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Zaccari B, Sherman ADF, Higgins M, Ann Kelly U. Trauma Center Trauma-Sensitive Yoga Versus Cognitive Processing Therapy for Women Veterans With PTSD Who Experienced Military Sexual Trauma: A Feasibility Study. J Am Psychiatr Nurses Assoc 2024; 30:343-354. [PMID: 35833676 PMCID: PMC9839891 DOI: 10.1177/10783903221108765] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a common sequela to military sexual trauma (MST) among women veterans. Yoga has shown promise in research examining its benefit for symptoms and sequela of PTSD. AIMS The objective of this study was to evaluate the feasibility of a randomized controlled trial (RCT) of Trauma Center Trauma-Sensitive Yoga (TCTSY) for women veterans with PTSD related to MST. METHOD In this feasibility study, the final sample included women veterans (n = 41) with PTSD related to MST accessing health care in a Veterans Affairs Health Care System in the southeast United States; the majority were African American (n = 33; 80.5%). Interventions used established protocols of 10 weekly sessions of group TCTSY versus 12 weekly sessions of group Cognitive Processing Therapy (CPT). PTSD was assessed via clinical interview and participant report. Additional data collection included multiple participant-reported outcomes commonly associated with PTSD and psychophysiological measures. We also collected data regarding participant satisfaction and feasibility-related feedback from participants and providers. RESULTS Feasibility and acceptability were evaluated via demand, practicality, fidelity, and acceptability. This was measured by expressed interest, attendance, program completion, barriers to care and satisfaction with treatment, and satisfaction with interventions and data collection. CONCLUSIONS Results indicate the RCT design and TCTSY implementation were feasible; a full-scale RCT was subsequently conducted to determine efficacy of the experimental intervention. Recommendations for successful research strategies are provided.
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Affiliation(s)
- Belle Zaccari
- Belle Zaccari, PsyD, Veterans Affairs Portland Health Care System, Portland, OR, USA
- Belle Zaccari, PsyD, Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Athena D F Sherman
- Athena D. F. Sherman, PhD, PHN, RN, CNE, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Melinda Higgins
- Melinda Higgins, PhD, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Ursula Ann Kelly
- Ursula Ann Kelly, PhD, APRN, ANP-BC, PMHNP-BC, FAANP, FAAN, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
- Ursula Ann Kelly, PhD, APRN, ANP-BC, PMHNP-BC, FAANP, FAAN, Atlanta VA Health Care System, Atlanta, GA, USA
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Courtney RE, Schadegg MJ, Bolton R, Smith S, Harden SM. Using a Whole Health Approach to Build Biopsychosocial-Spiritual Personal Health Plans for Veterans with Chronic Pain. Pain Manag Nurs 2024; 25:69-74. [PMID: 37839983 DOI: 10.1016/j.pmn.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023]
Abstract
Chronic pain affects over 50 million Americans per year and costs society billions of dollars annually. It is widely accepted that the biomedical model is outdated and research on the biopsychosocial model of chronic pain has increased in recent years, concurrent with investigations into self-management of chronic pain. The Veterans Health Administration (VHA) has incorporated both of these approaches into their Whole Health System. This work describes the VHA Whole Health System, reviews the literature on alignment between the Whole Health System's Circle of Health and chronic pain, and explains how the VHA Whole Health model may be used as a method for organizing self-management strategies within a personal health plan in the context of chronic pain. Given the infusion of nurses throughout the healthcare system, nurses are in a unique position to champion this biopsychosocial-spiritual approach to care.
