Rebecca A. Raciborski

Central Arkansas Veterans Healthcare System

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Corey J. Hayes

Central Arkansas Veterans Healthcare System

Jacob T. Painter

University of Arkansas for Medical Sciences

Bradley C. Martin

University of Arkansas for Medical Sciences

Adam J. Gordon

Easy Global Market (France)

Michael A. Cucciare

Mental Illness Research, Education and Clinical Centers

Teresa J. Hudson

University of Arkansas for Medical Sciences

David Adkins

United States Department of Veterans Affairs

Ciara M. Oliver

United States Department of Veterans Affairs

Katherine J. Hoggatt

University of California, San Francisco

Sara J. Landes

Central Arkansas Veterans Healthcare System

Cooperative Institutions

United States Department of Veterans Affairs

Central Arkansas Veterans Healthcare System

University of Arkansas for Medical Sciences

Mental Illness Research, Education and Clinical Centers

Quality Enhancement Research Initiative

Veterans Health Administration

Health Services Research & Development

University of Colorado Anschutz Medical Campus

Boston University

Center for Innovation

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Medications for opioid use disorder: Predictors of early discontinuation and reduction of overdose risk in US military veterans by medication type

Addiction (2024)

Corey J. Hayes Rebecca A. Raciborski Matthew Nowak Mahip Acharya Edward V. Nunes

This study: (1) estimated the effect of early discontinuation of medication for opioid use disorder (MOUD) on overdose probability and (2) measured the relationship between patient characteristics and early discontinuation probability for each MOUD type.

Discontinuation

Drug overdose

Opioid Overdose

harm reduction

10.1111/add.16659

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A Systematic Review and Meta-Analysis of Moral Injury Outcome Measures

Current Treatment Options in Psychiatry (2025)

Brandon J. Griffin Larry R. Price Zoe Jenkins Alexis Childs Lauren Tong

Abstract Purpose of Review As evidence accumulates for the pernicious effects of exposure to potentially morally injurious events (PMIEs) on mental health, the need for improved measurement of moral injury has grown. This article summarizes the psychometric properties of scales that assess cognitive, emotional, social, and spiritual concerns linked to PMIE exposure and uses meta-analysis to describe associations between these scales and measures of posttraumatic stress and depression. Findings We reviewed 104 articles reporting results from 110 samples, in which 13 different scales were administered to assess the impacts of PMIE exposure (i.e., moral injury). Overall, the scales exhibited good to excellent internal consistency and moderate to large bivariate associations with posttraumatic stress ( r = .63, 95% Confidence Interval [CI] [.55, .71]) and depression ( r = .59, 95% CI [.51, .66]). Measures varied as to whether they indexed problems to a specific event, had a unidimensional or multidimensional factor structure, used a unipolar or bipolar response format to record item responses, used a cut score to distinguish moral injury from normative distress, were assessed for sensitivity to change over time, and were validated for use with multiple at-risk populations. Summary Assessment of moral injury has progressed tremendously. Recent scales extend prior work that focused on whether respondents endorsed PMIE exposure by measuring the potential impacts of an exposure. Mental health clinicians and researchers can use this article to choose a scale that best fits their moral injury measurement needs.

10.1007/s40501-024-00342-9

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OP8 Justice-Informed Analysis: A Unified Framework for Increasing Inclusivity and Methodological Rigor in Health Inequities Research

Value in Health (2024)

Rebecca A. Raciborski RS Singh JT Painter Catherine Hayes

Rigour

Social Justice

10.1016/j.jval.2024.03.1595

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Are gaps in rates of retention on buprenorphine for treatment of opioid use disorder closing among veterans across different races and ethnicities? A retrospective cohort study

Journal of Substance Use and Addiction Treatment (2024)

Corey J. Hayes Rebecca A. Raciborski Bradley C. Martin Adam J. Gordon Teresa J. Hudson

Opioid Overdose

10.1016/j.josat.2024.209461

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Engaging stakeholders to retrospectively discern implementation strategies to support program evaluation: Proposed method and case study

Evaluation and Program Planning (2023)

Jacob T. Painter Rebecca A. Raciborski Monica M. Matthieu Ciara M. Oliver David Adkins

10.1016/j.evalprogplan.2023.102398

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Citations (2)

Impact of Implementation Facilitation on the REACH VET Clinical Program for Veterans at Risk for Suicide

Psychiatric Services (2024)

Sara J. Landes Bridget B. Matarazzo Jeffery A. Pitcock Karen L. Drummond Brandy N. Smith

In 2017, the Veterans Health Administration (VHA) implemented a national suicide prevention program, called Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment (REACH VET), that uses a predictive algorithm to identify, attempt to reach, assess, and care for patients at the highest risk for suicide. The authors aimed to evaluate whether facilitation enhanced implementation of REACH VET at VHA facilities not meeting target completion rates.

Outreach

Facilitation

Receipt

Odds

10.1176/appi.ps.20230277

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Economic analyses of behavioral health intervention implementation: Perspective on stakeholder engagement

Frontiers in Psychiatry (2022)

Rebecca A. Raciborski Eva N. Woodward Jacob T. Painter

To provide full potential benefits to patients, behavioral health interventions often require comprehensive and systematic implementation efforts. The costs of these efforts should therefore be included when organizations decide to fund or adopt a new intervention. However, existing guidelines for conducting economic analyses like cost-effectiveness analyses and budget impact analyses are not well-suited to the complexity of the behavioral healthcare pathway and its many stakeholders. Stakeholder engagement, when used effectively with recent innovations in economic analysis, advance more equitable access to interventions for individuals living with behavioral health conditions. But early and ongoing stakeholder engagement has not yet been incorporated into best-practice guidelines for economic evaluation. We discuss our perspective, as researchers and clinicians in a large integrated health system, on how the integration of stakeholder engagement with existing economic analysis methods could improve decision-making about implementation of behavioral health interventions.

