Serving Those Who Served: Veterans' Donations of Research Incentives to Fellow Veterans

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

In the November - December 2025 Issue:

• Introduction: Many Veterans, after serving their country, volunteer to participate in VA research studies. Some of these studies offer financial incentives to boost participation rates, but the incentives are typically modest and have little impact.
• The Survey and Results: A team of HSR researchers evaluated study participants' preferences for either receiving a monetary incentive or donating an equal amount to a Veteran-focused service organization. More than half of the 3,430 Veteran respondents to a national survey elected to donate their monetary incentive to Disabled American Veterans.
• Discussion: These findings suggest that for many Veterans, participation in the study may have been motivated by the desire to contribute to research supporting fellow Veterans.

Introduction

Veterans are the heart of VA’s century-long history of research into science, medicine, and healthcare delivery, and have been instrumental to advancements including the development of an implantable cardiac pacemaker, treatments for post-traumatic stress disorder, the development of the CT scan, and the world’s largest genomic biorepository.

VA researchers sometimes offer modest monetary incentives, approved as part of the overall review and approval of a study, to Veteran participants. In Spring 2025, a team of researchers from three HSR Centers of Innovation had the opportunity to examine whether VA research participants preferred a traditional monetary incentive or would opt to donate their incentive to a Veteran-focused service organization

The Survey and Results

An evaluation of Veterans’ incentive preferences wasn’t on the minds of researchers when they began devising a national survey on social risks. They had devised two primary goals: to identify social challenges prevalent in the Veteran population, and to examine the association between these social risks and health and patient experience outcomes.

Veteran engagement is a foundational principle of VA Health Systems Research and the Quality Enhancement Research Initiative (QUERI), and since 2015 the national Veteran Engagement Workgroup has fostered meaningful collaborations between Veterans and VA researchers. The social risks survey was meticulously prepared in collaboration with an advisory group that included VA and non-VA researchers, Veterans, and VA operational leaders. After an initial draft, it was presented to Veteran Engagement Groups (VEGs) at four organizations, including each of the HSR Centers of Innovation with which the co-authors were affiliated: the Center for Innovation to Implementation (Ci2i) in Palo Alto, CA; the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) in Durham, NC; and the Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care. The fourth VEG was from the national Women’s Improvement Network, a virtual group of women Veterans who use VA care.

The survey was modified based on Veteran group discussions, and then pilot tested by five volunteers from these groups, who offered individual feedback. As the survey was being developed, the team decided to offer a $10 monetary incentive to encourage Veteran participation. VEG members made a further suggestion that had rarely been implemented in prior VA survey studies: the team should also offer participants the option of donating their incentive to an organization that supports Veterans.

The final survey was distributed nationally from March through June 2024. Respondents were offered $10, which they could receive as cash or an Amazon gift card, or as a $10 donation to Disabled American Veterans (DAV), a non-profit that offers support and aid to more than a million Veterans. The offer was accompanied by a two-part questionnaire to measure social and financial circumstances – including financial strain – and demographic data. The average age of respondents was 61.

More than half of the 3,430 study participants opted to donate their research incentive, resulting in a $17,200 donation to DAV. Even among respondents who reported experiencing financial strain, the desire to help other Veterans was strong: more than a third chose to donate their research incentive.

Discussion

On the centennial anniversary of VA’s research program, it’s important to note the extent to which VA’s scientific discoveries rely on collaboration with Veterans across all stages of the process, where their experiences, values, and expertise guide decision making. Veterans not only help guide the design of HSR studies, some often co-author the resulting papers.

Millions of Veterans support VA research by volunteering to participate in studies—and as this evaluation suggests, their participation is often motivated by a desire to contribute to research supporting fellow Veterans. As one member of the ADAPT Center’s Veteran Research Engagement Panel (VetREP) put it:

It is an honor for those who serve on VetREP to support the health and success of Veterans, whether or not money is offered. We who served, or serve those who served, are willing to continue to offer our time, to take or help design surveys and participate in other research, in the belief that the results will help someone like us, sometime and somewhere.

Another Veteran advisor considered the study “another example of how Veterans want to help Veterans! Even if they are total strangers, they're still battle buddies. That was a huge donation, all out of one little suggestion.”

The generosity of these Veterans reflects a legacy of sacrifice and service rooted in military experience: Long after separating from active duty, many Veterans remain committed to serving those who served.

Publication

Zulman DM, Rao M, Slightam C, Greene L, and Maciejewski ML. Veterans' Donations of Research Incentives to Fellow Veterans. JAMA Network Open. July 14, 2025;8(7):e2520307.

Donna Zulman, MD, is associate director of HSR’s Center for Innovation to Implementation (Ci2i) at VA Palo Alto and a principal investigator with VA’s Virtual Care Consortium of Research.

Matt Maciejewski, PhD, is a senior research career scientist with HSR’s Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) at the Durham VA Medical Center.

Mayuree Rao, MD, MS is an investigator with HSR’s Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care and a primary care physician with the VA Puget Sound Health Care System.

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The views expressed in this publication are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.