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Affiliation(s)
- Rena E Courtney
- PREVAIL Center for Chronic Pain, Salem, VA Health Care System, Salem, Virginia; Virginia Tech Carilion School of Medicine, Salem, Virginia.
| | - Mary J Schadegg
- NYU Grossman School of Medicine/NYU Langone Health, New York, New York
| | - Rendelle Bolton
- Center for Healthcare Organization and Implementation Research, Bedford VA Health Care System, Bedford, Massachusetts
| | - Stephanie Smith
- PREVAIL Center for Chronic Pain, Salem, VA Health Care System, Salem, Virginia
| | - Samantha M Harden
- Virginia Tech Carilion School of Medicine, Salem, Virginia; Virginia Tech, Blacksburg, Virginia
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Huang A, Anthonypillai J, Hapidou EG. Experiences of Veteran and Civilian Patients in Exploratory Yoga Sessions for Chronic Pain: A Qualitative Study. Can J Pain 2023; 7:2244025. [PMID: 37719472 PMCID: PMC10503449 DOI: 10.1080/24740527.2023.2244025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 07/15/2023] [Accepted: 07/31/2023] [Indexed: 09/19/2023]
Abstract
Background Yoga integrates all aspects of self, with biological, mental, intellectual, and spiritual elements. The practice of yoga aligns with the biopsychosocial model of health and, as such, it can be instrumental in pain treatment. Aims The purpose of this qualitative study was to explore perceptions regarding the yoga sessions for chronic pain through thematic content analysis with comparison of gender, veteran or civilian status, and delivery methods. Methods Patients with chronic pain attended a 5-week intensive interdisciplinary chronic pain management program at the Michael G. DeGroote Pain Clinic. Participants were asked to complete six open-ended questions following four weekly 1-h yoga classes, through in-person or virtual delivery. Survey responses were thematically and separately analyzed by reviewers. Results Forty-one (N = 41) participants (56% males, 71% veterans) with an average age of 50.87 (SD 10.10) years provided comments. Nine themes emerged: (1) mind and body are one through yoga practices; (2) meaningful practice of yoga basics is productive for range of motion/movement, tension in joints, and chronic pain; (3) yoga classes provide an enjoyable process of learning; (4) yoga reminds patients of their physical capabilities; (5) routine practices lead to improvements; (6) yoga improved on strategies for chronic pain; (7) yoga can be adapted for each patient; (8) mindset improves to include positive thinking, better focus, and willingness to try new things; and (9) improvements exist for the current yoga programming. Conclusion Findings of the current study were nine qualitative themes that present the experience of patients with chronic pain in the yoga sessions.
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Affiliation(s)
- Amy Huang
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | | | - Eleni G. Hapidou
- Michael G. DeGroote Pain Clinic, Hamilton Health Sciences, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Groessl EJ, Hafey C, McCarthy A, Hernandez RM, Prado-Nava M, Casteel D, McKinnon S, Chang DG, Ayers CR, Rutledge TR, Lang AJ, Bormann JE. Yoga Plus Mantram Repetition to Reduce Chronic Pain in Veterans With Post-Traumatic Stress Disorder: A Feasibility Trial. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2023; 12:27536130231220623. [PMID: 38152342 PMCID: PMC10752061 DOI: 10.1177/27536130231220623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 12/29/2023]
Abstract
Background Veterans with post-traumatic stress disorder (PTSD) are more likely to report chronic pain than veterans without PTSD. Yoga has been shown to reduce both chronic pain and PTSD symptoms in clinical trials. The goal of our study was to assess the feasibility and acceptability of conducting a randomized controlled trial (RCT) that combined yoga and mantram repetition (Yoga + MR) into one program for military veterans with both chronic pain and PTSD. Methods In this feasibility RCT, 27 veterans were randomized to either Yoga + MR or a relaxation intervention. Due to the COVID-19 pandemic, in-person recruitment, assessments, and intervention attendance were re-evaluated. Although remote delivery of aspects of the study were utilized, interventions were delivered in-person. Feasibility benchmarks met included full recruitment in 12 months or less, 75%+ retention at initial follow-up assessment, 50%+ attendance rate, and 75%+ of participants satisfied with the interventions. Results The sample was racially and ethnically diverse, and 15% of participants were women. Participant recruitment lasted approximately 11 months. Out of 32 participants initially randomized, two participants asked to be dropped from the study and three did not meet PTSD symptom criteria. For the remaining 27 participants, retention rates were 85% at 12 weeks and 81% at 18 weeks. Participants attended 66% of in-person yoga and 55% of in-person relaxation sessions. Satisfaction was high, with 100% of yoga participants and 75%/88% of relaxation participants agreeing or strongly agreeing they were satisfied with the intervention/instructors. After 12 weeks (end of intervention), Yoga + MR participants reported reduced back-pain related disability (primary outcome), reduced alcohol use, reduced fatigue, and increased quality of life, while relaxation group participants reported reductions in pain severity, PTSD symptoms, and fatigue. Conclusions Amidst many research challenges during the pandemic, recruitment, retention, and efficacy results from this feasibility trial support advancement to a larger RCT to study Yoga + MR for chronic pain and PTSD.
