Growing Rural Outreach through Veteran Engagement (GROVE)

HSR&D’s monthly publication Veterans’ Perspectives highlights research conducted by HSR&D and/or QUERI investigators, showcasing the importance of research for Veterans – and the importance of Veterans for research.

In the December 2021 Issue:

• Introduction: The GROVE Center is a resource for HSR&D investigators interested in incorporating Veteran engagement into their research.
• Consultation: Several HSR&D investigators and centers have benefitted from GROVE consultation in its first year.
• Jam Sessions: Informal "community of practice" forums where interested professionals can learn from others' experience.
• SERVE Toolkit: GROVE members assisted with the effort to build the web-based SERVE Toolkit and keep it up to date.
• Next Steps: A virtual platform for Veterans to connect with researchers, and a major revision to the SERVE website.

Introduction

The Center for Growing Rural Outreach through Veteran Engagement (GROVE) is a novel resource for HSR&D researchers who want to use engagement methodology in their projects. GROVE develops capacity and resources for VA researchers and staff to be more inclusive of rural Veteran populations and to serve as a resource center to support projects interested in including Veteran engagement in their methods.

Nearly a quarter of US Veterans live in rural areas, with approximately 60% of those rural Veterans enrolled in VA care. However, much of the HSR&D research portfolio has not benefited from formal rural Veteran input due to researchers typically being located in urban regions that have co-located VAMCs and academic institutions. GROVE was created as a VA resource center to address this challenge and continue to grow Veteran engagement best practices.

GROVE staff members have worked to promote Veteran engagement in HSR&D research for over a decade via the HSR&D Veteran Engagement Workgroup, at the Center of Innovation (COIN) level, and by incorporating Veteran engagement methods in their own HSR&D-funded research. They have learned that Rural Veterans’ expertise and lived experience can inform VA research projects at all stages - from recruitment and identification of eligible Veterans to the dissemination of learning and interventions. Much of GROVE’s work is consultation, outreach, and partnership building between rural communities, rural Veterans, and VA researchers.

The GROVE Team: (top row) Mark Flower, Jeff Whittle, Paige Backland-Jarquin, Kenda Steffensmeier (second row) Leah Wendleton, Katie LaChappelle, Gala True (third row)Ray Facundo, Kelty Fehling (bottom row) Kady Nearing, Sarah Ono, Amber Lane

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Consultation

In its first year, the GROVE team provided expert consultations for two HSR&D Career Development Award (CDA) submissions, the HSR&D Access Consortia of Research (CORE), and an HSR&D Innovation Award.

• One investigator approached the GROVE team hoping to increase participation through innovative recruitment strategies. These conversations led to changes in project proposals, including:
  • Consideration of hiring a Veteran with expertise in the subject matter to assist with recruitment of other Veterans
  • Utilizing Veteran feedback when interpreting qualitative findings
  • Incorporating alternative recruitment methods discussed during the consultation

• Another investigator came to GROVE for advice regarding best practices and evidence-based methods for photo-elicitation and data collection, as well as how to best communicate the details of a project proposal to the IRB.
  • She later expressed appreciation for “everyone taking the time to talk about their lessons learned, and their willingness to share in order to make the IRB process smoother.”
  • On the subject of engagement, she stated, “thinking through how and when participants will be engaged and involved in shared-decision making was particularly helpful.”

• The VA Access Research Consortium (VARC) met with three COIN-affiliated Veteran Engagement Groups (VEG) in the Fall of 2020 to gather feedback related to high priority access research questions identified by an expert panel of VA operational leaders and access researchers. Prior to continuing to meet with COIN VEGs, they asked GROVE to help brainstorm what kinds of questions they should be asking. Suggestions included:
  • Engaging more Veterans in discussions to inform VARC strategies
  • Including Veterans from more under-represented groups with greater access needs to increase sample sizes and address equity issues
  • Engage operational partners, outreach coordinators, and lesser known Veterans’ groups to help strategize research questions more deeply at a systemic level
  • Create more opportunities for Veterans to inform dissemination efforts

• An HSR&D innovation grant called the Veteran Informed Safety Intervention and Outreach Network (VISION) project hired 5 Veteran Peer Champions (VPCs) to connect the research team to various communities in an effort to build a coalition that promotes prevention of suicide by firearm and safe firearm storage practices. At the end of the VPCs’ year-long commitments, they asked GROVE to help brainstorm how they could measure the impact of their experience. GROVE helped the project leads:
  • Develop a set of questions for exit interviews for Veterans as they transitioned out of (or started a new year in) their positions as Veteran Peer Champions
  • Conduct interviews with the VPCs and provide the interview data to the VISION project

“The topic of approaching Veterans as professionals but keeping communication informal was something I had not thought about before! It's an excellent way to describe the balance needed.” – VA Investigator

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Jam Sessions

Jam Sessions are informal “community of practice” forums where clinicians, investigators, and research staff working in Veteran engagement can seek and provide solutions to problems they encounter. The name was adopted from the practice of like-minded musicians getting together to share ideas and collaborate. Jam sessions grew organically out of HSR&D’s prioritization of Veteran engagement, but GROVE team members formalized a process to collect and understand the needs of the VA community doing Veteran engagement. During meetings, less experienced professionals are encouraged to share barriers they have hit and participate in discussions with researchers who have more experience in Veteran engagement. This process allows for the GROVE Center to hear what tools and support the community needs to improve their work.

Jam sessions are currently held monthly during the summer, virtually over Microsoft Teams. GROVE staff plan a series of topics in advance and send out flyers to past participants. A core group of facilitators including investigators, research staff, and Veteran advisors attend every meeting to help lead conversations. Participants are encouraged to ask questions, contribute to discussions with peers, and network with others in the Veteran engagement community.

“Hearing the experiences of others has been really helpful… (T)o have some ideas when things pop up of what others have done is like having a tool ready just in case. ” – Jam Session participant

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SERVE Toolkit

The Strengthening Excellence in Research through Veteran Engagement (SERVE) Toolkit supports VA research centers and investigators in efforts to include Veterans and other stakeholders in the development, implementation, and dissemination of research studies. Several members of the GROVE team assisted with the collaborative effort between VA hospitals where research using Veteran engagement was a priority, culminating in the web-based SERVE Toolkit. GROVE now works to update this website, adding tools and processes developed in their projects and addressing gaps identified during consults and Jam sessions.

“I think that engagement with Veterans during the planning stage really informs a nuanced approach...(and) there will likely be more uptake on services that we're designing...” – HSR&D funded investigator

“Being involved with GROVE allows me to help create better research, hopefully leading to better results for my fellow Veterans” – Veteran, Research Advisor

Next Steps

Virtual Platform: Part of GROVE’s mission is to connect researchers and Veterans by developing virtual processes to facilitate Veteran engagement in rural settings. GROVE’s future website will provide a setting  for interested Veterans to learn about Veteran engagement, connect with researchers who have promoted their projects on the virtual platform, and network with other Veterans.

SERVE Toolkit: GROVE is currently working on an update to the SERVE Toolkit website, with rural engagement strategies and templates, virtual best practices, technology distribution, facilitation resources, visual elicitation resources, additional compensation options, and VSO engagement best practices.

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