Bedford

Researchers are evaluating a brief, values-based behavioral intervention to support Veterans with opioid use disorder OUD who are in early buprenorphine treatment. The goal is to improve interpersonal functioning, community reintegration, and quality of life during early medication treatment. The project follows the NIH Stage Model for Behavioral Intervention Development and includes phases for treatment development, pilot testing, and a pilot randomized controlled trial. The intervention consists of four weekly 50-minute sessions focused on values clarification, understanding the connection between values and addiction treatment engagement, addressing barriers and goal setting, and planning recovery. Phase 1 develops and refines the manual using interviews with Veterans and providers. Phase 2 tests the intervention in an open trial with 10 Veterans to refine the treatment and study procedures. Phase 3 involves a pilot trial with 40 Veterans receiving the finalized intervention, assessing feasibility and preliminary effects. Participants will engage in scheduled assessments at baseline, post-treatment, and follow-ups at 3 and 6 months. Assessments include measures of interpersonal functioning, social support, quality of life, substance use, and treatment adherence. Study therapists adherence and competence will be monitored. Data will be securely managed, and participant feedback will guide further refinements. The study period spans multiple years, supporting treatment development and evaluation.

Chronic pain is a common and serious issue, especially among Veterans who experience it at higher rates than the general population. This research compares two online pain management programs designed to help Veterans with chronic pain improve their daily functioning and quality of life. The study focuses on Acceptance and Commitment Therapy for Chronic Pain ACT-CP delivered digitally, which targets emotional and cognitive aspects of pain and has shown promise in previous research. Participants will be randomly assigned to one of two seven-week online programs. One group will use Veteran ACT for Chronic Pain VACT-CP, guided by an interactive virtual coach called Coach Anne, featuring interactive text conversations, videos, and goal-setting exercises. The other group will participate in Online Pain School, an active control program providing educational videos and behavioral exercises for pain management. Both interventions consist of weekly modules lasting about 15 minutes each. Throughout and after the treatment period, participants will complete surveys at week 7, 3 months, and 6 months to provide feedback and measure outcomes related to pain intensity, functioning, quality of life, psychological flexibility, and satisfaction. Researchers will monitor usability and the impact on mental and physical health, aiming to understand how these programs support Veterans pain management over time.

This research aims to develop and test a telehealth-delivered behavioral activation program called ACTIVaTE to support physical, cognitive, and social functioning in older Veterans at risk of losing their independence. The study focuses on community-dwelling older Veterans receiving VA primary care who face the risk of functional decline. The program is based on an evidence-based brief psychosocial intervention that helps individuals increase engagement in meaningful activities aligned with their values. The study includes three main parts first, adapting an existing behavioral activation model for Veterans and telehealth use second, testing the program with 10 Veterans to gather feedback and improve it and third, conducting a randomized controlled trial comparing ACTIVaTE to usual care with 48 Veterans. The ACTIVaTE intervention involves six sessions delivered by a psychology trainee via video telehealth, covering education, activity monitoring, values exploration, and planning to maintain functional independence. Participants in usual care will receive educational materials on maintaining activity and resources. Participants will be assessed at the start, and at 6 to 12 weeks, with measures including physical, cognitive, and social functioning tools like the Ambulatory Measure for Post-Acute Care and PROMIS Satisfaction with Social Roles. Researchers will monitor enrollment, retention, adherence, satisfaction, and conduct interviews to explore acceptability and potential benefits. The study aims to establish if the program is feasible and acceptable for older Veterans and gather preliminary data on its impact on daily functioning and well-being.

Justice-involved Veterans JIVs often face co-occurring substance use disorders SUD and mental health MH conditions, yet many do not receive appropriate treatment. This trial focuses on evaluating different strategies to implement Honest, Open, Proud HOP, a peer-led stigma reduction program, which aims to help Veterans reduce self-stigma and improve engagement in care. The study compares high-intensity versus low-intensity approaches to delivering this intervention and assesses their impacts and costs across multiple VA medical centers. The intervention, Veterans Affairs-Honest, Open, Proud VA-HOP, is a peer-delivered group program consisting of three lessons designed to guide participants through decisions about disclosing behavioral health conditions. Sessions are held weekly for nine weeks, either as 45-minute meetings or three longer sessions. The study uses two implementation strategies a low-intensity audit and feedback approach with monthly data reports and optional discussions, and a high-intensity implementation facilitation involving biweekly virtual meetings focused on problem-solving and planning. These strategies are tested sequentially over six months each, followed by a nine-month sustainment period without active support. Participants are Veterans enrolled in specific VA Justice Programs who meet criteria for mental health or substance use disorders and are willing to engage in VA-HOP. Throughout the study, researchers track the number of sessions delivered, adherence to the HOP model, and patient outcomes like outpatient care usage, emergency visits, and suicide risk. Data collection spans pre-implementation, active implementation, and sustainment phases, with qualitative interviews to explore long-term maintenance. The total study period covers up to 21 months of intervention and follow-up.

Lung cancer causes more deaths in the United States than breast, prostate, and colon cancers combined, with Veterans being particularly affected. This study evaluates a new approach called prediction-augmented lung cancer screening LCS to improve screening rates and reduce disparities, especially among Black Veterans who are at higher risk but less likely to be screened. The goal is to show that using personalized prediction models in routine care is feasible and can increase the number of Veterans who complete lung cancer screening. The study compares usual care based on simple age and smoking history criteria to prediction-augmented LCS that uses personalized tools for primary care providers and lung cancer screening teams. These tools include enhanced clinical reminders, decision aids with personalized information, and population management dashboards and outreach toolkits. The trial uses a factorial stepped wedge design across multiple sites, with Veterans enrolled passively if they meet either the standard screening criteria or a high-benefit threshold based on predicted life-year gains. Participants will be monitored to see if they complete an initial low-dose CT LDCT scan as part of lung cancer screening. Researchers will track screening orders and completions, especially among high-benefit and Black Veterans, and will evaluate lung cancer detection rates and outcomes related to screening procedures. Implementation success will be studied through mixed methods including surveys and interviews. The study runs from June 2026 to September 2029, with screening decisions and outcomes observed over time.

This research study focuses on veterans with a history of substance use disorder and chronic pain. It aims to evaluate how effective Battlefield Acupuncture BFA is in treating chronic pain over an 8-week period. The study also looks at how BFA might affect stress, mood, and sleep patterns, as well as measures of depression, anxiety, and substance use at three points during the 16-week study. This is a randomized clinical trial recruiting 60 veterans to compare treatments. Participants are randomly assigned to either a waitlist control group or an immediate treatment group. Those receiving treatment will have weekly 15-20 minute sessions for 8 weeks, during which up to 5 acupuncture tacks are placed in each ear. Pain levels are recorded before, during, and after the treatment at each visit. The waitlist group receives no treatment for 8 weeks and then begins treatment, followed by 8 weeks of follow-up. Throughout the study, participants complete questionnaires on pain, stress, mood, sleep, depression, anxiety, and substance use. Data will be securely stored and analyzed later. The primary measurement is chronic pain level assessed by the acupuncture questionnaire during treatment and follow-up. Secondary measurements assess mood, stress, sleep, and behavioral factors monthly. The total time commitment for participants is approximately 16 weeks, including treatment and follow-up phases.