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This month our focus is on research into health equity and closely related topics, such as homelessness and rural health.
Cancer is a general term that includes more than 200 different diseases. In all forms of cancer, cells in the body grow and multiply abnormally, eventually taking over and destroying normal tissue. In 2014, the five most frequently diagnosed cancers among VA cancer patients were prostate, lung and bronchial, colorectal, urinary and bladder cancers, and skin melanomas. VA researchers have long been interested in exploring the causes of cancers, finding new treatments for different forms of cancer, and evaluating the effectiveness of existing treatments.
VA is committed to ending homelessness among Veterans. The department's focus includes conducting coordinated outreach; connecting homeless and at-risk Veterans with housing solutions; and collaborating with federal, state, and local agencies to expand employment and affordable housing options for homeless Veterans.
In the past 10 to 15 years, VA has launched a number of initiatives to expand and ensure access to high-quality health care for Veterans enrolled in the VA health care system who live in rural areas. VA researchers have been instrumental in these efforts by developing and evaluating new technologies and models of care like VA's telehealth initiative.
Two VA studies on the Veterans Choice Program found that patients generally liked the health care they received but found the process challenging.... (12/04/2018)
Veterans and the criminal justice system
Dr. Andrea Finlay in Palo Alto is one of several VA researchers who are exploring trends and characteristics related to Veterans who collide with the criminal justice system. ... (09/07/2018)
A new battlefront
Researchers are helping VA design and deliver services for homeless women Veterans, or those at risk for becoming homeless—and seeking to understand the factors that drive homelessness in this population... (03/21/2018)
Research rocks for homeless Vets at the Louisville VA
A pilot study at the Louisville VA in Kentucky showed the therapeutic benefit of rocking chairs for homeless Veterans in treatment for substance abuse problems, mainly alcohol addiction.... (02/08/2018)
Veteran profiles for VA homeless program use VA researchers analyzed the records of over 61,000 homeless Veterans to find out which homeless assistance programs they used, how often they accessed services, and for what length of time. The team identified five different Veteran usage profiles that, they say, can inform future research into VA homeless assistance programs. (December 2018)
Helping homeless and marginally housed Veterans through photography
Researchers at the VA Pittsburgh Healthcare System examined the use of photography to help homeless or marginally housed Veterans express their feelings about their health. Most study participants said they felt positive about their experiences taking photographs. (December 2017)
Telemedicine outreach for PTSD The Telemedicine Outreach for PTSD (TOP) program, now in use at 12 VA clinics serving rural Veterans, delivers therapy and other care through phone and interactive video contact. It was developed based on several VA studies showing that remote delivery of psychotherapy for PTSD can be safe, feasible, and effective.
Addressing homelessness in Veteran populations
Guest: Dr. Jack Tsai with the New England Mental Illness Research, Education and Clinical Center (MIRECC) at the VA Connecticut Healthcare System. (Episode #11)
Harassment of women Veterans by male Veterans common at VA medical centers
Harassment of women Veterans by male Veterans at VA medical centers is prevalent, found a VA Greater Los Angeles Health Care System study. Researchers surveyed more than 1,000 women Veterans who used VA health care at any one of 12 facilities. One in four women said they experienced inappropriate or unwanted comments or behavior from male Veterans on VA grounds. The negative interactions included catcalls, sexual remarks, and denigration of Veteran status. Reports of harassment were more common among women with histories of military sexual trauma; other trauma exposure; anxiety, depression, or PTSD; and poorer health. Not surprisingly, women experiencing harassment were significantly less likely to feel welcome at VA and were more likely to not feel safe. Importantly, they were also more likely to delay or miss care. More efforts are needed to make VA health care facilities more inclusive, welcoming, and respectful of women Veterans, say the researchers. (Women’s Health Issues, Jan. 24, 2019)
Racial disparities in electroconvulsive therapy
Racial disparities exist in the use of electroconvulsive therapy to treat depression in older adults, found a study including a Houston VA health Care System researcher. ECT involves applying electrical current to the brain to treat mood disorders. It has proven effective in treating major depressive disorder when medication does not work. The researchers looked at nearly 700,000 patients older than 65 in a national health care database. They found that black and Hispanic patients were nearly half as likely to receive ECT, compared with white patients. While the research team acknowledges that patient preference may have played some role, they assert that efforts are needed in any case to ensure that minority groups have equal access to care. (American Journal of Geriatric Psychiatry, Nov. 29, 2018)
Rural, urban ICUs perform similarly in VA system
Rural intensive care units (ICUs) in VA facilities perform similarly to their urban counterparts, found an Iowa City VA Health Care System study. Researchers looked at data on nearly 10,000 rural patients and almost 66,000 urban patients. They found that patients treated at rural ICUs had similar mortality rates, despite rural locations having lower-complexity facilities. Rural patients were less likely to have respiratory illnesses and more likely to have sepsis than urban patients, and they had higher illness severity scores. Rural patients also had fewer inter-hospital transfers and shorter ICU length of stay. The results indicate that being part of a national health care system may have benefits for rural facilities that should be explored outside the VA system, according to the researchers. (Journal of Critical Care, Oct. 19, 2018)
Homeless Veterans are more satisfied with specially tailored care teams
Homeless Veterans at VHA facilities with tailored primary care teams had better care experiences than non-homeless Veterans, according to a National Center on Homelessness Among Veterans study. Researchers surveyed more than 340,000 Veterans receiving care through VHA nationwide. About 4 percent were homeless. In facilities without homeless-tailored teams, homeless patients had more negative and fewer positive experiences than non-homeless patients. In facilities with Homeless Patient Aligned Care Teams (HPACTs), this pattern was reversed. HPACTs appear to offer homeless Veterans a better primary care experience than that received by non-homeless Veterans. (Medical Care, May 12, 2018)
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