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Affiliation(s)
- Erik J. Groessl
- VA San Diego Healthcare System, San Diego, CA, USA
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
- UCSD Health Services Research Center, San Diego, CA, USA
| | - Carol Hafey
- VA San Diego Healthcare System, San Diego, CA, USA
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
- UCSD Health Services Research Center, San Diego, CA, USA
| | - Adhana McCarthy
- VA San Diego Healthcare System, San Diego, CA, USA
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
- US Army, San Antonio, TX, USA
| | - Rahil M. Hernandez
- VA San Diego Healthcare System, San Diego, CA, USA
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Miguel Prado-Nava
- VA San Diego Healthcare System, San Diego, CA, USA
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
- UCSD Health Services Research Center, San Diego, CA, USA
| | - Danielle Casteel
- VA San Diego Healthcare System, San Diego, CA, USA
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
- UCSD Health Services Research Center, San Diego, CA, USA
| | - Symone McKinnon
- VA San Diego Healthcare System, San Diego, CA, USA
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
- UCSD Health Services Research Center, San Diego, CA, USA
| | - Douglas G. Chang
- Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, University of California San Diego, La Jolla, CA, USA
| | - Catherine R. Ayers
- VA San Diego Healthcare System, San Diego, CA, USA
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Thomas R. Rutledge
- VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Ariel J. Lang
- VA San Diego Healthcare System, San Diego, CA, USA
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Jill E. Bormann
- VA San Diego Healthcare System, San Diego, CA, USA
- Hahn School of Nursing and Health Sciences, Beyster Institute of Nursing Research, University of San Diego, San Diego, CA, USA
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Zaccari B, Sherman ADF, Febres-Cordero S, Higgins M, Kelly U. Findings from a pilot study of Trauma Center Trauma-Sensitive Yoga versus cognitive processing therapy for PTSD related to military sexual trauma among women Veterans. Complement Ther Med 2022; 70:102850. [PMID: 35820575 PMCID: PMC9704511 DOI: 10.1016/j.ctim.2022.102850] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/03/2022] [Accepted: 07/07/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The study objective was to explore the preliminary efficacy of trauma-sensitive yoga compared to cognitive processing therapy (CPT) for women Veterans with posttraumatic stress disorder (PTSD) related to military sexual trauma (MST) in a pilot randomized control trial (RCT). We then compared these results to published interim results for the subsequent full-scale RCT. METHOD The analytic sample included women Veterans (N = 41) with PTSD related to MST accessing healthcare in a southeastern Veterans Affairs Health Care System. The majority were African American, non-Hispanic (80.5 %). The protocol-driven group interventions, Trauma Center Trauma-Sensitive Yoga (TCTSY; n = 17) and the evidence-based control condition, CPT (n = 24), were delivered weekly for 10 and 12 sessions, respectively. Multilevel linear models (MLM) were used to compare changes over time between the two groups. RESULTS The primary outcomes presented here are PTSD symptom severity and diagnosis, assessed using the Clinician Administered PTSD Scale (CAPS) and the PTSD Symptom Checklist (PCL) total scores. PTSD symptom severity on both clinician-administered (CAPS) and self-reported (PCL) measures, improved significantly (p < .005) over time, with large within group effect sizes (0.90-0.99) consistent with the subsequent RCT. Participants in the TCTSY group showed clinically meaningful improvements earlier than the CPT group participants from baseline on the CAPS and PCL Total scores. CONCLUSIONS Results support published findings of the effectiveness of TCTSY in the treatment for PTSD related to MST among women Veterans, particularly African American women. TCTSY warrants consideration as an adjunctive, precursor, or concurrent treatment to evidence-based psychotherapies. Future research should include patient preference, men with sexual trauma, and civilian populations.
