Center to Improve Veteran Involvement in Care (CIVIC)
Affiliate Investigators
Jennifer L. Barton, MD, MCR is the Rheumatology Section Chief at the VA Portland Health Care System and Associate Professor of Medicine at Oregon Health & Science University. Her research focuses on patient-clinician communication, shared decision making, and the rheumatic diseases. She is also co-lead of the VISN 20 VA Rheumatology ECHO which began in 2019.
Dr. Barton has received a K23 award from the NIH to examine patient-clinician goal concordance in rheumatoid arthritis. Dr. Barton completed fellowship at University of California, San Francisco, and was an assistant professor at UCSF, where she received a career development award from the American College of Rheumatology to study patient-physician discordance around assessment of disease severity in rheumatoid arthritis, and led the development of a low literacy medication summary guide and decision aid tool for vulnerable populations with RA.
Dr. Barton is currently a co-investigator on three CIVIC projects: "Listening to Gulf War Veterans: A Qualitative Inquiry into the Health Experience and Treatment of those with Chronic Multisymptom Illness" (VA HSR&D grant I01 HX002148-01A@; PI: Helfand); "Patient-Centered Decision Support for Veterans Making Choices About Where to Get Their Health Care: 'Should I Stay or Should I Go?'" (VA HSR&D Research to Impact for Veterans grant; PI: Slatore); and "Adapting Caring Contacts to Counteract Adverse Effects of Social Distancing during COVID-19" (HSR&D grant C19 20-216; PI: Teo).
Incorporating PRO Data Into RA Clinical Encounters Using Health-IT (PACT) (Consultant)
Principal Investigator: Schmajuk
Grant ID: R01 HS025405
STOPGout: Comparative Effectiveness in Gout: Allopurinol v. Febuxostat (Sub-Investigator for VA Portland HCS)
Principal Investigator: O'Dell
Grant ID: CSP#594
Listening to Gulf War Veterans: A Qualitative Inquiry into the Health Experience and Treatment of those with Chronic Multisymptom Illness (Co-Investigator)
Principal Investigator: Mark Helfand
Grant ID: I01 HX002148-01A2
RA Choice 2.0: Update and digitization of a tool to facilitate shared decision making in rheumatoid arthritis (Prinicpal Investigator)
Grant ID: Gerlinger Award
Patient-Centered Decision Support for Veterans Making Choices About Where to Get Their Health Care: "Should I Stay or Should I Go?" (Co-PI)
Principal Investigator: Christopher Slatore
Grant ID: HSR&D Research to Impact for Veterans
You can find a full list of publications at PubMed.
- Liu LH, Garrett SB, Li J, Ragouzeos D, Berrean B, Dohan D, Katz PP, Barton JL, Yazdany J, Schmajuk G. Patient and clinician perspectives on a patient-facing dashboard that visualizes patient reported outcomes in rheumatoid arthritis [published online ahead of print, 2020 Apr 9]. Health Expect. PMID: 32270591
- Decary S, Barton JL, Proulx L, et al. How to Effectively Support Patients with Rheumatic Conditions Now and Beyond COVID-19 [published online ahead of print, 2020 May 13]. ACR Open Rheumatol. 2020;10.1002/acr2.11152.
- Barton JL, Decary S. New galaxies in the universe of shared decision-making and rheumatoid arthritis. Curr Opin Rheumatol. 2020 May;32(3):273-278. PubMed PMID: 32141955.
- Matsumoto RA, England BR, Mastarone G, Richards JS, Chang E, Wood PR, Barton JL. Rheumatology Clinicians' Perceptions of Telerheumatology Within the Veterans Health Administration: A National Survey Study. Mil Med. 2020 Aug 13;. doi: 10.1093/milmed/usaa203. [Epub ahead of print] PubMed PMID: 32789463.
- Desilet LW, England BR, Michaud K, Barton JL, Mikuls TR, Baker JF. Posttraumatic Stress Disorder, Depression, Anxiety, and Persistence of Methotrexate and TNF Inhibitors in Patients with Rheumatoid Arthritis. ACR Open Rheumatol. 2020 Sep 13;. doi: 10.1002/acr2.11175. [Epub ahead of print] PubMed PMID: 32921004.
- Singh JA, Richards JS, Chang E, Toupin-April K, Barton JL. Shared decision-making in gout treatment: a national study of rheumatology provider opinion and practice. Clin Rheumatol. 2020 Sep 30;. doi: 10.1007/s10067-020-05421-9. [Epub ahead of print] PubMed PMID: 32997317.
