HSR&D Research Briefs disseminates news and information to the HSR&D investigator community. In this issue:
The Investigator Spotlight offers HSR&D investigators an opportunity to share insights about their past and present work, and provide colleagues with a sense of the work's potential impact within VA. This spotlight profiles Alison Hamilton, Ph.D., Research Health Scientist and Director, Qualitative Methods Group with the Center for the Study of Healthcare Innovation, Implementation, & Policy at the VA Greater Los Angeles Healthcare System.
Please describe a bit about your work and research interests.
My work focuses on women's health and mental health. As a medical anthropologist, I'm particularly interested in the ways that people's life experiences affect their health and healthcare decision-making. As a health services researcher, I'm interested in how to design or improve the context and delivery of healthcare with the consumer at the center. Most of my work involves mixed methods, and I am strongly oriented toward qualitative methodology. In the past decade or so, I have taken on a lot of work in implementation science, which is actually a great home for a social scientist.
What are you currently working on?
The main projects I'm working on right now are in women's health and mental health. In women's health, I am a Principal Investigator in the Women's Health CREATE, led by Dr. Becky Yano and partnered with Dr. Patricia Hayes in VA Women's Health Services. Dr. Susan Frayne and I are leading a study of women Veterans' attrition from VA healthcare. This study will assess whether and how patient experiences of VA care contribute to attrition, recognize patient subgroups at risk for attrition, and identify promising, patient-centered remedies to set the stage for refinements to national implementation of comprehensive women's healthcare delivery policy. I am also leading, with Drs. Yano and Frayne, the HSR&D Women's Health Research Network (WHRN), with a particular focus on barriers to and facilitators of effective engagement of VA stakeholders (i.e., patients, providers, leaders, and researchers) in VA women's health research. Our overall goal is to support HSR&D's advancement of the scientific evidence base needed to improve women Veterans' care and address VA gender differences through a sustainable women's health research infrastructure. While those are my two main studies, I also lead the qualitative cores of the Women's Health CREATE and the WHRN, and I conduct implementation evaluations for two of the Women's Health CREATE studies, as well as a study of patient-aligned care teams (PACT) for Veterans with serious mental illness (SMI-PACT), led by Dr. Alex Young.
What drew you to health services research?
I have always been interested in health and healthcare, and even toyed with the idea of becoming a physician for a few years. However, once I found a direction academically that allowed me to continue thinking about health while being an anthropologist, I decided against medical school. I was clear on my trajectory as a researcher, but my path as a health services researcher emerged over time, as opportunities to do this type of research became available. From the moment I started doing health services research, I knew it was the right fit for me, as I prefer to be an applied anthropologist. For me, the opportunity to use my research toward the improvement of health and health services is incredibly gratifying.
Of your current work, what do you think might have the most impact on Veterans and VA healthcare?
I hope our study of attrition will have an impact on women Veterans and their VA healthcare, and more broadly, I hope the Women's Health CREATE demonstrates the value of partnered research in fostering quality improvement in healthcare delivery. Our study of attrition could be informative beyond women's health, and this is why I think it's so exciting. In health services, we know relatively little about why and how people make decisions to get care from different places. In the context of the Affordable Care Act, it's very important to understand what drives people to seek care, and what they prefer when they access care. Ideally, if we understand and address these factors, health will be improved and we can move more toward a wellness (versus illness) paradigm.
Have you learned something from a study, project, or research investment that provided an unexpected result, and that you feel is valuable to share with your HSR&D colleagues?
I have learned that partnership and collaboration is at the heart of health services research, an inherently interdisciplinary endeavor. There's a commitment among health services researchers to learn from one another and draw on strengths and insights from many disciplines. There's also a commitment to intellectual evolution, but it doesn't stop at the intellectual -- it actually extends to the practical. What keeps me grounded in the practical is consistent interaction with Veterans, whose personal histories, achievements, needs, and preferences can and should motivate all that we do in VA health services research.
- New HSR&D Awards. HSR&D is pleased to announce the creation of three new awards:
- Angela Fagerlin, Ph.D., part of HSR&D's Center for Clinical Management (CCMR) ranked as one of the most-cited researchers. Learn more...
- HSR&D to benefit from settlement. HSR&D to receive extra $4,000,000 over the next two years. Learn more...
- New HSR&D Investigator Videos. Several new videos in the ongoing "Investigator Insights" series have been posted to the HSR&D website, along with a special video in honor of Veterans Day. Topics for the new videos include quality improvement, traumatic brain injury, and women's health.
- Women's Health Issues. In honor of Veterans Day, the journal Women's Health Issues has released a special collection focusing on women Veterans. Access is free for the month of November. Learn more...
