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Book: Fields of combat

Finley, Erin P.

understanding PTSD among veterans of Iraq and Afghanistan

(The culture and politics of health care work)

2011

Author's details	Erin P. Finley
Series title	The culture and politics of health care work
Keywords	Combat Disorders ; Veterans / psychology ; Veterans Health ; Iraq War, 2003 ; Afghan Campaign 2001 ; History, 21st Century ; United States
Subject code	616.85/212
Language	English
Size	XIII, 221 S. : Ill., 25 cm
Publisher	ILR Press
Publishing place	Ithaca u.a.
Publishing country	United States
Document type	Book
Note	Fourth of July : a tradition of service in San Antonio -- War stories : case studies of combat deployment -- Home again : early experiences of post-deployment stress -- Of men and messages : how everyday cultural influences affect living with PTSD -- Clinical histories : from soldier's heart to PTSD -- Under pressure : military socialization and stigma -- Embattled : the politics of PTSD in VA mental health care -- Navigation : identity and social relations in treatment seeking and recovery ; Includes bibliographical references and index
HBZ-ID	HT017411906
ISBN	978-0-8014-4980-2 ; 0-8014-4980-4
Database	Catalogue ZB MED Medicine, Health

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Article: The Feasibility of Using Point of Care Ultrasound as a Visual Substitute for Physical Examination During Telehealth Visits: A Pilot Project.

Passero, Vida C / Conley, Nicole / Finley, Erin P / Schott, Christopher Kevin

Journal of patient experience

2024 Volume 11, Page(s) 23743735231224516

Abstract: Telehealth provides greater opportunity for specialty access but lacks components of the physical exam. Point-of-care ultrasound (POCUS) may assist telehealth as a visual substitute for the provision of palpation. We conducted a prospective observational ...

Abstract	Telehealth provides greater opportunity for specialty access but lacks components of the physical exam. Point-of-care ultrasound (POCUS) may assist telehealth as a visual substitute for the provision of palpation. We conducted a prospective observational pilot project to survey oncologists about (1) their expectations of POCUS, (2) their use of POCUS in oncology telehealth visits, and (3) post-project assessment of their experiences. The results of the pre-assessment survey showed an interest among the oncologists in the ability to evaluate structures remotely via POCUS. POCUS was utilized in 6.4% of visits, most commonly for lymph node assessment (60% of use). POCUS was not utilized most often due to not being applicable to the patient's visit. There were 14 instances of technical issues limiting views of the relevant anatomy reported. Oncologists rated the use of POCUS as very satisfied or satisfied in the vast number of recorded responses. This pilot study suggests POCUS can be integrated into oncology telehealth visits for specific applications such as lymph node assessment. The surveys indicated a potential interest and positive responses that provide for the foundation of expansion to subspecialty care access for patients with telehealth supported by POCUS.
Language	English
Publishing date	2024-01-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2857285-3
ISSN	2374-3743 ; 2374-3735
ISSN (online)	2374-3743
ISSN	2374-3735
DOI	10.1177/23743735231224516
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Article ; Online: Facilitators of and barriers to gastric cancer and precursor diagnosis among South Texas residents: Social determinants of health.

Parma, Dorothy Long / Finley, Erin P / Fernandez, Roman / Gelfond, Jonathan A L / Ramirez, Amelie G

Cancer medicine

2024 Volume 13, Issue 6, Page(s) e7002

Abstract: Background: Latinos/Hispanics are at higher risk for developing gastric cancer (GC) compared with non-Hispanic whites, and social determinants of health (SDoH) are thought to contribute.: Aims/materials and methods: This study addressed SDoH and ... ...

Abstract	Background: Latinos/Hispanics are at higher risk for developing gastric cancer (GC) compared with non-Hispanic whites, and social determinants of health (SDoH) are thought to contribute. Aims/materials and methods: This study addressed SDoH and their interactions contributing to disparities in the testing and treatment of Helicobacter pylori (HP) infection and diagnosis of GC and its known precursors, among Latinos/Hispanics relative to non-Latinos at two affiliated but independent health systems in San Antonio, Texas, using a mixed methods approach. Results: Secondary data abstraction and analysis showed that GCs represented 2.6% (n = 600) of our population. Men and older individuals were at higher GC risk. Individuals with military insurance were 2.7 times as likely to be diagnosed as private insurance. Latinos/Hispanics had significantly (24%) higher GC risk than Whites. Poverty and lack of insurance contributed to GC risk among the minorities classified as other (Asians, Native Americans, Multiracial; all p < 0.01). All SDoH were associated with H. pylori infection (p < 0.001). Qualitative analysis of patient and provider interviews showed providers reporting insurance as a major care barrier; patients reported appointment delays, and lack of clinic staff. Providers universally agreed treatment of H. pylori was necessary, but disagreed on its prevalence. Patients did not report discussing H. pylori or its cancer risk with providers. Discussion/conclusion: These data indicate the importance of considering SDoH in diagnosis and treatment of GC and its precursors, and educating providers and patients on H. pylori risks for GC.
MeSH term(s)	Male ; Humans ; Stomach Neoplasms/diagnosis ; Stomach Neoplasms/epidemiology ; Stomach Neoplasms/therapy ; Texas/epidemiology ; Social Determinants of Health ; Hispanic or Latino ; Helicobacter Infections/diagnosis ; Helicobacter Infections/epidemiology ; White
Language	English
Publishing date	2024-03-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2659751-2
ISSN	2045-7634 ; 2045-7634
ISSN (online)	2045-7634
ISSN	2045-7634
DOI	10.1002/cam4.7002
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Article ; Online: A structured approach to modifying an implementation package while scaling up a complex evidence-based practice.