- Barton JL, Kunneman M, Hargraves I, LeBlanc A, Brito JP, Scholl I, Montori VM. Envisioning Shared Decision Making: A Reflection for the Next Decade. MDM Policy & Practice. In press.
Catherine "Terri" Hough, MD, MSc is the Chief of the Division of Pulmonary and Critical Care Medicine at OHSU, where she is the Edwards Professor of Medicine. Her research focuses on understanding and improving patient-centered outcomes after critical illness, through epidemiologic methods, randomized clinical trials, and implementation science.
Dr. Hough completed fellowship in Pulmonary and Critical Care Medicine at the University of Washington, where she received a Master's in Epidemiology at the School of Public Health. She was awarded an NHLBI funded K23 to develop an inception cohort of patients with the acute respiratory distress syndrome who underwent systematic assessment for neuromuscular dysfunction and other sequelae of critical illness. Currently, she is PI and MPI of multiple NIH funded R01 and U01 awards, including her role as a Principal Investigator for the NHLBI Prevention and Early Treatment of ARDS (PETAL) Network. Additionally, she received an NHLBI K24 mid-career mentorship award, recognizing her commitment to mentorship.
Pacific Northwest Clinical Center for the NHLBI PETAL Network (Multiple-Principal Investigator)
Principal Investigators: Catherine Hough, MD and Bryce Robinson, MD
Grant Source: NIH/NHLBI U01
Effect of randomization to neuromuscular blockade on physical functional impairment and recovery in ARDS (Multiple-Principal Investigator)
Principal Investigators: Catherine Hough, MD, Theodore Iwashyna, MD, and Marc Moss MD
Grant Source: NIH/NHLBI R01
Prediction of Functional Outcomes from Chronic Critical Illness (Multiple-Principal Investigator)
Principal Investigators: Shannon Carson, MD, Catherine Hough, MD, and Ivor Douglas, MD
Grant Source: NIH/NHLBI R01
Optimizing a self-directed mobile mindfulness intervention for improving psychological outcomes after critical illness (Multiple-Principal Investigator)
Principal Investigators: Christopher Cox, MD, Catherine Hough, MD, and Marc Moss, MD
Grant Source: NIH/NHBI U01
Mentored Patient Oriented Research in ARDS and Critical Illness Outcomes (Principal Investigator)
Grant Source: NIH/NHLBI
Barriers to Implementation of Lung Tidal Volume Ventilation in ARDS (Co-Investigator)
Principal Investigator: Curtis Weiss
Grant Source: NIH/NHLBI R01
The PETAL Network COVID-19 Observational Study (CORAL) (Protocol Chair)
Principal Investigator: Taylor Thompson
Grant Source: NIH/NHLBI
A randomized clinical trial self-directed mobile mindfulness intervention for improving distress after COVID-19 (Multiple-Principal Investigator)
Principal Investigators: Chris Coz, Catherine Hough, and Marc Moss
Grant Source: NIH/NHLBI
You can find a full list of publications at her bibliography.
- Olsen HT, Nedergaard HK, Hough CL, Korkmaz S, Jensen HI, Strøm T, Toft P. Non-sedation-Does it improve health-related quality of life after critical illness? A 3-month follow-up sub-study of the NONSEDA trial. Acta Anaesthesiol Scand. 2020 Dec 29. PMID: 33377183
- Self WH, Semler MW, Leither LM, Casey JD, Angus DC, Brower RG, Chang SY, Collins SP, Eppensteiner JC, Filbin MR, Files DC, Gibbs KW, Ginde AA, Gong MN, Harrell FE Jr, Hayden DL, Hough CL, et al. Effect of Hydroxychloroquine on Clinical Status at 14 Days in Hospitalized Patients With COVID-19: A Randomized Clinical Trial. JAMA. 2020 Dec 1;324(21):2165-2176. PMID: 33165621
- Haines KJ, Hibbert E, McPeake J, Anderson BJ, Bienvenu OJ, Andrews A, Brummel NE, Ferrante LE, Hopkins RO, Hough CL, Jackson J, Mikkelsen ME, Leggett N, Montgomery-Yates A, Needham DM, Sevin CM, Skidmore B, Still M, van Smeden M, Collins GS, Harhay MO. Prediction Models for Physical, Cognitive, and Mental Health Impairments After Critical Illness: A Systematic Review and Critical Appraisal. Crit Care Med. 2020 Dec;48(12):1871-1880. PMID: 33060502.
- Ervin JN, Rentes VC, Dibble ER, Sjoding MW, Iwashyna TJ, Hough CL, Ng Gong M, Sales AE. Evidence-Based Practices for Acute Respiratory Failure and Acute Respiratory Distress Syndrome: A Systematic Review of Reviews. Chest. 2020 Dec;158(6):2381-2393 PMID: 32682771.