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Affiliation(s)
- Belle Zaccari
- Veterans Affairs Portland Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR 97239, USA; Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA.
| | - Athena D F Sherman
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA, USA.
| | - Sarah Febres-Cordero
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA, USA.
| | - Melinda Higgins
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA, USA.
| | - Ursula Kelly
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA, USA; Atlanta VA Health Care System, Decatur, GA, USA.
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Trauma and Behavioral Health Care for Patients with Chronic Pain. Prim Care 2022; 49:415-423. [DOI: 10.1016/j.pop.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Essman M, Lin CY. The Role of Exercise in Treating Low Back Pain. Curr Sports Med Rep 2022; 21:267-271. [PMID: 35946845 DOI: 10.1249/jsr.0000000000000982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT The purpose of this review is to highlight the role of exercise in preventing and managing acute and chronic axial low back pain (LBP). LBP is one of the leading contributors to years lived with disability as well as health care expenditures in the United States. With an expected increase in prevalence due to an aging population, sports medicine providers have a unique opportunity to provide effective treatment strategies incorporating exercise advice and prescription. Although the majority of individuals with acute LBP will have their symptoms resolve spontaneously, almost 40% will have recurrence or develop chronic LBP within 1 year. No single exercise method has been shown to be more effective than another. The evidence for walking programs, aerobic exercise, yoga, Pilates, and tai chi for LBP is discussed. Our review summarizes the beneficial role of a personalized exercise program and related counseling strategies in the prevention and management of LBP.
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Affiliation(s)
- Matthew Essman
- Department of Rehabilitation Medicine, University of Washington Medical Center, Seattle, WA
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Reis DJ, Gaddy MA, Chen GJ. Exercise to Reduce Posttraumatic Stress Disorder Symptoms in Veterans. Fed Pract 2022; 39:158-166. [PMID: 35756827 PMCID: PMC9217079 DOI: 10.12788/fp.0248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
BACKGROUND Physical exercise offers benefits for treating psychological disorders, particularly depression. Exercise is associated with reduction of posttraumatic stress disorder (PTSD) symptoms in civilians. Given the comorbidities and unique trauma experiences of the veteran population, the current work aims to estimate the effect of exercise on PTSD symptoms in veteran samples. OBSERVATIONS A systematic review identified 6 single-arm studies and 3 randomized controlled trials (RCTs) using exercise as an interventional treatment among veteran samples with full or subsyndromal PTSD. Most single-arm studies used yoga-based interventions, whereas RCTs showed more variety and included yoga, aerobic activity, and resistance exercises. Data synthesis of study results revealed a medium standardized mean difference for the single-arm trials (Hedges g, -0.60, P = .03) and a small-to-medium standardized mean difference for the RCTs (Hedges g, -0.40, P = .06). Single-arm studies were all rated at serious risk of bias. Only 1 RCT was rated at high risk of bias, although the remaining RCTs showed some concern of elevated bias. CONCLUSIONS There is preliminary evidence that exercise may be a useful treatment option for PTSD symptom reduction in veterans. Our review also highlights the need for additional high-quality randomized trials to confirm the benefits of exercise for PTSD symptom reduction in veterans.