Cordasco, Kristina M / Gabrielian, Sonya E / Barnard, Jenny / Harris, Taylor / Finley, Erin P

Health services research

2024

Abstract: Objective: To describe a structured, iterative, data-driven approach for modifying implementation strategies for a complex evidence-based practice during a nationwide scale-up initiative.: Data sources and study setting: We scaled-up implementation ... ...

Abstract	Objective: To describe a structured, iterative, data-driven approach for modifying implementation strategies for a complex evidence-based practice during a nationwide scale-up initiative. Data sources and study setting: We scaled-up implementation of Critical Time Intervention (CTI)-an evidence-based case management model-across 32 diverse community-based Veterans Affairs (VA) "Grant and Per Diem" case management (GPD-CM) agencies that serve homeless-experienced Veterans transitioning to independent living. Primary data were collected using qualitative methods. Study design: We embarked on a scale-up initiative while conducting a pragmatic randomized evaluation using a roll-out design, comparing two versions of a CTI implementation package tailored to VA's GPD-CM program. We iteratively assessed contextual factors and implementation outcomes (e.g., acceptability); findings informed package modifications that were characterized using the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies. Data collection methods: We conducted semi-structured interviews with Veterans, GPD-CM staff, and liaising VA clinicians; periodic reflections with liaising VA clinicians and implementation team members; and drew upon detailed meeting notes. We used rapid qualitative methods and content analysis to integrate data and characterize modifications. Principal findings: After each scale-up wave-in response to variations in agency-level characteristics- we made iterative modifications to the implementation package to increase CTI adoption and fidelity across the diverse contexts of our scale-up sites. Modifications included adding, deleting, integrating, and altering the package; core package components were preserved. Conclusions: Implementation packages for complex evidence-based practices undergoing scale-up in diverse contexts may benefit from iterative modifications to optimize practice adoption with fidelity. We offer a structured, pragmatic approach for iteratively identifying data-driven, midstream implementation package adjustments, for use in both VA and non-VA scale-up initiatives. Our project demonstrates the importance of assessing for and making modifications in a scale-up initiative, as well as the trade-offs of projects having simultaneous formative and summative evaluation aims.
Language	English
Publishing date	2024-05-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	410435-3
ISSN	1475-6773 ; 0017-9124
ISSN (online)	1475-6773
ISSN	0017-9124
DOI	10.1111/1475-6773.14313
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Article ; Online: Editorial: The theory and pragmatics of power and relationships in implementation.

Finley, Erin P / Closser, Svea / Sarker, Malabika / Hamilton, Alison B

Frontiers in health services

2023 Volume 3, Page(s) 1168559

Language	English
Publishing date	2023-03-23
Publishing country	Switzerland
Document type	Editorial
ISSN	2813-0146
ISSN (online)	2813-0146
DOI	10.3389/frhs.2023.1168559
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Article ; Online: Evidence-Based Intervention Adaptations Within the Veterans Health Administration: a Scoping Review.

Kroll-Desrosiers, Aimee / Finley, Erin P / Hamilton, Alison B / Cabassa, Leopoldo J

Journal of general internal medicine

2023 Volume 38, Issue 10, Page(s) 2383–2395

Abstract: Background: Veterans receiving care within the Veterans Health Administration (VA) are a unique population with distinctive cultural traits and healthcare needs compared to the civilian population. Modifications to evidence-based interventions (EBIs) ... ...