- Parke S, Hough CL, E Bunnell A. The Feasibility and Acceptability of Virtual Therapy Environments for Early ICU Mobilization. PM R. 2020 Dec;12(12):1214-1221. PMID: 32107863.
- Su H, Dreesmann NJ, Hough CL, Bridges E, Thompson HJ. Factors associated with employment outcome after critical illness: Systematic review, meta-analysis, and meta-regression. J Adv Nurs. 2020 Nov 19. PMID: 33210753.
- Cobb NL, Sathe NA, Duan KI, Seitz KP, Thau MR, Sung CC MD, Morrell ED, Mikacenic C, Kim HN, Liles WC, Luks AM, Town J, Pipavath S, Wurfel MM, Hough CL, West TE, Bhatraju PK. Comparison of Clinical Features and Outcomes in Critically Ill Patients Hospitalized with COVID-19 versus Influenza. Ann Am Thorac Soc. 2020 Nov 13; PMID: 33183067.
- Mikkelsen ME, Still M, Anderson BJ, Bienvenu OJ, Brodsky MB, Brummel N, Butcher B, Clay AS, Felt H, Ferrante LE, Haines KJ, Harhay MO, Hope AA, Hopkins RO, Hosey M, Hough CL, Jackson JC, Johnson A, Khan B, Lone NI, MacTavish P, McPeake J, Montgomery-Yates A, Needham DM, Netzer G, Schorr C, Skidmore B, Stollings JL, Umberger R, Andrews A, Iwashyna TJ, Sevin CM. Society of Critical Care Medicine's International Consensus Conference on Prediction and Identification of Long-Term Impairments After Critical Illness. Crit Care Med. 2020 Nov;48(11):1670-1679. PMID: 32947467.
- Seitz KP, Caldwell ES, Hough CL. Fluid management in ARDS: an evaluation of current practice and the association between early diuretic use and hospital mortality. J Intensive Care. 2020;8:78.7. PubMed PMID: 33062283.
Shannon Nugent, PhD is a core investigator at the VA Portland Healthcare System, Center to Improve Veteran Involvement in Care (CIVIC) and an Assistant Professor at Oregon Health and Science University in the Department of Psychiatry. Dr. Nugent's research interests are in the areas of palliative medicine, psychosocial oncology, chronic pain, evidence synthesis, and improving access to health care for older adults. She is in her second year of a five-year Mentored Research Scholar Grant from the American Cancer Society, "Survivors of Head and Neck Cancer: Optimizing Pain Management." In addition, she is a co-investigator on a VA HSR&D study that aims to qualitatively describe the health experiences of Gulf War Era Veterans. She completed her PhD in Clinical Health Psychology from the University of Colorao Denver in 2015 and completed a two-year health services research fellowship with CIVIC in 2018.
You can contact Shannon Nugent by email at Shannon.Nugent@va.gov.
Listening to Gulf War Era Veterans: A Qualitative Inquiry into the Health Experiences of Veterans with Chronic Multisymptom Illness (Co-Investigator)
Principal Investigator: Mark Helfand
Grant ID: SDR 17-151
Impact of the COVID-19 Pandemic on Patient-Clinician Relationships and the Well-Being of Frontline Clinicians: A Qualitative Study (Co-PI)
Principal Investigator: Shannon Nugent & Kelly Vranas
Grant ID: Local Pilot Funding
You can find a full list of publications at PubMed.
- Kondo K., Morasco BJ, Nugent SM, Ayers C, O’Neil ME, Freeman M, Paynter R, & Kansagara D. (2020). Pharmacotherapy for the treatment of cannabis use disorder: a systematic review. Annals of Internal Medicine, 172(6), pp.398-412.
- Nugent SM, Meghani S, Rogal S, & Merlin J. (2020) Cannabis use among individuals with cancer: An unresolved and timely issue. Cancer, 126 (9), 1832-1836.
- Nugent SM, Golden S, Hooker E, Sullivan D, Thomas C, Deffebach M, Sukumar M, Schipper P, Tieu P, Moghanaki D, Wisnivesky J, Samson P, Robinson C, Slatore C. (2020). Longitudinal Health-Related Quality of Life among Individuals Considering Treatment for Stage I Non-Small Cell Lung Cancer. Annals of American Thoracic Society, 17 (8) 988-997.