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Affiliation(s)
- Daniel J Reis
- Veterans Affairs Dwight D. Eisenhower Medical Center, Leavenworth, Kansas
- Rocky Mountain Mental Illness Research Education and Clinical Center for Veteran Suicide Prevention, Aurora, Colorado
- Department of Psychiatry, University of Colorado Anschutz School of Medicine, Aurora
| | - Melinda A Gaddy
- Veterans Affairs Dwight D. Eisenhower Medical Center, Leavenworth, Kansas
- University of Kansas Medical Center, Department of Internal Medicine, Kansas City
| | - Guoqing J Chen
- University of Kansas Medical Center, Department of Internal Medicine, Kansas City
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Yoga as an Integrative Therapy for Mental Health Concerns: An Overview of Current Research Evidence. PSYCHIATRY INTERNATIONAL 2021. [DOI: 10.3390/psychiatryint2040030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Because the prevalence of mental health concerns is high and access or full responsiveness to pharmacological or psychotherapeutic treatment for many individuals is low, there has been increased interest in yoga as a potential therapy for many mental health concerns. Approach: We synthesize and critique current research on the efficacy of yoga relative to pharmacological approaches for anxiety disorders, mood disorders, posttraumatic stress disorder, obsessive-compulsive disorder, and eating disorders. Results: Yoga has been tested mostly as a complementary treatment to standard psychiatric and psychotherapeutic approaches. Findings from efficacy trials largely support the notion that yoga can help reduce symptoms of many psychiatric conditions, including anxiety, depression, and PTSD symptoms, above and beyond the effects achieved by standard pharmacological treatments alone; however, most evidence is of poor to moderate quality. Plausible transdiagnostic bottom-up and top-down mechanisms of yoga’s therapeutic effects have been advanced but remain untested. Conclusions: While results should be considered preliminary until more rigorous evidence is available, yoga appears to have the potential to provide many people suffering with psychiatric symptoms additional relief at relatively little cost. Yoga may be a viable complementary therapy to psychiatric and psychotherapeutic approaches for people with mental health challenges.
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Auguste EJ, Weiskittle RE, Sohl SJ, Danhauer SC, Doherty K, Naik AD, Moye J. Enhancing Access to Yoga for Older Male Veterans After Cancer: Examining Beliefs About Yoga. Fed Pract 2021; 38:450-458. [PMID: 34733065 PMCID: PMC8560106 DOI: 10.12788/fp.0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Yoga is an effective clinical intervention for cancer survivors. Most studies of the positive effects of yoga on cancer patients report on predominantly middle-aged women with breast cancer. Less is known about the use of yoga in older adults, veterans, and those from diverse racial or ethnic backgrounds. METHODS We examined strategies to enhance access to yoga in older veterans after cancer, focusing on education (study 1) and intervention (study 2). Study 1 included 110 participants with a median (SD) age of 64.9 (9.4) years who were mostly male (99%) cancer survivors who were interviewed 12 months after their cancer diagnosis. Study 2 included 28 participants with a median (SD) age of 69.2 (10.9) years who were mostly male (96%) cancer survivors who participated in a yoga program within 3 years of their cancer diagnosis. Standardized interviews assessed interest in and barriers to yoga while self-reporting assessed health-related quality of life and beliefs about yoga. RESULTS In study 1, interest in yoga increased from 5.5 to 31.8% (χ 2 = 22.25, P < .001) following education. In open-ended questions 4 themes related to negative beliefs or barriers emerged: lack of knowledge or skepticism, disinterest or dislike, physical health barriers, and logistical barriers. In study 2, beliefs were more positive following intervention for expected benefits (t = 4.44, P < .001), discomfort (t = 4.92, P < .001), and social norms (t = 4.38, P < .001) related to yoga. Physical function improved after participation in a yoga class, especially for those with higher beliefs in yoga prior to class. Age was not associated with beliefs about yoga in either sample. CONCLUSIONS A portion of older veterans who are cancer survivors were interested in yoga but faced access barriers. Implications for practice and research include increasing knowledge about yoga benefits and addressing physical health and logistical barriers to enhance access to yoga for older veterans.
