Institutional Incentives for Mentoring at the U.S. Department of Veterans Affairs and Universities: Associations With Mentors' Perceptions and Time Spent Mentoring.

Purpose: Limited empirical attention to date has focused on best practices in advanced research mentoring in the health services research domain. The authors investigated whether institutional incentives for mentoring (e.g.

Feasibility and challenges of inpatient psychotherapy for psychosis: lessons learned from a veterans health administration pilot randomized controlled trial.

Background: In large health care systems, decision regarding broad implementation of psychotherapies for inpatients with psychosis require substantial evidence regarding effectiveness and feasibility for implementation. It is important to recognize challenges in conducting research to inform such decisions, including difficulties in obtaining consent from and engaging inpatients with psychosis in research. We set out to conduct a feasibility and effectiveness Hybrid Type I pilot randomized controlled trial of acceptance and commitment therapy (ACT) and a semi-formative evaluation of barriers and facilitators to implementation.

The Changing Faces of Mentorship: Application of a Developmental Network Framework in a Health Services Research Career Development Program.

Historically, mentorship has been conceived of as a dyadic relationship between a senior mentor and an early-career investigator. Models involving multiple mentors have gained favor in recent years, but empirical research on multiple-mentor models has been lacking. The current work aims to fill this gap by describing a long-standing health services research mentoring program at the U.

Evaluating the Productivity of VA, NIH, and AHRQ Health Services Research Career Development Awardees.

Purpose: To evaluate the academic advancement and productivity of Department of Veterans Affairs Health Services Research and Development (HSR&D) Career Development Award (CDA) program recipients, National Institutes of Health (NIH) K awardees in health services research (HSR), and Agency for Healthcare Research and Quality (AHRQ) K awardees.

Method: In all, 219 HSR&D CDA recipients from fiscal year (FY) 1991 through FY2010; 154 NIH K01, K08, and K23 awardees FY1991-FY2010; and 69 AHRQ K01 and K08 awardees FY2000-FY2010 were included. Most data were obtained from curricula vitae.

Longitudinal changes in somatic symptoms and family disagreements among depression and community groups: a 23-year study.

Background: Few longitudinal studies describe the relationship between somatic symptoms and family disagreements. We examined changes over time in somatic symptoms, family disagreements, their interrelationships, and whether these patterns differed between individuals treated for depression (depression group) and individuals from the same community (community group).

Methods: We followed participants in the depression (N = 423) and community (N = 424) groups for 23 years (the community group was matched to the depression group on socioeconomic status, gender, and marital status).

Family conflict and somatic symptoms over 10 years: a growth mixture model analysis.

Objective: While family conflict and somatic symptoms are mutually associated, few longitudinal studies have examined multiple (heterogeneous) trajectory subgroups for family conflict and somatic symptoms and their covariation over time. The aim of this study was to identify heterogeneous trajectory subgroups for family conflict and somatic symptoms and their joint trajectories.

Methods: A representative sample of 424 community participants completed surveys at baseline and 1-, 4-, and 10-year follow-ups.

Ten-Year Publication Trajectories of Health Services Research Career Development Award Recipients: Collaboration, Awardee Characteristics, and Productivity Correlates.

This study's purpose was to identify distinct publishing trajectories among 442 participants in three prominent mentored health services research career development programs (Veterans Affairs, National Institutes of Health, and Agency for Healthcare Research & Quality) in the 10 years after award receipt and to examine awardee characteristics associated with different trajectories. Curricula vitae (CVs) of researchers receiving awards between 1991 and 2010 were coded for publications, grants, and awardee characteristics. We found that awardees published at constant or increasing rates despite flat or decreasing rates of first-author publications.

Life stressors and resources and the 23-year course of depression.

Background: Life stressors and personal and social resources are associated with depression in the short-term, but little is known about their associations with the long-term course of depression. The current paper presents results of a 23-year study of community adults who were receiving treatment for depression at baseline (N=382).

Methods: Semi-parametric group-based modeling was used to identify depression trajectories and determine baseline predictors of belonging to each trajectory group.

A modeled analysis of telehealth methods for treating pressure ulcers after spinal cord injury.

Home telehealth can improve clinical outcomes for conditions that are common among patients with spinal cord injury (SCI). However, little is known about the costs and potential savings associated with its use. We developed clinical scenarios that describe common situations in treatment or prevention of pressure ulcers.

Addressing substance abuse and violence in substance use disorder treatment and batterer intervention programs.

Background: Substance use disorders and perpetration of intimate partner violence (IPV) are interrelated, major public health problems.

Methods: We surveyed directors of a sample of substance use disorder treatment programs (SUDPs; N=241) and batterer intervention programs (BIPs; N=235) in California (70% response rate) to examine the extent to which SUDPs address IPV, and BIPs address substance abuse.

Results: Generally, SUDPs were not addressing co-occurring IPV perpetration in a formal and comprehensive way.

Dually diagnosed patients' benefits of mutual-help groups and the role of social anxiety.

There is debate about whether dually diagnosed patients benefit from mutual-help groups (MHGs), partly because social anxiety may make participation problematic. We examined dually diagnosed patients' participation in MHGs and outcomes at 6, 12, and 24 months post-treatment, and the extent to which social anxiety was associated with participation. We also examined whether MHG participation and social anxiety were related to outcomes, and whether social anxiety moderated associations between participation and outcomes.

Organizational factors associated with screening for military sexual trauma.

Purpose: This exploratory study investigated organizational factors associated with receipt of military sexual trauma (MST) screening during an early timeframe of the Veterans Health Administration's (VHA) implementation of the universal MST screening policy.

