Veterans Affairs Military Toxic Exposure Research Conference: Veteran-centric Approach and Community of Practice.

The U.S. Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act expands benefits and services to U.S. Veterans exposed to military and deployment-related toxicants. Open-air burn pits were used on military bases in the Middle East and Southwest Asia for trash disposal, exposing U.S. troops to numerous and profound health consequences. Research is underway to understand the scope of the health and wellness impacts from burn pit exposures and to establish care standards and meaningfully address the needs of Veterans and military personnel. A virtual plenary conference and a subsequent hybrid in-person/virtual conference were conducted to foster a cross-professional Community of Practice (CoP) approach to address knowledge and implementation gaps in research and clinical care. For the plenary conference, leading experts in Veteran health care advocacy, preclinical, clinical and implementation scientists, clinicians, Veterans, and their families were engaged to present information on the current state of knowledge and solicit feedback from attendees. Often, clinical trials and health care delivery enterprises function as separate entities, with siloed goals, infrastructure, and incentives. Consequently, trials can have less relevance and be less responsive to the needs of Veterans and those responsible for their care. The conference highlighted the need to support Veteran health systems learning, requiring continuous cooperation and a loop of basic and clinical knowledge generation and uptake, and how best to provide care under real-world conditions, not just in determining what interventions work, under what contexts, and also how best to ensure they are provided to Veterans who need them. The in-person/virtual hybrid conference was held to further discuss what was learned from the plenary conference and propose next steps in collaborative efforts to address unmet needs. The purpose of this publication is to disseminate information presented and discussed in the two conferences. Findings are summarized related to centering the Veteran voice and creating a novel, CoP approach for research and health care. U.S. Veteran health care and policy are strengthened and informed by collaborative scientific knowledge, research, and innovation generated by bringing together stakeholders for effective implementation and sustained improvement of Veterans' health.