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Affiliation(s)
- Elizabeth J Auguste
- is a Research Assistant; is an Advanced Fellow; is a Health Science Specialist; and is Associate Director for Education and Evaluation; all at US Department of Veterans Affairs (VA) New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System in Massachusetts. is a Assistant Professor, and is a Professor and Director of Faculty Well-Being & Resilience, both at the Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine in Winston Salem, North Carolina. is Chief of Implementation Science at the VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center and a Professor and Robert Luchi, MD Chair in Geriatric Medicine at the Baylor College of Medicine in Houston, Texas. Rachel Weiskittle is a Research Fellow and Jennifer Moye is a Professor, both at the Department of Psychiatry, Harvard Medical School
| | - Rachel E Weiskittle
- is a Research Assistant; is an Advanced Fellow; is a Health Science Specialist; and is Associate Director for Education and Evaluation; all at US Department of Veterans Affairs (VA) New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System in Massachusetts. is a Assistant Professor, and is a Professor and Director of Faculty Well-Being & Resilience, both at the Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine in Winston Salem, North Carolina. is Chief of Implementation Science at the VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center and a Professor and Robert Luchi, MD Chair in Geriatric Medicine at the Baylor College of Medicine in Houston, Texas. Rachel Weiskittle is a Research Fellow and Jennifer Moye is a Professor, both at the Department of Psychiatry, Harvard Medical School
| | - Stephanie J Sohl
- is a Research Assistant; is an Advanced Fellow; is a Health Science Specialist; and is Associate Director for Education and Evaluation; all at US Department of Veterans Affairs (VA) New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System in Massachusetts. is a Assistant Professor, and is a Professor and Director of Faculty Well-Being & Resilience, both at the Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine in Winston Salem, North Carolina. is Chief of Implementation Science at the VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center and a Professor and Robert Luchi, MD Chair in Geriatric Medicine at the Baylor College of Medicine in Houston, Texas. Rachel Weiskittle is a Research Fellow and Jennifer Moye is a Professor, both at the Department of Psychiatry, Harvard Medical School
| | - Suzanne C Danhauer
- is a Research Assistant; is an Advanced Fellow; is a Health Science Specialist; and is Associate Director for Education and Evaluation; all at US Department of Veterans Affairs (VA) New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System in Massachusetts. is a Assistant Professor, and is a Professor and Director of Faculty Well-Being & Resilience, both at the Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine in Winston Salem, North Carolina. is Chief of Implementation Science at the VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center and a Professor and Robert Luchi, MD Chair in Geriatric Medicine at the Baylor College of Medicine in Houston, Texas. Rachel Weiskittle is a Research Fellow and Jennifer Moye is a Professor, both at the Department of Psychiatry, Harvard Medical School
| | - Kelly Doherty
- is a Research Assistant; is an Advanced Fellow; is a Health Science Specialist; and is Associate Director for Education and Evaluation; all at US Department of Veterans Affairs (VA) New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System in Massachusetts. is a Assistant Professor, and is a Professor and Director of Faculty Well-Being & Resilience, both at the Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine in Winston Salem, North Carolina. is Chief of Implementation Science at the VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center and a Professor and Robert Luchi, MD Chair in Geriatric Medicine at the Baylor College of Medicine in Houston, Texas. Rachel Weiskittle is a Research Fellow and Jennifer Moye is a Professor, both at the Department of Psychiatry, Harvard Medical School
| | - Aanand D Naik
- is a Research Assistant; is an Advanced Fellow; is a Health Science Specialist; and is Associate Director for Education and Evaluation; all at US Department of Veterans Affairs (VA) New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System in Massachusetts. is a Assistant Professor, and is a Professor and Director of Faculty Well-Being & Resilience, both at the Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine in Winston Salem, North Carolina. is Chief of Implementation Science at the VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center and a Professor and Robert Luchi, MD Chair in Geriatric Medicine at the Baylor College of Medicine in Houston, Texas. Rachel Weiskittle is a Research Fellow and Jennifer Moye is a Professor, both at the Department of Psychiatry, Harvard Medical School
| | - Jennifer Moye
- is a Research Assistant; is an Advanced Fellow; is a Health Science Specialist; and is Associate Director for Education and Evaluation; all at US Department of Veterans Affairs (VA) New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System in Massachusetts. is a Assistant Professor, and is a Professor and Director of Faculty Well-Being & Resilience, both at the Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine in Winston Salem, North Carolina. is Chief of Implementation Science at the VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center and a Professor and Robert Luchi, MD Chair in Geriatric Medicine at the Baylor College of Medicine in Houston, Texas. Rachel Weiskittle is a Research Fellow and Jennifer Moye is a Professor, both at the Department of Psychiatry, Harvard Medical School
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