Methods: The sample consisted of all VHA patients eligible for MST screening in fiscal year 2005 at 119 VHA facilities. Analyses were conducted separately by gender and by user status (i.

Differential relationships between continuity of care practices, engagement in continuing care, and abstinence among subgroups of patients with substance use and psychiatric disorders.

Objective: We examined whether patient subgroups with differing substance use disorders (SUDs) and psychiatric severity levels varied on engagement in continuing care and abstinence outcomes, the association of continuity of care practices to engagement, and the association of engagement to abstinence.

Method: Staff in 28 Veterans Affairs SUD treatment programs used the Addiction Severity Index to assess 865 (98% male) patients' alcohol, other drug, and psychiatric problems at treatment entry. At discharge, staff supplied data on patients' treatment, motivation, and continuity of care practices.

Intensive referral to 12-step dual-focused mutual-help groups.

Background: This study implemented and evaluated procedures to help clinicians effectively refer dually diagnosed (substance use and psychiatric disorders) patients to dual-focused mutual-help groups (DFGs).

Methods: Using a cohort cyclical turnover design, individuals with dual diagnoses beginning a new outpatient mental health treatment episode (N=287) entered a standard- or an intensive-referral condition. Participants provided self-reports of 12-step mutual-help (DFG and substance-focused group [SFG]) attendance and involvement and substance use and psychiatric symptoms at baseline and six-month follow-up.

The influence of abuse victimization on attendance and involvement in mutual-help groups among dually diagnosed male veterans.

Although abuse victimization and dual diagnosis are associated with poor functioning across numerous domains, their impact on attendance and involvement in mutual-help groups (MHGs) is not well understood. This study examined the impact of physical or sexual abuse victimization on MHG attendance and involvement and the influence of abuse on the association between MHG involvement and outcomes of abstinence and psychiatric health. Participants were 217 dually diagnosed men assessed at intake into mental health treatment and 6 months later.

Behavioral medicine perspectives on the design of health information technology to improve decision-making, guideline adherence, and care coordination in chronic pain management.

Development of clinical decision support systems (CDSs) has tended to focus on facilitating medication management. An understanding of behavioral medicine perspectives on the usefulness of a CDS for patient care can expand CDSs to improve management of chronic disease. The purpose of this study is to explore feedback from behavioral medicine providers regarding the potential for CDSs to improve decision-making, care coordination, and guideline adherence in pain management.

Medical care needs of returning veterans with PTSD: their other burden.

Background: There has been considerable focus on the burden of mental illness (including post-traumatic stress disorder, PTSD) in returning Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans, but little attention to the burden of medical illness in those with PTSD.

Objectives: (1) Determine whether the burden of medical illness is higher in women and men OEF/OIF veterans with PTSD than in those with No Mental Health Conditions (MHC). (2) Identify conditions common in those with PTSD.

Military-related sexual trauma among Veterans Health Administration patients returning from Afghanistan and Iraq.

We examined military-related sexual trauma among deployed Operation Enduring Freedom and Operation Iraqi Freedom veterans. Of 125 729 veterans who received Veterans Health Administration primary care or mental health services, 15.1% of the women and 0.

Depression and vulnerability to incident physical illness across 10 years.

Background: While considerable research exists on the role of physical illness in initiating depressive reactions, the role of depression in the onset of physical illness is much less studied. Moreover, whereas almost all previous research on depression and incident physical illness has involved specific physical illnesses, the present study examines the link between depression and incident physical illness more generally.

Methods: The study followed 388 clinically depressed patients who were entering treatment for unipolar depressive disorders and 404 matched community controls across 10 years.

Validation of home telehealth for pressure ulcer assessment: a study in patients with spinal cord injury.

The reliability and validity of assessments and diagnoses made via home telehealth was measured in 42 patients with spinal cord injury. Two telehealth modalities were investigated: telephone-only contact and videoconferencing. The results were compared with a reference (gold-standard) method, the in-person assessment and diagnosis of skin integrity and pressure ulcers.

Parental depression as a moderator of secondary deficits of depression in adult offspring.

This study examined whether having a depressed parent intensifies the secondary deficits that often co-occur with offspring's depression symptoms. The sample was adult offspring of parents who had been diagnosed with depression 23 years earlier (N = 143) and demographically matched nondepressed parents (N = 197). Respondents completed mailed questionnaires.

Treatment staff's continuity of care practices, patients' engagement in continuing care, and abstinence following outpatient substance-use disorder treatment.

Objective: Although speculation suggests that continuity of care predicts abstinence following substance-use disorder (SUD) treatment, models examining staff's continuity of care practices and engagement in continuing care and whether they mediate or moderate the association between patient and treatment factors and abstinence are lacking. In this study, we aimed to model abstinence using combinations of independent pretreatment and treatment factors, discharge continuity of care practices, and posttreatment engagement and to identify mediators or moderators of relationships between these factors and abstinence.

Method: Staff in 18 Department of Veterans Affairs (VA) outpatient SUD programs used the Addiction Severity Index to assess 429 nonabstinent patients' alcohol and drug problems at treatment entry.

Characteristics of depressed and nondepressed adult offspring of depressed and matched nondepressed parents.

Background: Our aim was to compare adults who were depressed or nondepressed offspring of depressed or matched nondepressed parents on functioning.

Methods: Participants were adult children of depressed (n=143) or nondepressed (n=197) parents who participated in a larger study. They completed self-report measures of depression symptoms, medical conditions and pain, family and social functioning, life stressors and coping, and help used for mental health problems.