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Dang S, Garcia-Davis S, Noël PH, Hansen J, Brintz BJ, Munoz R, Valencia Rodrigo WM, Rupper R, Bouldin ED, Trivedi R, Penney LS, Pugh MJ, Kinosian B, Intrator O, Leykum LK. Measuring the unmet needs of American military Veterans and their caregivers: Survey protocol of the HERO CARE survey. J Am Geriatr Soc 2023; 71:3814-3825. [PMID: 37698336 DOI: 10.1111/jgs.18577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/29/2023] [Accepted: 08/14/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Empowering Veterans to age in place is a Department of Veterans Affairs priority. Family or unpaid caregivers play an important role in supporting Veterans to achieve this goal. Effectively meeting the needs of Veterans and caregivers requires identifying unmet needs and relevant gaps in resources to address those needs. METHODS Using a modified Socio-Ecological Model, we developed a prospective longitudinal panel design survey. We randomly selected 20,000 community-dwelling Veterans enrolled in the Veterans Health Administration (VHA), across five VHA sites. We oversampled Veterans with a higher predicted 2-year long-term institutional care (LTIC) risk. Veterans were mailed a packet containing a Veteran survey and a caregiver survey, to be answered by their caregiver if they had one. The Veteran survey assessed the following health-related domains: physical, mental, social determinants of health, and caregiver assistance. Caregivers completed questions regarding their demographic factors, caregiving activities, impact of caregiving, use of VA and non-VA services, and caregiver support resources. Follow-up surveys will be repeated twice at 12-month intervals for the same respondents. This article describes the HERO CARE survey protocol, content, and response rates. RESULTS We received responses from 8,056 Veterans and 3,579 caregivers between July 2021 and January 2022, with 95.6% being received via mail. Veteran respondents were mostly males (96.5%), over 65 years of age (94.9%), married (55.0%), Non-Hispanic White (75.2%), and residing in urban areas (80.7%). CONCLUSIONS This longitudinal survey is unique in its comprehensive assessment of domains relevant to older Veterans stratified by LTIC risk and their caregivers, focusing on social determinants, caregiver support, and the use of caregiver support resources. Survey data will be linked to Centers for Medicare & Medicaid Services and VA data. The results of this study will inform better planning of non-institutional care services and policy for Veterans and their caregivers.
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Affiliation(s)
- Stuti Dang
- Department of Veterans Affairs Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, San Antonio, Texas, USA
- Miami VA Healthcare System, Geriatric Research, Education, & Clinical Center GRECC, Miami, Florida, USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Miami School of Medicine, Miami, Florida, USA
- Department of Public Health Sciences, University of Miami, Coral Gables, Florida, USA
| | - Sandra Garcia-Davis
- Department of Public Health Sciences, University of Miami, Coral Gables, Florida, USA
| | - Polly H Noël
- Department of Veterans Affairs Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, San Antonio, Texas, USA
- South Texas Veterans Health Care System, San Antonio, Texas, USA
- School of Medicine, Family & Community Medicine, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Jared Hansen
- Department of Veterans Affairs Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, San Antonio, Texas, USA
- VA Salt Lake City Health Care System, IDEAS Center, Salt Lake City, Utah, USA
- Division of Epidemiology, University of Utah Health, Salt Lake City, Utah, USA
| | - Benjamin J Brintz
- Department of Veterans Affairs Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, San Antonio, Texas, USA
- VA Salt Lake City Health Care System, IDEAS Center, Salt Lake City, Utah, USA
- Division of Epidemiology, University of Utah Health, Salt Lake City, Utah, USA
| | - Richard Munoz
- Robert Stempel College of Public Health & Social Work, Department of Health Policy & Management, Florida International University, Miami, Florida, USA
| | | | - Rand Rupper
- Department of Veterans Affairs Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, San Antonio, Texas, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
- GRECC George E. Wahlen Veteran Affairs Medical Center, Salt Lake City, Utah, USA
| | - Erin D Bouldin
- Department of Veterans Affairs Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, San Antonio, Texas, USA
- VA Salt Lake City Health Care System, IDEAS Center, Salt Lake City, Utah, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Ranak Trivedi
- Department of Veterans Affairs Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, San Antonio, Texas, USA
- Department of Psych/Public Mental Health Population Sciences, Stanford University, Stanford, California, USA
- Center for Innovation to Implementation, VA Palo Alto Healthcare System, Palo Alto, California, USA
| | - Lauren S Penney
- Center for Scientific Review, National Institutes of Health, Bethesda, Maryland, USA
| | - Mary Jo Pugh
- Department of Veterans Affairs Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, San Antonio, Texas, USA
- VA Salt Lake City Health Care System, IDEAS Center, Salt Lake City, Utah, USA
- Division of Epidemiology, University of Utah Health, Salt Lake City, Utah, USA
| | - Bruce Kinosian
- Department of Internal Medicine, Division of Geriatrics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Orna Intrator
- Geriatrics & Extended Care Data Analysis Center and Finger Lakes Healthcare System, Canandaigua Veterans Affairs Medical Center, Canandaigua, New York, USA
- Department of Public Health Sciences, University of Rochester, Rochester, New York, USA
| | - Luci K Leykum
- Department of Veterans Affairs Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, San Antonio, Texas, USA
- South Texas Veterans Health Care System, San Antonio, Texas, USA
- Department of Internal Medicine, University of Texas at Austin Dell Medical School, Austin, Texas, USA
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