Stakeholder Engagement

Economic Evaluation

10.3389/fpsyt.2022.1031325

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Implementation of collaborative care for depression in VA HIV clinics: Translating Initiatives for Depression into Effective Solutions (HITIDES): protocol for a cluster-randomized type 3 hybrid effectiveness-implementation trial

Implementation Science Communications (2024)

Jacob T. Painter Jeffrey M. Pyne Geoffrey M. Curran Rebecca A. Raciborski Shane Russell

Abstract Background Depression is the most diagnosed mental health condition among people living with HIV. Collaborative care is an effective intervention for depression, typically delivered in primary care settings. The HIV Translating Initiatives for Depression into Effective Solutions (HITIDES) clinical intervention involves a depression care team housed off-site that supports depression care delivery by HIV care providers. In a randomized controlled trial, HITIDES significantly improved depression symptoms for veterans living with HIV and delivered cost savings. However, no HIV clinics in the Veterans Health Administration (VHA) have implemented HITIDES; as such, it is unclear what implementation strategies are necessary to launch and sustain this intervention. Methods This hybrid type-3 effectiveness-implementation trial examines the implementation and effectiveness of HITIDES in 8 VHA HIV clinics randomly assigned to one of two implementation arms. Each arm uses a different implementation strategy package. Arm 1 includes an intervention operations guide; an on-site clinical champion who, with the help of a peer community of practice, will work with local clinicians and leadership to implement HITIDES at their site; and patient engagement in implementation tools. Arm 2 includes all strategies from Arm 1 with assistance from an external facilitator. The primary implementation outcomes is reach; secondary outcomes include adoption, implementation dose, depressive symptoms, and suicidal ideation. We will conduct a budget impact analysis of the implementation strategy packages. We hypothesize that Arm 2 will be associated with greater reach and adoption and that Arm 1 will be less costly. Discussion Preliminary work identified implementation strategies acceptable to veterans living with HIV and HIV care providers; however, the effectiveness and cost of these strategies are unknown. While the depression care team can deliver services consistently with high quality, the ability of the depression care team to engage with HIV care providers at sites is unknown. Findings from this study will be used to inform selection of implementation strategies for a broad rollout to enhance depression and suicide care for people living with HIV. Trial registration ClinicalTrials.gov ID: NCT05901272, Registered 10 May 2023, https://clinicaltrials.gov/study/NCT05901272

Depression

Facilitator

Implementation research

Collaborative Care

10.1186/s43058-024-00639-z

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Legal Services for Veterans (LSV): Protocol for evaluating the grant-based LSV initiative supporting community organizations’ delivery of legal services to veterans

PLoS ONE (2024)

Bo Kim Beth Ann Petrakis Ida Griesemer Samantha K. Sliwinski Amanda M. Midboe

Background 1.8 million Veterans are estimated to need legal services, such as for housing eviction prevention, discharge upgrades, and state and federal Veterans benefits. While having one’s legal needs met is known to improve one’s health and its social determinants, many Veterans’ legal needs remain unmet. Public Law 116–315 enacted in 2021 authorizes VA to fund legal services for Veterans (LSV) by awarding grants to legal service providers including nonprofit organizations and law schools’ legal assistance programs. This congressionally mandated LSV initiative will award grants to about 75 competitively selected entities providing legal services. This paper describes the protocol for evaluating the initiative. The evaluation will fulfill congressional reporting requirements, and inform continued implementation and sustainment of LSV over time. Methods Our protocol calls for a prospective, mixed-methods observational study with a repeated measures design, aligning to the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) and Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) frameworks. In 2023, competitively selected legal services-providing organizations will be awarded grants to implement LSV. The primary outcome will be the number of Veterans served by LSV in the 12 months after the awarding of the grant. The evaluation has three Aims. Aim 1 will focus on measuring primary and secondary LSV implementation outcomes aligned to RE-AIM. Aim 2 will apply the mixed quantitative-qualitative Matrixed Multiple Case Study method to identify patterns in implementation barriers, enablers, and other i-PARIHS-aligned factors that relate to observed outcomes. Aim 3 involves a mixed-methods economic evaluation to understand the costs and benefits of LSV implementation. Discussion The LSV initiative is a new program that VA is implementing to help Veterans who need legal assistance. To optimize ongoing and future implementation of this program, it is important to rigorously evaluate LSV’s outcomes, barriers and enablers, and costs and benefits. We have outlined the protocol for such an evaluation, which will lead to recommending strategies and resource allocation for VA’s LSV implementation.

Human services

10.1371/journal.pone.0297424

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Citations (1)

Development and validation of machine-learning algorithms predicting retention, overdoses, and all-cause mortality among US military veterans treated with buprenorphine for opioid use disorder

Journal of Addictive Diseases (2024)

Corey J. Hayes Nahiyan Bin Noor Rebecca A. Raciborski Bradley C. Martin Adam J. Gordon

Background Buprenorphine for opioid use disorder (B-MOUD) is essential to improving patient outcomes; however, retention is essential.

Opioid Overdose

10.1080/10550887.2024.2363035

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