Research Programs and Initiatives
Each of the CoE's research programs reflects a key area of focus in determinants of health care quality, with each area informing the CoE's research activities across the theme as a whole. Towards this end, the CoE places a special emphasis on collaboration among Center investigators across research programs, with the expectation that these collaborations will result in products that reflect multiple research perspectives and address multiple research goals.
| Patient Encounter | Outcomes of Care | Health Care Practice | Policy Development | |
|---|---|---|---|---|
| Houston VA HSR&D CoE Scientific Programs | Health Decision-Making and Communication | Clinical Epidemiology and Outcomes | Health Services Delivery and Organization | Health Policy and Quality |
| Strategic Goals | Improve decision-making, risk communication, and patient participation in the encounter | Translation of genome-based medical discoveries into improved outcomes | Implement innovative interventions and modes of care delivery | Measure, monitor, improve, and reward facility performance |
| VA HSR&D Portfolio Areas | Implementation and management research; Equity | Chronic diseases | Implementation and management research; Special populations; Chronic diseases | Implementation and management research; Quality measurement and effectiveness |
Collaborators
Our investigators collaborate with many other investigators within the Texas Medical Center, with other HSR&D investigators, and researchers across the country at other VA Medical Centers and academic institutions. Further information about these collaborators may be found in our Helpful Links.
Current Research
Current research efforts by our HSR investigators include the following. Click here for a table detailing examples of collaborative research projects, both internal and external.
- Health Decision-Making and Communication:
- Medical Education (Paul Haidet). Studies focused on development and implementation of an integrated curriculum in cultural competence at medical schools and ensuring that the institutional environment reinforces students' acquisition of knowledge, skills and attitudes.
- Expanding the Concept and Assessment of Autonomy to Meet the Challenges of Elder Self-Neglect (Aanand Naik). The project focuses on the development of a clinical tool that reliably screens for both decisional and executive autonomy and preserves the ethical and legal presumption of competence.
- Psychiatric barriers to outpatient care in released HIV-infected offenders (Thomas Giordano). This database project's goal is to determine the prevalence of successful linkage to HIV care after release from prison in Texas among HIV-infected prisoners, and to determine if psychiatric diseases affect that linkage.
- Clinical Epidemiology and Outcomes:
- Evaluating the Utilization of Screening for Hepatocellular Carcinoma (HCC) (Hashem El-Serag, Jessica Davila, Robert Morgan). This current project examines the determinants of pre-diagnosis screening among patients diagnosed with HCC, including patient characteristics, socioeconomic status, and physician provider factors.
- Obesity, H. pylori and Risk of Barrett's Esophagus (BE) (Hashem El-Serag, Neena Abraham and Jennifer Kramer). The project studies potential risk factors for BE in a case-control study nested within a large cross-sectional study, with the primary aim of estimating the association between obesity and BE and a secondary aim of estimating the association between Helicobacter pylori (H. pylori) infection and BE.
- Genetic Epidemiology of Hepatitis C Related Liver Disease (Donna White).The project aims to conduct a genetic association case-control study to evaluate selected insulin resistance (IR) and adiposity polymorphisms as risk factors for advanced fibrosis among veterans with HCV.
- Health Services Delivery and Organization:
- Partners in Dementia Care (Mark Kunik, Michael Kallen, Nancy Wilson). Projects focus on behavior in patients with dementia and their caregivers.
- Cognitive Behavior Therapy for Anxiety in Dementia (Melinda Stanley; Mark Kunik and Nancy Wilson). The objective of this project is to develop, refine, and pilot test a manual for cognitive behavior therapy (CBT) of anxiety in dementia (CBT-AD). CBT-AD will integrate empirically supported interventions for late-life anxiety with strategies that facilitate comprehension, encoding, and retrieval for people with dementia (e.g., memory cueing, spaced retrieval).
- Psychosocial Needs of Prostate Cancer Patients on Surveillance (David Latini). By reducing cancer-related anxiety, the project aims to delay active treatment for prostate cancer and the concomitant treatment-related side-effects that result in reduced health related quality of life.
- Economic and Clinical Outcomes of Recommended Nonsteroidal Antiinflammatory Drug (NSAID) Prescription Strategies (Neena Abraham & Hashem El-Serag). Projects focus on assisting VA policy makers in deciding whether or not they should embrace current recommended guidelines for the safer prescription of NSAIDs.
- Health Policy and Quality:
- RCT of Financial Incentives to Translate ALLHAT into Practice (Laura Petersen and LeChauncey Woodard). In this era of rising health care costs and limited resources, this study seeks to determine whether financial incentives are cost-effective. Thus, the findings will provide critical information needed to implement methods of "paying for performance."
- Patient Safety (Laura Petersen, Hardeep Singh). The project focuses on improving the process of electronic communication in ambulatory care. See VA National Center for Patient Safety.
-
Organizational Correlates of Outpatient Performance Trends in VAMCs (Sylvia Hysong). This research examines changes in facility performance when specific quality measures change status from actively evaluated to not actively evaluated and explores organizational mechanisms that could explain the observed performance changes.