- Nugent SM, Freeman M, Ayers CK, Winchell KA, Press A, O’Neil ME, Kansagara D. Gulf War Illness – A Systematic Review of Therapeutic Interventions and Management Strategies. In press, Military Medicine.
Donald Sullivan, MD, MA, MCR is an Associate Professor and Associate Fellowship Program Director in the Department of Medicine, Division of Pulmonary and Critical Care Medicine at Oregon Health and Science University. He received his M.D. from the University of Arizona, and completed residency at the University of Maryland and fellowship at OHSU. His primary research focus is on improving the quality of palliative and end-of-life care among patients with serious illness. Dr. Sullivan is also interested in enhancing comprehensive cancer care among persons diagnosed with lung cancer. Specifically, he is interested in improving patients' and families' outcomes and experiences through advances in the delivery of care as well as patient participation in treatment decision making. He has methodological expertise in mixed-methods, qualitative, and population-based database research. Dr. Sullivan is or has been funded by the National Institutes of Health- National Cancer Institute and National Institute on Aging, American Thoracic Society, American Lung Association, Borchard Foundation, Knight Cancer Institute, Medical Research Foundation, and UPENN Roybal Center. Dr. Sullivan also enjoys providing clinical research mentorship to medical students, residents, fellows, and post-doctoral candidates at OHSU and CIVIC. Dr. Sullivan teaches pulmonary medicine at the OHSU School of Medicine and within the Department of Medicine at OHSU. Clinically, he provides pulmonary and critical care medical services at OHSU.
You can contact Donald Sullivan by email at Donald.Sullivan3@va.gov or at sullivad@ohsu.edu.
Promoting Advance Care Planning Using a Prognosis and Outcome Information Sheet among Persons with Advanced Dementia in Long Term Services and Support Facilities (Principal Investigator)
The goal of this mixed-methods study is to develop, refine, and pilot test an advance care planning intervention among families of persons with advanced dementia.
Grant ID: NIH-NIA P30AG064105
Impact of Specialist Palliative Care on Outcomes in Advanced Stage Lung Cancer (Principal Investigator)
The goal of this study is to determine the impact of palliative care on mortality, healthcare utilization and patient-centered outcomes among advanced stage lung cancer patients in a national healthcare system.
Grant ID: NIH-NCI 1K07CA190706-01A1
A Lung Cancer Treatment Conversation Tool (Principal Investigator)
The goal of this study is to conduct a trial of a computer-based lung cancer treatment conversation tool to engage patients in shared decision making to improve patient-centered outcomes.
Grant ID: ATS Foundation/American Lung Association
Improving Decision Making in Lung Cancer: A Low-Literacy Conversation Tool (Principal Investigator)
The goal of this study is to develop and pilot-test a low-literacy lung cancer treatment conversation tool to engage patients in shared decision making to improve health and decisional outcomes.
Grant ID: MRF-New Investigator Award
Invasive and Non-Invasive Mechanical Ventilation Outcomes in Advancd Dementia (Co-Investigator)
The goal of this study is to determine the use and outcomes of different types of ventilation among advanced dementia patients in a national database.
Principal Investigator: Teno
Grant ID: NIH NIA 1R56AG063748-01
Hospital-level variation in ICU admitting patterns among patients presenting to the emergency department: a mixed-methods approach (Mentor/Co-Investigator)
The goal of this study is to examine variability of ICU utlization among hospitals within the VA Healthcare System for patients to determine aspects of healthcare delivery.
Principal Investigator: Kelly Vranas
Grant ID: NIH NHLBI K12
Palliative Care Interventions for Outpatients Newly Diagnosed with Lung Cancer: Phase II (Co-Investigator)
The purpose of this randomized control trial is to test the efficacy of delivering a nurse-led telephone-based intervention with early provision of palliative care to improve patient-centered outcomes for Veterans with newly diagnosed lung cancer.
Principal Investigator: Reinke
Grant ID: VA Nursing Research NRI 15-456
You can find a full list of publications at his bibliography.