Abstract	Background: Veterans receiving care within the Veterans Health Administration (VA) are a unique population with distinctive cultural traits and healthcare needs compared to the civilian population. Modifications to evidence-based interventions (EBIs) developed outside of the VA may be useful to adapt care to the VA healthcare system context or to specific cultural norms among veterans. We sought to understand how EBIs have been modified for veterans and whether adaptations were feasible and acceptable to veteran populations. Methods: We conducted a scoping review of EBI adaptations occurring within the VA at any time prior to June 2021. Eligible articles were those where study populations included veterans in VA care, EBIs were clearly defined, and there was a comprehensive description of the EBI adaptation from its original context. Data was summarized by the components of the Framework for Reporting Adaptations and Modifications to Evidence-based interventions (FRAME). Findings: We retrieved 922 abstracts based on our search terms. Following review of titles and abstracts, 49 articles remained for full-text review; eleven of these articles (22%) met all inclusion criteria. EBIs were adapted for mental health (n = 4), access to care and/or care delivery (n = 3), diabetes prevention (n = 2), substance use (n = 2), weight management (n = 1), care specific to cancer survivors (n = 1), and/or to reduce criminal recidivism among veterans (n = 1). All articles used qualitative feedback (e.g., interviews or focus groups) with participants to inform adaptations. The majority of studies (55%) were modified in the pre-implementation, planning, or pilot phases, and all were planned proactive adaptations to EBIs. Implications for d&i research: The reviewed articles used a variety of methods and frameworks to guide EBI adaptations for veterans receiving VA care. There is an opportunity to continue to expand the use of EBI adaptations to meet the specific needs of veteran populations.
MeSH term(s)	Humans ; Veterans Health ; Delivery of Health Care ; Veterans/psychology ; Mental Health ; Evidence-Based Medicine/methods
Language	English
Publishing date	2023-05-30
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural
ZDB-ID	639008-0
ISSN	1525-1497 ; 0884-8734
ISSN (online)	1525-1497
ISSN	0884-8734
DOI	10.1007/s11606-023-08218-z
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Article ; Online: Reprint of: Qualitative methods in implementation research: An introduction.

Hamilton, Alison B / Finley, Erin P

Psychiatry research

2019 Volume 283, Page(s) 112629

Abstract: Qualitative methods are a valuable tool in implementation research because they help to answer complex questions such as how and why efforts to implement best practices may succeed or fail, and how patients and providers experience and make decisions in ... ...

Abstract	Qualitative methods are a valuable tool in implementation research because they help to answer complex questions such as how and why efforts to implement best practices may succeed or fail, and how patients and providers experience and make decisions in care. This article orients the novice implementation scientist to fundamentals of qualitative methods and their application in implementation research, describing: 1) implementation-related questions that can be addressed by qualitative methods; 2) qualitative methods commonly used in implementation research; 3) basic sampling and data collection procedures; and 4) recommended practices for data analysis and ensuring rigor. To illustrate qualitative methods decision-making, a case example is provided of a study examining implementation of a primary care-based collaborative care management model for women Veterans with anxiety, depression, and PTSD.
Language	English
Publishing date	2019-11-14
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	445361-x
ISSN	1872-7123 ; 1872-7506 ; 0925-4927 ; 0165-1781
ISSN (online)	1872-7123 ; 1872-7506
ISSN	0925-4927 ; 0165-1781
DOI	10.1016/j.psychres.2019.112629
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Article ; Online: Qualitative methods in implementation research: An introduction.

Hamilton, Alison B / Finley, Erin P

Psychiatry research

2019 Volume 280, Page(s) 112516

Abstract	Qualitative methods are a valuable tool in implementation research because they help to answer complex questions such as how and why efforts to implement best practices may succeed or fail, and how patients and providers experience and make decisions in care. This article orients the novice implementation scientist to fundamentals of qualitative methods and their application in implementation research, describing: 1) implementation-related questions that can be addressed by qualitative methods; 2) qualitative methods commonly used in implementation research; 3) basic sampling and data collection procedures; and 4) recommended practices for data analysis and ensuring rigor. To illustrate qualitative methods decision-making, a case example is provided of a study examining implementation of a primary care-based collaborative care management model for women Veterans with anxiety, depression, and PTSD.
MeSH term(s)	Adult ; Biomedical Research/methods ; Female ; Humans ; Qualitative Research ; Stress Disorders, Post-Traumatic/diagnosis ; Stress Disorders, Post-Traumatic/psychology ; Stress Disorders, Post-Traumatic/therapy ; Veterans/psychology
Language	English
Publishing date	2019-08-10
Publishing country	Ireland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	445361-x
ISSN	1872-7123 ; 1872-7506 ; 0925-4927 ; 0165-1781
ISSN (online)	1872-7123 ; 1872-7506
ISSN	0925-4927 ; 0165-1781
DOI	10.1016/j.psychres.2019.112516
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Article ; Online: Emergence of probable PTSD among U.S. veterans over the military-to-civilian transition.

Copeland, Laurel A / Finley, Erin P / Rubin, Miriam L / Perkins, Daniel F / Vogt, Dawne S

Psychological trauma : theory, research, practice and policy

2022 Volume 15, Issue 4, Page(s) 697–704

Abstract: Objective: Despite theorizing that posttraumatic stress disorder (PTSD) symptomatology may be exacerbated during the military-to-civilian transition, little research has delved into the trajectory of trauma-related symptomatology or the impact of ... ...

