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SDR 24-060 – HSR Study

 
SDR 24-060
Home Excellence Research and Outcomes Center to Advance, Redefine and Evaluate Non-institutional Caregiving (HERO CARE)
Luci K. Leykum,
San Antonio
San Antonio, TX
Funding Period: October 2024 - September 2029
Portfolio Assignment: Long Term Care and Aging

Abstract

Background: The goal of the Elizabeth Dole Center of Excellence (EDCoE) is to expand VA capacity to deliver integrated, Veteran- and caregiver-partnered, data-driven approaches to non-institutional care. The care of Veterans across a range of disabilities and ages requires the involvement of caregivers and use of home- and community-based services. Yet information regarding which Veterans are most likely to benefit specific services is lacking, current systems of treatment delivery too often fail to meet Veterans’ needs, services available are often limited, and a comprehensive system for implementing, evaluating, and disseminating best practices through VA operational offices has not been fully developed. Significance: Using the chronic care model as our framework, we propose a set of aims that builds on our results to date to enable the VA to provide the most effective non-institutional care matched to each Veteran’s needs and circumstances. Our work supports the rapid production of knowledge, using shared metrics as a common platform for evaluation, with the goal of empowering Veterans, caregivers, VA and non-VA providers, and leadership to make informed choices regarding care services and program planning. Innovation & Impact: Over 5 million Veterans receive support from unpaid caregivers, typically family or friends. Identifying ways to better support these caregivers and the Veterans for whom they care improves both Veteran and caregiver outcomes, allowing Veterans to remain safely in their homes for as long as possible, and enabling VA to make the most effective use of its resources. Specific Aims: Aim 1: Implement and assess innovative interventions to improve HCBS at each of the EDCoE VAMCs, using a hybrid implementation / effectiveness approach to evaluate feasibility and impact. We will leverage novel innovations already being undertaken at our VAMCs and by our operational partners. Aim 2: Develop, validate, and refine targeted measures for evaluating HCBS based on Veteran, caregiver, and operational priorities. We will use findings from our stakeholder engagement work, environmental scan, and research agenda setting to identify target measures for adoption within the VA to address measurement gaps, including those consistent with the VA’s goal to implement the Campaign for Inclusive Care. Aim 3: Better match home- and community-based services based on Veterans’ and caregivers’ needs. We will extend our analyses of administrative and survey data to improve our understanding of the services that best meet the different populations’ needs, linking with our longitudinal survey to incorporate caregiver data. Aim 4: Identify and assess underrepresented caregivers: youth, non-family caregivers, and survivors. Our work to date has underscored the need to better serve these groups. Our proposal will provide a better understanding of their lived experiences to allow VA to develop targeted programs to best meet their needs. Aim 5: Expand VA capacity to deliver and assess HCBS and caregiver supports through disseminating findings and supporting the development of the next generation of caregiver researchers. Methodology: Our multi-disciplinary team of clinicians and researchers across seven VAMCs will work in tandem to ensure the EDCoE continues to serve as a model for excellence in training, innovation, evaluation, implementation and dissemination of best practices in non-institutional care. The resulting work will enable a cycle of improvement that is vital to the VA transformation to a Learning Health Care System, and that will enable VA to meet the needs of Veterans and caregivers in the decades to come. Next Steps / Implementation: We will continue to use briefings, newsletters, interest groups, and other media to share results. We will expand on the fellowship to develop training opportunities for the VA research community, expanding VA capacity to conduct rigorous evaluation of caregiving and HCBS.

External Links for this Project

NIH Reporter

Grant Number: I50HX002767-06
Link: https://reporter.nih.gov/project-details/11000574



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PUBLICATIONS:

None at this time.

DRA: None at this time.
DRE: None at this time.
Keywords: None at this time.
MeSH Terms: None at this time.

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