Veterans

Mixed-Methods Research in a Complex Multisite Veterans Affairs’ Health Services Study

By Frank M. Painter|June 18, 2016|Veterans|

Mixed-Methods Research in a Complex Multisite Veterans Affairs’ Health Services Study

SOURCE: Evid Based Complement Alternat Med. 2013: 701280

Raheleh Khorsan, Angela B. Cohen, Anthony J. Lisi,
Monica M. Smith, Deborah Delevan, Courtney Armstrong,
and Brian S. Mittman

VA Center for Implementation Practice and Research Support,
VA Greater Los Angeles Healthcare System,
16111 Plummer Street,
Sepulveda, Los Angeles, CA 91343, USA

Maximizing the quality and benefits of newly established chiropractic services represents an important policy and practice goal for the US Department of Veterans Affairs’ healthcare system. Understanding the implementation process and characteristics of new chiropractic clinics and the determinants and consequences of these processes and characteristics is a critical first step in guiding quality improvement. This paper reports insights and lessons learned regarding the successful application of mixed methods research approaches-insights derived from a study of chiropractic clinic implementation and characteristics, Variations in the Implementation and Characteristics of Chiropractic Services in VA (VICCS). Challenges and solutions are presented in areas ranging from selection and recruitment of sites and participants to the collection and analysis of varied data sources. The VICCS study illustrates the importance of several factors in successful mixed-methods approaches, including (1) the importance of a formal, fully developed logic model to identify and link data sources, variables, and outcomes of interest to the study’s analysis plan and its data collection instruments and codebook and (2) ensuring that data collection methods, including mixed-methods, match study aims. Overall, successful application of a mixed-methods approach requires careful planning, frequent trade-offs, and complex coding and analysis.

The Full-Text Article:

Introduction

There is growing consumer interest in complementary and alternative medicine (CAM) in the USA and internationally. [1-3] Healthcare systems have responded to this demand by offering a range of CAM services in outpatient and inpatient settings. [4, 5] Patients enrolled in the US Department of Veterans Affairs (VA) healthcare delivery system often use CAM services outside of VA but have a strong interest in receiving these services within the VA system. [6-11] In response, VA began providing selected in-house CAM services in about 2001. [12] VA’s most substantial undertaking in delivering any CAM-related service has been its introduction of chiropractic services.

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Q&A With the First VA Chiropractic Residents

By Frank M. Painter|June 29, 2015|News, Veterans|

Q&A With the First VA Chiropractic Residents

The Chiro.Org Blog

SOURCE: Dynamic Chiropractic ~ July 1, 2015 ~ FULL TEXT

Clinton Daniels, DC, MS, Amanda Dluzneiwski, DC, Derek Golley, DC,
Benjamin Liang, DC and Rachel Perrucci, DC

The Inaugural class of 2015 shares their residency experiences.

As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.1-2 This program is the result of years of dedication and strategic planning by the VA chiropractic leadership, and is congruent with the VA’s mission to train providers to serve the VA and the nation at large.

As the inaugural class, we are honored to have participated in the first phase of the three-year pilot program.

In March 2015, we had the opportunity to gather for a VA meeting held in advance of the Association of Chiropractic Colleges /Research Agenda Conference in Las Vegas. At this meeting, we worked with representatives from VA Central Office, the five residency program directors, and representatives from each program’s academic affiliates: Logan University, New York Chiropractic College, Southern California University of Health Sciences and the University of Bridgeport.

After this, many of us attended the ACC/RAC conference itself, where we participated in workshops and observed several cutting-edge research presentations. In our interaction with many of the ACC/RAC attendees, we noted a tremendous amount of interest in the VA Chiropractic Residency Program. We received questions ranging from inquiries about our future career plans to how perspective residents may apply. The following are some of the most frequent questions we fielded, as well as personal residency experiences.

How long is the residency program and is it a paid position?

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Chiropractic Management for Veterans with Neck Pain: A Retrospective Study of Clinical Outcomes

By Frank M. Painter|September 27, 2011|Outcome Assessment, Veterans|

Chiropractic Management for Veterans with Neck Pain:
A Retrospective Study of Clinical Outcomes

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2011 (Oct); 34 (8): 533–538

Andrew S. Dunn, DC, MEd, MS, Bart N. Green, DC, MSEd, Lance R. Formolo, DC, MS, David R. Chicoine

Chiropractic Department, Medical Care Line, VA Western New York, Buffalo, NY, USA. andrew.dunn@va.gov

OBJECTIVE: The purpose of this study was to report demographic characteristics, chiropractic treatment methods and frequency, and clinical outcomes for chiropractic management of neck pain in a sample of veteran patients.

METHODS: This is a retrospective case series of 54 veterans with a chief complaint of neck pain who received chiropractic care through a Veterans Health Administration medical center. Descriptive statistics and paired t tests were used with the numeric rating scale and Neck Bournemouth Questionnaire serving as the outcome measures. A minimum clinically important difference was set as 30% improvement from baseline for both outcomes. (more…)