Abstract	Objective: Despite theorizing that posttraumatic stress disorder (PTSD) symptomatology may be exacerbated during the military-to-civilian transition, little research has delved into the trajectory of trauma-related symptomatology or the impact of diverse factors on timing of PTSD onset. To understand risk and protective factors for PTSD during the transition into civilian life, this study examined demographic, experiential, and psychosocial characteristics that may explain variation in PTSD symptoms and timing of onset. Method: A nationwide sample representing 48,965 U.S. veterans separating from military service in fall 2016 responded to six Web-based surveys over 3 years. Assessments included PTSD symptoms, stress, warfare exposures, military sexual trauma, moral injury events, resilience, and social support. Multivariable models estimated covariates of positive PTSD screen or symptoms. Results: Trauma exposure during military service was high at 59%. Probable PTSD was detected in 26% of the sample at baseline, with additional cases in each survey wave for an overall rate of 30%. Meeting criteria for probable PTSD covaried with current stress, female gender, and minority race/ethnicity; baseline psychological resilience and concurrent social support mitigated the risk. PTSD symptoms correlated positively with stress levels at current and previous time points. Social support was protective but only when contemporaneous with the PTSD symptoms. Conclusions: This study illustrates the need for ongoing social support for veterans coping with symptoms of PTSD, life stressors, and postmilitary trauma, suggesting a countervailing influence of psychological resilience and contemporaneous (but not historical) social support on symptom exacerbation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
MeSH term(s)	Humans ; Female ; Veterans/psychology ; Stress Disorders, Post-Traumatic/psychology ; Military Personnel/psychology ; Adaptation, Psychological ; Resilience, Psychological
Language	English
Publishing date	2022-08-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2497028-1
ISSN	1942-969X ; 1942-9681
ISSN (online)	1942-969X
ISSN	1942-9681
DOI	10.1037/tra0001329
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Article ; Online: Utilizing PRISM and RE-AIM to implement and evaluate the Rural Telementoring Training Center (RTTC) for health care workforce development in rural communities.

Melhado, Trisha V / Schneegans, Suyen / Rochat, Andrea / Kawasaki, Keito / Finley, Erin P / Wheeler, Denna / Allison, Waridibo E

Frontiers in health services

2023 Volume 3, Page(s) 1219308

Abstract: Introduction: Amid rural health worker shortages and hospital closures, it is imperative to build and maintain the local workforce. Telementoring (TM) or technology-enabled mentoring, is a tool for improving health care quality and access by increasing ... ...

Abstract	Introduction: Amid rural health worker shortages and hospital closures, it is imperative to build and maintain the local workforce. Telementoring (TM) or technology-enabled mentoring, is a tool for improving health care quality and access by increasing workforce capacity and support. The national Rural Telementoring Training Center (RTTC) was developed to compile and disseminate TM best practices by delivering free training, tools, and technical assistance to support the implementation, sustainability, and evaluation of new and current TM programs for rural health workers. This paper details how the Practical, Robust Implementation and Sustainability Model (PRISM) was used to understand the context that shaped implementation as well as how Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) was concurrently applied to frame outcomes. Methods: The RTTC has three implementation strategies: outreach, training and technical assistance (TTA), and a Quality Measure Toolkit. Ongoing periodic reflections with the RTTC team, informed by PRISM, were collected, as were RE-AIM outcomes. Central to this design was the continuous review of incoming data in team meetings to inform programmatic changes by identifying challenges and applying modifications to strategies in real time. Results: Major implementation changes discussed during reflections included providing timely and relevant messaging through various platforms, streamlining and customizing a TTA approach, and offering different options for accessing the Toolkit. The outreach strategy resulted in high Reach across the US, with over 300 organizations contacted. The effectiveness of the RTTC was demonstrated by counts of people engaging with outreach (ex. over 8,300 impressions on LinkedIn), the website (over 6,400 views), and e-bursts (33% open rate). Moreover, there were 32 TTA requests and 70 people accessing the Toolkit. Adoption was demonstrated by 27 people participating in TTA and 14 individuals utilizing the Toolkit. Discussion: The integration of PRISM and RE-AIM frameworks promoted a holistic implementation and evaluation plan. Using PRISM, the RTTC team was able to reflect on the implementation strategies through the lens of contextual factors and make rapid programmatic changes within team meetings. That process resulted in outcomes framed by RE-AIM. The integration of two frameworks in tandem provided an adaptive and comprehensive approach to implementing a large-scale, national program.
Language	English
Publishing date	2023-10-19
Publishing country	Switzerland
Document type	Journal Article
ISSN	2813-0146
ISSN (online)	2813-0146
DOI	10.3389/frhs.2023.1219308
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