- Medysky ME, Dieckmann NF, Winters-Stone KM, Sullivan DR, Lyons KS. Trajectories of Self-reported Physical Functioning and Symptoms in Lung Cancer Survivors. Cancer Nurs. 2020 Jan 31. PMID: 32022778
- Sullivan DR, Slatore CG. Association of Early Palliative Care With Survival in Patients With Advanced Lung Cancer—Reply. JAMA Oncol. 2020 Jan 16. PMID: 31944220
- Vranas KC, Ouyang D, Lin AL, Slatore CG, Sullivan DR, Kerlin MP, Liu KD, Baron RM, Calfee CS, Ware LB, Halpern SD, Matthay MA, Herridge M, Mehta S, Rogers AJ. Gender Differences in Authorship of Critical Care Literature. Am J Respir Crit Care Med. 2020 Apr 1;201(7):840-847. PMID: 31968182
- Vranas KC, Scott JY, Badawi O, Harhay MO, Slatore CG, Sullivan DR, Kerlin MP. The Association of ICU Acuity with Adherence to Evidence-Based Practices. Chest. 2020 Mar 27:S0012-3692(20)30544-4. PMID: 32229228
- Lee RY, Brumback LC, Sathitratanacheewin A, Lober WB, Modes ME, Lynch YT, Ambrose CI, Sibley J, Vranas KC, Sullivan DR, Engelberg RA, Curtis JR, Kross EK. Association of Physician Orders for Life-Sustaining Treatment with ICU Admission among Patients Hospitalized Near the End of Life. JAMA. 2020, 16;323(10):950-960. PMID: 32062674 PMCID: PMC7042829
- Sahni N, Tourani R, Sullivan D, Simon G. min-SIA: A Lightweight Algorithm to Predict the Risk of 6-Month Mortality at the Time of Hospital Admission. J Gen Intern Med J. 2020 May;35(5):1413-1418. PMID: 32157649 PMCID: PMC7210334
- Nugent SM, Golden SE, Sullivan DR, Thomas CR, Deffebach ME, Sukumar, Schipper PH, Tieu BH, Moghanaki D, Wisnivesky J, Samson P, Robinson C, Slatore CG. Longitudinal Health-Related Quality of Life among Individuals Considering Treatment for Stage I Non-Small Cell Lung Cancer. Ann Am Thorac Soc. 2020 May 20. PMID: 32433897
- Vranas KC Lapidus JA, Ganzini L, Slatore CG, Sullivan DR. Association of Palliative Care Use and Setting with Healthcare Utilization and Quality of Care at the End of Life Among Patients with Advanced Lung Cancer. Chest 2020. Jun 23:S0012-3692(20)31721-9. PMID: 32589949
- Sharm R, Gonzalo P, Dawn H, Sullivan DR, Teno JM. The Black and White of Invasive Mechanical Ventilation in Advanced Dementia. J Am Geriatr Soc (in press)
- Sullivan DR and Curtis JR. A View from the Frontline: Palliative and Ethical Considerations of the COVID-19 Pandemic. J Palliat Med (in press)
- Sullivan DR, Kim H, Gozalo P, Bunker J, Teno JM. Trends in Non-Invasive and Invasive Mechanical Ventilation among Medicare Beneficiaries at the End of Life. JAMA-IM (in press)
- Gutiontov SI, Golden DW, Gunderson L, McCloskey S, Shumway D, Sullivan DR, Wall T, Jagsi R. Informed Consent in Radiation Oncology. Int J Radiat Oncol Biol Phys (in press)
Belle Zaccari, PsyD is an Affiliate Investigator at the VA Portland Health Care System (VAPORHCS), Center to Improve Veteran Involvement in Care (CIVIC), a staff psychologist in the Rural TeleMental Health Clinic of the VAPORHCS, and an Instructor in the Department of Psychiatry at Oregon Health & Science University (OHSU). Her research interests include: telehealth modalities, chronic pain, posttraumatic stress disorder (PTSD), women Veterans, and complementary and integrative health (CIH). Dr. Zaccari currently serves as the site PI for a multi-site RCT comparing psychophysiological and mental health outcomes between groups of Women Veterans receiving trauma sensitive yoga or Cognitive Processing Therapy for treatment of PTSD related to military sexual trauma. She completed her PsyD at Adler University, Chicago in 2014 and completed a two-year advanced research postdoctoral fellowship at the VISN 20 Pacific Northwest Mental Illness Research, Education, and Clinical Center (MIRECC) in Portland, OR in 2016.
Trauma-Sensitive Yoga for Women Veterans with PTSD who Experienced Military Sexual Trauma (Site Principal Investigator)
This RCT investigates a novel approach to treating PTSD symptoms, chronic pain, and insomnia, which appear to be the most intractable symptoms associated with MST and PTSD.
Grant ID: NRI 15-151, HSR&D Merit Review Award
Principal Investigator: Ursula Kelly
You can find a full list of publications at PubMed.
- Zaccari, B., Callahan, M., Storzbach, D., McFarlane, N., Hudson, R., & Loftis, J. (2020). Yoga for Veterans with PTSD: Cognitive Functioning, Mental Health, and Salivary Cortisol. Submitted to Psychological Trauma: Theory, Research, Practice and Policy