- Report on Integrating Mental Health Into PACT in VA. The report provides recommendations on the facility-level, VISN-level, and VACO-level for integrating mental health into PACT.
- AJPH Supplement on Health Disparities Research. This special supplement (open access) to the August 2014 issue of the American Journal of Public Health highlights health disparities research in VA.
- JGIM Special Supplement on Patient-Aligned Care Teams. This special supplement (open access) to the July 2014 issue of the Journal of General Internal Medicine includes 19 articles that share lessons learned by researchers and their clinical and policy partners during the early stages of PACT implementation.
- HSR&D FORUM. The past two issues of HSR&D FORUM are available online. The August issue focuses on care coordination and patient-aligned care teams. The October issue looks at big data and healthcare data analytics.
- New ESP Reports Published. HSR&D's Evidence-Based Synthesis Program (ESP) was established to provide timely and accurate syntheses of targeted healthcare topics of particular importance to VA managers and policymakers, and to disseminate these reports throughout VA. The following reports are publicly accessible on the VA HSR&D website:
The following reports are available on the VA's ESP **intranet site only**
- e-Interventions for Alcohol Misuse
- Evidence Brief: The Quality of Care Provided by Advanced Practice Nurses
- Visual Dysfunction in Patients with Traumatic Brain Injury: A Systematic Review
- Factors that Optimize Therapy with Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Depressions
- The Effects of Shared Decision Making on Cancer Screening
- Memo: An Evidence-Based Wait Time Threshold
- Fecal Microbiota Transplantation for Clostridium Difficile Infection
- Evidence Brief: The Effectiveness of Mandatory Computer-Based Trainings on Government Ethics, Workplace Harassment, or Privacy and Information Security-Related Topics
- Emerging Evidence. Emerging Evidence is a quarterly publication featuring topic-specific overviews culled from HSR&D Final Reports. The summer issue focuses on improving access to comprehensive care for Veterans, and the fall issue looks at improving healthcare for Veterans with diabetes.
Notices & Calls for Submission
- Updated: QUERI RFAs. The QUERI RFAs have been updated, and can be accessed only through the VA intranet.
- Calls for Papers:
- Call for concept papers for a new QUERI Partnered Evaluation Center, in partnership with the Veterans Engineering Resource Center (VERC) to evaluate specific areas of VA's Lean Enterprise Transformation. Submission deadline is November 21, 2014.
- In partnership with the National Center for Ethics in Health Care, HSR&D is accepting concept papers to perform research related to informed consent for long-term opioid therapy for pain. The submission deadline is November 24, 2014.
- Call for concept papers for a new QUERI Partnered Evaluation Center, in partnership with VA's Office of Health Equity, to evaluate the extent to which there are observed gaps in quality and outcomes of care across major health conditions facing Veterans. Submission deadline is December 1, 2014.
- The online journal, Innovative Technology in Rehabilitation, has issued a call for manuscripts. The submission deadline is January 2, 2015. Learn more...
- VA Women's Health Research Network. Investigators planning to submit a proposal to VA HSR&D in December 2014 and who need help in meeting requirements to include women in their study are encouraged to contact the VA Women's Health Research Network. Learn more...
- AHRQ Career Development Awards. The Agency for Healthcare Research and Quality (AHRQ) announces its continued interest in supporting individual Patient Centered Outcomes Research career development awards. Currently, two Funding Opportunity Announcements are accepting applications. Learn more...
To submit an award notice for possible publication on the HSR&D website, be sure that the award is recognized at a national and/or international level. Internal awards, such as departmental awards, are not accepted. The award can be for a Center-wide achievement or for an individual investigator.
Please let us know as soon as you have an article accepted for publication. This applies to all publications based on an HSR&D-funded or managed project, and for publications authored/co-authored by an HSR&D-supported investigator, regardless of funding source.
To submit your notification, please use the VA Intranet-based PubTracker system. Instructions for accessing PubTracker are available on the Publication Notification Requirement page of the For Researchers section on the HSR&D website.
Looking for published research? The search tools for articles, presentations, citations, and HSR&D internal publications include the following:
- Research by Topic is a new feature on the HSR&D website. Searches can be conducted on any of 21 priority topic areas, and results collect all current HSR&D projects, citations, reports, cyberseminars, videos, or other products and resources that are on the HSR&D website.
- For citations from journals, meetings, conferences, and reports that were credited to HSR&D researchers, use the HSR&D citations search feature.
- For HSR&D-produced publications and evidence synthesis reports, use the HSR&D publications search feature.
- For citations, studies, and publications about women Veterans health and healthcare, use the Women's Health Literature Search database.
Find links to studies for which funding began within the last three months.
If you have feedback about Research Briefs, or suggestions for topics of interest about which you'd like to read, please send an email to: HSRDWeb.Boston@va.gov.