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Center to Improve Veteran Involvement in Care (CIVIC)


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Affiliate Investigators

Khaya Clark, PhD
Khaya D. Clark, PhD

Khaya D. Clark, PhD is a Research Investigator at the National Center for Rehabilitative Auditory Research and Assistant Professor in the Department of Medical Informatics and Clinical Epidemiology at the Oregon Health and Science University (OHSU). In her role as a rehabilitative researcher, Dr. Clark uses implementation science, human factors frameworks, quality improvement models, and qualitative, mixed-methods approaches to understand processes that support, or impede, the implementation of evidence-based practices in VA and Department of Defense rehabilitative settings. Dr. Clark's areas of research include the use of Veterans' health narratives on chronic health conditions to inform research, system improvement, and clinical services related to the provision of tinnitus management, and the implementation of ototoxicity management guidelines (with Dr. Konrad-Martin) in VA and non-VA settings.

Auditory Rehabilitation Needs in COVID-19 Survivors (Collaborator)

SARS-CoV-2, the virus responsible for the COVID-19 infectious disease, is likely to circulate for the foreseeable future. There is a need to understand the short- and long-term consequences of COVID-19 on the auditory system, especially among Veterans who are already at risk for underlying auditory complications, and to conceptualize these within a rehabilitation framework. The objective of this project is to quantitatively examine and qualitatively understand the impact of COVID-19 on Veterans’ auditory function.
Principal Investigator: Reavis
Grant Source: SPiRE

Traumatic Brain Injury Among Veterans (Collaborator)

Principal Investigator: Mark Helfand, MD

Physiological, Behavioral, and Predictive Correlates of Ototoxicity in Humans (Collaborator)

Principal Investigator: Dawn Konrad-Martin, PhD
Grant Source: VA RR&D Merit Award 2019-2024

You can find a full list of publications at PubMed.

  • Clark, K., Garinis, A., & Konrad-Martin, D. (in press). Incorporating patient narratives to enhance audiological care and clinical research outcomes. American Journal of Audiology.
  • Dobscha, S., Clark, K., Newell, S., Kenyon, E., Karras, E., Simonetti, J., & Gerrity, M. (2021). Strategies for discussing firearms storage safety in primary care: Veterans perspectives. Journal of General Internal Medicine, 36(6), 1492-1502
  • Christensen, V., Clark, K., Tallett, S., Kenyon, E., & Dobscha, S. (2021). Integration of patient and clinician narratives into systematic reviews: An applied proof of concept. Journal of Clinical and Translational Science, 5(1). DO1: 10.1017/cts.2021.2
  • Summer, N., Kenyon, E., Clark, K., Elliott, V., Rynerson, A., Gerrity, M., Karras, E., Simonetti, J., & Dobscha, S. (2021). Veterans are agreeable to discussions about firearms safety in primary care. Journal of the American Board of Family Medicine, 34(2), 338-345


Lisa C. Silbert MD, MCR, FAAN
Lisa C. Silbert MD, MCR, FAAN

Lisa C. Silbert, MD, MCR, FAAN, is a Professor in the Department of Neurology at Oregon Health & Science University (OHSU) School of Medicine, Director of the Neuroimaging Core at the Oregon Aging and Alzheimer's Disease Research Center, and Director of the Cognitive Care Clinic at the VA Portland Health Care System. She completed her neurology residency at UCLA and fellowship training in both Geriatric Neurology and Clinical Neuropysiology at OHSU. Dr. Silbert's clinical practice consists primarily of patients with neurodegenerative disease affecting cognitive function, and intraoperative neurophysiological monitoring.

Dr. Silbert's primary research interest is to identify the principal and contributory causes of older onset dementia, and establish unique biomarkers for which diagnostic tests, treatment, and prevention studies can be conducted. Her research has focused on the effects of cerebral white matter ischemic change on cognitive and motor function in the elderly. Her studies include investigations of how differing rates of white matter damage affect cognition, how changes in cerebral blood flow and microstructural white matter integrity impact expansion of white matter hyperintensity lesions, and the utilization of post-mortem high field MRI for targeted histopathological characterization of small vessel cerebrovascular disease. Dr. Silbert has additional research interests in the use of home-based technologies to detect cognitive impairment in older individuals. She has received funding for this work from the Veterans Affairs (HSR&D), Alzheimer's Association, the American Academy of Neurology Foundation, and the NIH/NIA, including a K23/Paul B. Beeson career development award in aging research and R01s.

