety and Self-Advocacy Skills in Students With Disabilities-Follow-Up Study.

Background: Research shows that individuals with disabilities are more likely to experience abuse than their peers without disabilities. Yet, few evidenced-based abuse prevention interventions exist. This study examines whether positive outcomes identified previously in an evaluation of IMPACT:Ability were maintained 1 year later.

Effectiveness of the IMPACT:Ability program to improve safety and self-advocacy skills in high school students with disabilities.

Background: Individuals with disabilities experience higher rates of abuse than the nondisabled. Few evidence-based prevention interventions have been published despite a need for such work. This study evaluated

Impact: Ability, a safety and self-advocacy training for individuals with cognitive and/or physical disabilities.

Leveraging text messaging and mobile technology to support pediatric obesity-related behavior change: a qualitative study using parent focus groups and interviews.

Background: Text messaging (short message service, SMS) is a widely accessible and potentially cost-effective medium for encouraging behavior change. Few studies have examined text messaging interventions to influence child health behaviors or explored parental perceptions of mobile technologies to support behavior change among children.

Objective: Our aim was to examine parental acceptability and preferences for text messaging to support pediatric obesity-related behavior change.

Provider perspectives on electronic decision supports for obesity prevention.

Despite the availability of national evidenced-based guidelines related to pediatric obesity screening and prevention, multiple studies have shown that primary care physicians find it difficult to adhere to them or are unfamiliar with them altogether. This article presents physicians' perspectives on the use of electronic decision support tools, an alert and Smart Set, to accelerate the adoption of obesity-related recommendations into their practice. The authors interviewed providers using a test encounter walk-through technique that revealed a number of barriers to using electronic decision supports for obesity care in primary care settings.

Phoenix Rising: use of a participatory approach to evaluate a federally funded HIV, hepatitis and substance abuse prevention program.

This paper highlights the value of utilizing a participatory evaluation approach when working with community agencies receiving federal funding for prevention and intervention services. Drawing from our experience as evaluators of a SAMHSA-funded substance abuse, HIV and Hepatitis prevention program targeting homeless young adults, we describe the importance of and strategies for creating a participatory evaluation partnership with program implementers. By participatory evaluation we mean the active involvement of program implementers in defining the evaluation, developing instruments, collecting data, discussing findings, and disseminating results.