Center for Care Delivery and Outcomes Research

Featured Research Projects

TRAUMA RECOVERY

HOMEFRONT
Laura Meis, PhD and her team surveyed 272 veterans with PTSD as they began trauma-focused therapy at 4 different VAs. Researchers found that veterans were twice as likely to stay in PTSD treatment when a loved one encouraged them to face their distress. More Information

ARMOR
Melissa Polusny, PhD and Chris Erbes, PhD were funded through NIH’s National Institute of Complementary and Integrative Health (NCCIH) UG3/UH3 Phase Innovation Awards Cooperative Agreement mechanism to conduct a prospective, longitudinal cohort study of new military enlistees. More Information

Primary Care for Women with Past Trauma
Elisheva Danan, MD, MPH, has been working with the Minnesota Learning Health Systems Mentored Career Development Program to develop and implement trauma-sensitive, patient-centered primary and preventive healthcare practices for women Veterans who have experienced sexual assault. More Information

COACH
Laura Meis, PhD, is pilot testing a new method of treating PTSD in veterans by partnering with veterans’ significant others. Couples participate in treatment together. The treatment integrates one of the most effective treatments for PTSD (Prolonged Exposure therapy) with one of the most effective treatments for relationship distress (Integrative Behavioral Couples Therapy). More Information

Social Determinant Influences
Michele Spoont, PhD, and her colleagues in CCDOR and at Purdue University have been working on a mixed-methods study exploring how social determinants of health among Veterans with PTSD influence their mental health treatment beliefs, treatment preferences, and views of PTSD. More Information

PAIN/OPIOIDS

LAMP
Diana Burgess, PhD is heading a 6-year, $5.2 million study, funded by the Department of Defense (DoD), on the effectiveness of mindfulness to treat chronic pain and co-morbid conditions such as PTSD, insomnia, depression, and substance abuse. More Information

VOICE
Erin Krebs, PhD, MPH was awarded $12.5 million from the Patient-Centered Outcomes Research Institute (PCORI) to conduct a comparative effectiveness study to improve pain management and opioid safety in Veterans with chronic pain. More Information

ACTION
Diana Burgess, PhD and colleagues are testing the effectiveness of a multi-component intervention involving proactive outreach, a pedometer-based walking program, action planning, motivational interviewing and the use of cognitive behavioral techniques among black and non-black Veterans with chronic musculoskeletal pain. More Information

EPOCH
Erin Krebs, MD, is evaluating the effects of changes in opioid prescribing practice on Veterans treated with opioid therapy for chronic pain. More Information

ADAPT
Hildi Hagedorn, PhD and team are working with 8 VA sites to increase use of medications for treating opioid use disorders (M-OUD). M-OUD effectively manages cravings and prevents overdose, yet, <40% of Veterans with OUD receive it. At 6 months, we’ve learned it takes more than training to make this happen. More Information

Pain ESP
Lizzy Goldsmith, MD, and team found Evidence-based psychotherapies (EBPs) are effective for chronic pain, yet underused. To identify key gaps for future research to improve uptake of EBPs for chronic pain, we completed an evidence review on barriers, facilitators, and evaluations of implementation strategies. More Informatio

PREVENTION & CHRONIC DISEASE

VAntage Support
Dr. Fu is funded through VA HSR&D for a 4-year project looking at Veteran Social Support and Smoking Cessation. The primary outcome is use of any evidence-based cessation treatments (EBCT), this outcome is recommended for advancing the science of tobacco treatment among smokers in the motivation or pre-cessation phases. More Information

Diuretic Comparison Project (DCP)
Dr. Areef Ishani’s Diuretic Comparison Project (DCP) compared the effectiveness of two common high blood pressure medications in a study with over 13,500 Veteran participants. No differences were found in major cardiovascular outcomes (e.g., stroke, heart attack, heart failure) or non-cancer deaths. This was one the VA’s first point-of-care intervention trials. Because the trial was integrated into primary care clinics, patients could continue with their normal care and usual care team.

Evaluating COPD care for rural Veterans
Dr. Arianne Baldomero has conducted groundbreaking research on COPD care for Veterans in rural clinics, which found that longer drive time was associated with less frequent receipt of guideline-recommended health care services across multiple components of care. This work also identified barriers to COPD care in rural communities and disparities in outcomes for COPD patients in rural areas (e.g., more hospitalizations and deaths).

Implementing Pap Hub and Spoke Program to Improve Cervical Cancer Screening Management
Dr. Elisheva Danan is a leader of a research-clinical partnership that is reshaping VA’s approach to cervical cancer screening. With VISN 23 strategic initiative funding, Dr. Danan and her team developed the Pap Hub and Spoke Program. The program has now been implemented at the Minneapolis VAMC and 4 other VISN 23 sites. Since July 2022, the Pap Hub has reduced the number of patients overdue for cervical cancer screening at the Minneapolis VAMC by 30% and has improved evidence-based management of abnormal screening results (from an error rate of 7.6% to <2%), while maintaining high patient and clinician satisfaction. Additionally, VHA Directive 1330.01 requires patient notification of abnormal cervical cancer screening results within 7 days: a metric that nearly half of inspected VA facilities failed in VA Office of Inspector General inspection in 2019-20. Under the Pap Hub, result notifications average less than 24 hours. The Pap Hub was selected as a finalist out of 355 applicants in the 2023 VHA Shark Tank Competition and awarded “Pitch of the Day.”

OTHER RESEARCH AREAS

Long COVID Practice Based Research Network
A multi-site effort including the Minneapolis VA Health Care System (Minneapolis, MN), the James J. Peters VA Medical Center (Bronx, NY), and the Puget Sound VA Health Care System (Seattle, WA), the Long COVID Practice Based Research Network (PBRN) is an effort to build an infrastructure that will facilitate and support rigorous practice-based and data-driven research to address gaps in access, treatment, and cost-effective delivery of Long COVID care. More Information

 

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Project Websites

	Advancing Research on Mechanisms of Resilience (ARMOR) http://armor.umn.edu/
	Learning to Apply Mindfulness to Pain (LAMP) http://lamp.umn.edu/
	Veteran Support for Smoking Cessation Pilot Project (VAntage) https://www.ccdor.research.va.gov/vantage/
	Suicide Prevention for Recent Veterans (SeRV) https://www.ccdor.research.va.gov/CCDORRESEARCH/SeRV/SeRVStudy.asp