Impact of Social Distancing During the COVID-19 Pandemic on Cognitive, Physical, and Mental Health in Urban and Rural Veterans in the Pacific Northwest (Principal Investigator)

The primary aims of this study are: 1) To examine whether there are changes in weekly reported social activities during the COVID-19 pandemic social distancing mandate and whether changes are associated with reports of greater physical and mental illness; 2) To determine which factors (i.e. rurality, marriage) work as buffers between social isolation and its negative effect of physical and psychological state; and 3) To determine which home-based digital biomarkers (i.e. sleep duration, daily step count) are associated with physical and psychological distress.
Grant ID: HSR&D COVID-19 Rapid Response Supplement

White matter hyperintensity-associated astrocytopathy in Alzheimer’s disease and vascular cognitive impairment: A targeted histopathologic study using postmortem 7T MRI (Co-Principal Investigator)

The goal of this project is to investigate how cerebrovascular disease, manifested as white matter hyperintensities, is associated with changes in astroglial phenotypes and that these changes contribute both to white matter injury and to regionally associated AD pathologies.
Principal Investigator: Silbert and Woltjer
Grant ID: NIH/NIA R01AG056712

ORCATECH Collaborative Aging (in Place) Research Using Technology (CART) (Site Principal Investigator)

The ORCATECH Collaborative Aging (in Place) Research Using Technology (CART) program develops and validates an infrastructure for rapid and effective conduct of research utilizing technology to facilitate aging in place (AiP).
Principal Investigator: Kaye
Grant ID: NIH/NIA U2C AG054397

Alzheimer’s Disease Neuroimaging Initiative-3 (ADNI 3) (Site Principal Investigator)

The purpose of this observational study is to determine the relationships among clinical, cognitive, imaging, genetic, and biomarker characteristics of the entire spectrum of Alzheimer's disease as it progresses from a preclinical stage to very mild symptoms to mild cognitive impairment (MCI) to dementia. Participants sought include those with normal cognition, MCI, or mild Alzheimer's dementia.
Principal Investigator: Weiner
Grant ID: NIH/NIA U01 79634019

Oregon Alzheimer’s Disease Research Center (Co-Investigator; Clinical Core Neurologist; Neuroimaging Core Lead; Co-Associate Director)

The goal is to facilitate AD research by providing core resources for clinical and basic research, fostering interdisciplinary collaboration, sharing resources and expertise, mentoring new professionals, raising awareness and providing education. Cores: Administrative, Clinical, Data, Biomarkers, Neuropathology, Outreach Recruitment & Education, Neuroimaging, and Digital Technology; Research Education Component.
Principal Investigator: Kaye
Grant ID: P30AG066518

Conversational Engagement as a Means to Delay Alzheimer’s Disease Onset: Phase II (Co-Investigator)

The goal is to examine conversational engagement as a means to improve cognitive functions among subjects aged 80 and older without Mild Cognitive Impairment and limited opportunities of social interactions.
Principal Investigator: Dodge
Grant ID: NIH/NIA R01AG051628

Web-enabled social interaction to delay cognitive decline among seniors with MCI: Phase I (Co-Investigator)

The goal of this project is to examine conversational engagement as a means to improve cognitive functions amount subjects aged 80 and older with Mild Cognitive Impairment and limited opportunities for social interactions.
Principal Investigator: Dodge
Grant ID: NIH/NIA R01AG056102

Anti-amyloid treatment in asymptomatic Alzheimer’s disease (A4 Study) (Site Co-Investigator)

The A4 trial will treat clinically normal older individuals who have evidence that the process of AD has already begun in their brain, in the hope that we can delay the onset of memory problems and progression to AD dementia.
Principal Investigator: Sperling
Grant ID: NIH/NIA 5U19AG010483-26

Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN Study) (Site Co-Investigator)

The primary aim of this study is to characterize the longitudinal change on the cognitive, clinical, and biomarker measures used in the A4 trial in Abeta negative individuals in comparison to the Abeta A4 placebo arm individuals.
Principal Investigator: NIH/NIA U19AG010483
Grant ID:

Alzheimer’s Clinical Trials Consortium (ACTC) (Site Associate Investigator)

This proposal aims aim to create an optimized infrastructure to optimally design, efficiently launch, rapidly recruit with improved diversity, and successfully complete NIH supported clinical trials in AD and related dementias.
Principal Investigator: Aisen, Sperling, Peterson
Grant ID: NIH/NIA U24AG057437

You can find a full list of publications at PubMed.

