Selected Publications
In Fiscal Year 2025 our investigators published 148 manuscripts in peer reviewed journals. Here is a select sample of those publications. Our investigators are designated in bold.
Ackland PE, Cutting A, Spoont MR, Nugent S, Clothier BA, Hudson EM, Salameh H, Lefchak HM, Degerstrom R, Taylor BC. Was training enough? Examining the implementation of evidence-based psychotherapies for depression in Veterans Health Administration. Psychological Services. 2025 Aug 1; 22(3):432-439, DOI: 10.1037/ser0000910.
Impact or significance: Depression is one of the top risk factors for suicide among Veterans. Fortunately, there are effective treatments for depression available in the VA; however, preliminary data suggested that utilization may be low. As part of Dr. Ackland’s VA study, “From Training to Practice: Understanding the Integration of Evidence-based Psychotherapies for Depression,” Dr. Ackland and her team produced the first publication documenting the utilization of evidence-based psychotherapies for depression in VA clinics. They found that utilization of these therapies was significantly lower than that of depression medications, and that their utilization was less likely for male and older Veterans and for Veterans with mental health comorbidities. This foundational inquiry can serve as a springboard for further study and improvement of depression evidence-based psychotherapy implementation for Veterans.
Baldomero AK, Melzer AC, Kunisaki KM, Wendt CH, Vardeny O, Hagedorn HJ, Fu SS, Dudley RA. Geographic Disparities by Rural-Urban Status and Drive Time to Care in Tobacco Treatment for COPD. JAMA Network Open. 2025 Aug 1; 8(8):e2528898, DOI: 10.1001/jamanetworkopen.2025.28898.
Impact or significance: This work demonstrates that evidence-based tobacco dependence treatment for veterans with COPD is significantly underused, especially the combination of counseling and pharmacotherapy that is known to be most effective for quitting. It shows that rural residence and longer travel times to pulmonary specialty care are associated with even lower treatment rates, suggesting actionable geographic disparities that health systems can target through policy, telehealth, and care delivery redesign.
Burgess DJ, Calvert C, Bangerter A, Branson M, Cross LJS, Evans R, Ferguson JE, Friedman JK, Hagel Campbell EM, Haley AC, Hennessy S, Kraft C, Mahaffey M, Matthias MS, Meis LA, Serpa JG, Taylor SL, Taylor BC. Do mindfulness interventions cause harm? Findings from the Learning to Apply Mindfulness to Pain (LAMP) Pragmatic Clinical Trial. Pain medicine (Malden, Mass.). 2024 Nov 1; 25(Supplement_1):S68-S76, DOI: 10.1093/pm/pnae056.
Impact or significance: This paper demonstrated that, in a pragmatic trial of patients with chronic pain, the majority of whom had comorbid mental health conditions, participants in the LAMP mindfulness-based interventions designed for a veteran population with high levels of psychiatric comorbidities (e.g., trauma informed, with shorter, guided meditations) were significantly less likely to experience psychological and physical deterioration than were participants in usual care. These findings add to the nascent literature showing MBIs to be relatively safe, including for patients with mental health diagnoses. These results also were persuasive in helping our team get buy-in from VA leadership to implement the LAMP self-paced mindfulness program as part of usual clinical practice.
Diem SJ, Miles-McLean HA, Carney DV, Shekelle JE, Nicosia F, Frayne SM, Yano EM, Gibson CJ. Menopause-Related Service Needs in Veterans Health Administration Medical Centers: Findings From the Women's Health Practice-Based Research Network Menopause Practice Scan. Women's health issues : official publication of the Jacobs Institute of Women's Health. 2025 Jun 2; 35(4):283-291, DOI: 10.1016/j.whi.2025.04.004.
Impact or significance: This paper described the results of a survey of 60 Women’s Clinics in VA facilities that sought to understand current menopause-related services and needs in VA. The results of the survey provided the VA Office of Women’s Health critical data for informing future efforts to improve VA clinical services, and the findings can be used to generate a roadmap for clinical initiatives, research, implementation, and ongoing evaluation to enhance menopause care for women veterans. This work also led to the formation of a national VA Menopause Research Group, of which Dr. Diem is co-chair. It has brought together over 50 VA researchers with the goal of increasing menopause-related research in VA.
Drekonja DM, Shaukat A, Huang Y, Zhang JH, Reinink AR, Nugent S, Dominitz JA, Davis-Karim A, Gerding DN, Kyriakides TC. A Randomized Controlled Trial of Efficacy and Safety of Fecal Microbiota Transplant for Preventing Recurrent Clostridioides difficile Infection. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2025 Feb 5; 80(1):52-60, DOI: 10.1093/cid/ciae467.
Impact or significance: Our team designed and conducted a centralized clinical trial that facilitated participant recruitment from across the US, including rural and highly rural areas. Our study found that Veterans with clinically diagnosed recurrent Clostridioides difficile infection (CDI) did not benefit from an orally-administered fecal microbiota transplant (FMT) product, raising questions about an increasingly popular treatment with mixed evidence from randomized clinical trials. Use of non-FDA approved FMT therapies should be reconsidered now that FDA-approved products with a stronger evidence base have become available.