  • Juan Piantino; Erin L. Boespflug; Daniel L. Schwartz; Madison Luther; Angelica M. Morales; Amber Lin; Ryan Van Fossen; Lisa Silbert; Bonnie J. Nagel. Link between mild traumatic brain injury, poor sleep, and MRI-visible perivascular spaces in Veterans. Journal of Neurotrauma, In Press. 2021


Vanessa Somohano, MA, PhD
Vanessa Somohano, MA, PhD

Vanessa C. Somohano, MA, PhD, is a CIVIC Affiliate Junior Investigator and Affiliate Professor at Pacific University, School of Graduate Psychology. Her primary research interests involve understanding mechanisms maintaining comorbid PTSD and substance use disorder (PTSD-SUD), and ways to adapt and improve interventions for this comorbidity within marginalized populations. She completed her PhD at Pacific University in 2020 and was the recipient of an R36 dissertation award through the National Institute on Drug Abuse, through which she conducted a pilot randomized-controlled trial of a trauma-integrated adaptation of mindfulness-based relapse prevention for women with PTSD-SUD. After completing her pre-doctoral internship at the Southern Oregon VA, she accepted a postdoctoral position in the VA's NW Mental Illness Research, Education, and Clinical Centers (NW MIRECC) program. During her fellowship, she was awarded an HSR&D SWIFT award to analyze VA electronic health record data on rates and predictors of evidence-based psychotherapy utilization for PTSD among those with comorbid SUD. Her research also focuses on identifying gender differences in risk factors for worsening PTSD, substance use, and suicide outcomes in Veterans over time; understanding women-relevant mechanisms underlying interventions for PTSD-SUD, and investigating culturally-relevant adaptations to mindfulness-based interventions for substance use disorders for racial and ethnic minorities.

Suicide Prevention Trials Repository (Junior Investigator/Mentee)

The aims of this diversity supplement are to: 1) identify gender differences in risk profiles at the individual-, relational-, community-, and systemic-level among Veterans who have worsening PTSD, substance use, and suicidality over time, and 2) identify women-relevant mechanisms underlying interventions for comorbid PTSD and substance use disorder.
Principal Investigator: Lauren Denneson
Grant Source: VA CSR&D, Diversity Supplement

Rates and predictors of evidence-based psychotherapy (EBP) utilization and outcomes for veterans with comorbid PTSD and substance use disorder (Principal Investigator)

The aims of this study are twofold: 1) compare rates of EBP initiation, completion and PTSD symptom change in veterans with comorbid PTSD-SUD vs. PTSD only, and 2) identify health services and patient characteristic predictors of EBP initiation, completion, and PTSD symptom change among individuals with comorbid PTSD-SUD.
Grant Source: VA HSR&D SWI 21-002

Advanced fellowship program in mental illness research and treatment (Fellow)

Identify patient characteristics and health-service factors associated with EBP utilization and outcomes among Veterans with comorbid PTSD and substance use disorder. Assess mechanisms underlying a trauma integrated mindfulness-based intervention adapted for women with comorbid PTSD and substance use disorder.
Principal Investigator: Tsukuda and Boehnlein
Grant Source: VA NW MIRECC

You can find a full list of publications at PubMed.

  • Kaplan, J., Somohano, V.C., Eddy, A., Oken, B., & Wahbeh, H. (2022) Mindful non-reactivity moderates the relationship between posttraumatic stress disorder ad depression. Journal of Loss and Trauma, 1 – 15.
  • Somohano, V.C., Shank, T., Manuel, J., Mallik, D., Rehder, K., & Bowen, S. (2021). The role of pre-treatment expectancies on substance use outcomes in women mandated to Mindfulness-Based Relapse Prevention. Journal of Alternative and Complementary Medicine. Advanced online publication. doi: 10.1089/acm.2021.0123
  • Bowen, S., Dingle, T., Laue, C., Mallik, D., & Somohano, V.C. (2021). Overlaying Buddhist and Behaviorist lenses to better understand and address human suffering. Spirituality in Clinical Practice. Advance online publication. doi: 10.1037/scp0000275
  • Mallik, D., Kaplan, J., Somohano, V.C., Bergman, A., & Bowen, S. (2021). Examining the role of craving, mindfulness, and psychological flexibility in a sample of individuals with substance use disorder. Substance Use & Misuse. doi: 10.1080/10826084.2021.1899220


Donald Sullivan MD, MA, MCR
Donald Sullivan MD, MA ,MCR

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, the American Cancer Society, 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 or at

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

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

Palliative Care for Patients with Chronic Respiratory Disease (Principal Investigator)

The goal of this project is to improve the quality of care and quality of life among patients with respiratory disease by developing a joint-society taskforce that will create a comprehensive policy-statement.
Grant ID: Cambia Sojourns Scholar Award

You can find a full list of publications at his bibliography.

  • Vranas KC, Plinke W, Bourne D, Kansagara D, Lee RY, Kross EK, Slatore CG, Sullivan DR. The Influence of POLST on Treatment Intensity at the End of Life: A Systematic Review. J Am Geriatr Soc. 2021 (in press)
  • Vranas K, Golden S, Mathews K, Schutz A, Valley T, Duggal A, Seitz K, Chang S, Nugent S, Slatore CG, Sullivan DR, Hough CL, The Influence of the COVID-19 Pandemic on ICU Organization, Care Processes, and Frontline Clinician Experiences: A Qualitative Study. Chest. 2021 May 29, PMID: 34062115
  • Jia Z, Leiter RE, Sanders JJ, Sullivan DR, Gozalo P, Bunker JN, Teno JM. Asian American Medicare Beneficiaries Disproportionately Receive Invasive Mechanical Ventilation When Hospitalized at the End-of-Life. J Gen Intern Med. 2021 PMID: 33904035
  • Sullivan DR, Medysky ME, Tyzik AL, Dieckmann NF, Denfeld QE, Winters-Stone K. Feasibility and Potential Benefits of Partner-Supported Yoga on Psychosocial and Physical Function among Lung Cancer Patients. 2021 May;30(5):789-793. PMID: 33452752


Belle Zaccari, PsyD
Belle Zaccari, PsyD

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 Assistant Professor 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 is the PI on a Learning Health Systems K12 targeting CIH approaches for pain and PTSD in rural Veterans. 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.

NW Center of Excellence & K12 in Patient Centered Learning Health Systems Science (Scholar)

The aims of this program are to recruit, train, and support 5 scholars at all times to become our nation’s leaders and innovators in learning health systems science; prepare scholars to design, implement, and disseminate patient-engaged, evidence-based, real-world research projects to ensure the uptake of research into improvements in health, health decision-making, and health care systems; and convene a cross-systems collaborative to promote cross-institutional scholar interactions, cooperative sharing of curricula, methodological advances, and promote multi-site project opportunities.
Principal Investigator: Guise, Savitz
Grant ID: K12 HS026370

Collaborative Telepain Care for Rural Veterans (Co-Investigator)

The goal of this pilot intervention trial is to examine the feasibility and acceptability of a nurse care manager-led pain care coordination intervention delivered via telehealth to improve clinical outcomes in patients with chronic pain.
Principal Investigator: Travis Lovejoy
Grant ID: ORH-15531

Virtual Yoga for Social Isolation and loneliness in Rural Veterans (Co-Investigator)

This project aims to understand how to expand access to rural Veterans through virtual yoga group classes, while simultaneously evaluating fidelity of the intervention using sensor technology and addressing underlying issues of social isolation and loneliness in the target population.
Principal Investigator: Alan Teo
Grant Source: VHA VRHRC-Portland FY22

You can find a full list of publications at PubMed.

  • Zaccari, B., Sherman, A.D.F., Febres-Cordero, S., Higgins, M., & Kelly, U. (under review). Findings from a pilot study of trauma-sensitive yoga for PTSD in women veterans who experienced military sexual trauma
  • Zaccari, B., Sherman, A.D.F., Kelly, U.A. (under review). Trauma sensitive yoga vs. Cognitive Processing Therapy for women veterans with PTSD who experienced military sexual trauma: A feasibility study