Krebs EE, Becker WC, Nelson DB, DeRonne BM, Jensen AC, Kats AM, Morasco BJ, Frank JW, Makris UE, Allen KD, Naylor JC, Mixon AS, Bohnert A, Reznik TE, Painter JT, Hudson TJ, Hagedorn HJ, Manuel JK, Borsari B, Purcell N, Hammett P, Amundson EC, Kerns RD, Barbosa MR, Garvey C, Jones EJ, Noh MY, Okere JB, Bhushan S, Pinsonnault J, Williams BE, Herbst E, Lagisetty P, Librodo S, Mapara PS, Son E, Tat C, Marraffa RA, Seys RL, Baxley C, Seal KH, VOICE Study Group. Care Models to Improve Pain and Reduce Opioids Among Patients Prescribed Long-Term Opioid Therapy: The VOICE Randomized Clinical Trial. JAMA internal medicine. 2025 Feb 1; 185(2):208-220, DOI: 10.1001/jamainternmed.2024.6683.
Impact or significance: The “Veterans Pain Care Organizational Improvement Comparative Effectiveness (VOICE)” trial was a multisite pragmatic randomized clinical trial, conducted from 2016 to 2023. The study compared the effectiveness of two care models for managing pain and reducing opioid use: 1) integrated pain team vs. 2) telecare collaborative management led by a pharmacist. In a subset of patients treated with high-dose opioids, the study also evaluated effectiveness of adding a buprenorphine treatment option (vs. no option). They found that both models were equally effective at improving pain and reducing opioid use. Outcomes also did not differ based on receipt of the buprenorphine option.
Hagedorn HJ, Purcell N, DeRonne BM, Salameh H, Becker WC, Seal KH, Krebs EE. Incorporating Patient and Provider Voices into the Veterans Pain Care Organizational Improvement Comparative Effectiveness Study: Informing Future Implementation. Journal of general internal medicine. 2025 Jun 6 DOI: 10.1007/s11606-025-09639-8.
Impact or significance: This process evaluation was conducted parallel to the Veterans Pain Care Organizational Improvement Comparative Effectiveness (VOICE trial) which tested two strategies to manage pain and reduce opioid use in primary care settings: interdisciplinary pain team (IPT) and pharmacist collaborative management (PCM). The qualitative evaluation included ethnographic observations of study-related meetings, clinical staff interviews, and Veteran interviews and aimed to identify key recommendations to support clinical implementation of the VOICE interventions. This work details meaningful implementation considerations for clinical leaders to guide their determinations about which of the VOICE interventions to implement and strategies to support successful implementation and sustainability.
Pestka DL, Campbell ME, Schmulewitz NA, Melzer AC. Barriers to Integrating Tobacco Dependence Treatment into Lung Cancer Screening: A Qualitative Assessment. Journal of primary care & community health. 2025 Jan 1; 16:21501319251321608, DOI: 10.1177/21501319251321608.
Impact or significance: Most patients who are eligible for lung cancer screening smoke; however, these patients rarely receive tobacco dependence treatment. This project aimed to address this gap by understanding current practices and barriers for integrating tobacco dependence treatment and lung cancer screening within the VA. These results were directly shared with the Deputy Director of the Tobacco Use Treatment Program Office and the National Center for Lung cancer screening, and informed a current Partnered Evaluation Initiative funded by QUERI and the National Oncology Program.
Sistad Hall RE, Stevenson B, Bovin MJ, Kleiman S, Nelson D, Hagedorn HJ, Kehle-Forbes S. A network analysis of clinician-rated posttraumatic stress disorder and substance use disorder symptom clusters in a sample of veterans seeking outpatient treatment. Addictive Behaviors. 2025 Apr 1; 163:108249, DOI: 10.1016/j.addbeh.2025.108249.
Impact or significance: This article is important because it provides valuable insights into the interconnectedness of PTSD and substance use disorder (SUD) symptom clusters in Veterans with PTSD/SUD seeking outpatient treatment. By using network analysis, the study identifies key symptom interactions, which can inform more targeted and effective therapeutic interventions. Understanding these relationships is crucial in developing comprehensive care strategies for Veterans affected by these co-occurring conditions.
Trujeque J, Dudley RA, Mesfin N, Ingraham NE, Ortiz I, Bangerter A, Chakraborty A, Schutte D, Yeung J, Liu Y, Woodward-Abel A, Bromley E, Zhang R, Brenner LA, Simonetti JA. Comparison of six natural language processing approaches to assessing firearm access in Veterans Health Administration electronic health records. Journal of the American Medical Informatics Association : JAMIA. 2025 Jan 1; 32(1):113-118, DOI: 10.1093/jamia/ ocae169.
Impact or significance: The VA Office of Suicide Prevention tasked us with developing a model to identify veterans with access to firearms using electronic health records, addressing a critical factor associated with increased suicide risk. By analyzing clinical notes, we trained AI models to automate the identification of veterans with documented access to firearms, improving the sensitivity of firearm access identification from 57% to 89% and the positive predictive value from 69% to 90%. Understanding which patients have access to firearms is necessary for delivering patient-centered suicide prevention care.
