Talk to the Veterans Crisis Line now
An official website of the United States government
Curated by the VETCARE COIN Implementation Science CORE
The Implementation Science (IS) Core of the VETCARE COIN helps integrate, evaluate, and disseminate evidence-based IS interventions to promote excellence in healthcare across the cancer care continuum in the VA. Led by Dr. Erin Rogers and Dr. Daniel Becker, the IS Core offers the following to help investigators at all levels apply IS methods effectively in real-world research:
1:1 consultations
Research studios
Trainings
Measurement and framework tools
Logic model resources
Introductory content and foundational materials.
Start here if you're designing an implementation science study or grant. You'll find curated tools and websites to help choose frameworks, plan hybrid trials, and align with implementation outcomes.
Tools to measure implementation outcomes like fidelity, acceptability, reach, and sustainability.
Resources to select, apply, and report implementation strategies and metrics.
Use these models to structure your IS study and identify barriers/facilitators.
Guidance on collecting and analyzing qualitative data in IS studies.
Proposal-writing tips and successful examples of funded IS research.
Free trainings, toolkits, and community platforms to build your IS skills.
Background: The Veterans Health Administration (VA) efforts to deliver high quality, excellent care have led to improvements in cancer care and reducing differences in access to and processes of care. Yet, differences still persist in health outcomes, requiring novel strategies to overcome them. Our Center of Innovation (COIN), Veterans Excellence in the Cancer CAre Continuum REsearch (VETCARE) Center will leverage existing research and programmatic strengths at the VA New York Harbor Healthcare System (VA NYHHS) to study cancer care and chronic disease management. VETCARE will advance the science of health outcomes and help VA ensure excellent care for all Veterans.
Significance: VETCARE investigators will be able to to comprehensively develop, test, and implement interventions that address cancer care health differences among Veterans by increasing our ability to collaboratively address VA healthcare and research priorities, advance health systems research across the cancer continuum of care (e.g., prevention, treatment, survivorship), obtain more research funding through VA grants, train more health services researchers, and engage Veterans throughout the research process.
Impact Goals & Priorities: IG1: Develop and test strategies to support the adoption and use of promising interventions to optimize health outcomes across the continuum of VA cancer care. IG2: Develop and test strategies and interventions to improve the prevention and outcomes of other chronic conditions and foster healthy behaviors across the continuum of VA cancer care. IG3: Promote research to optimize delivery of remote cancer care across the VA. VETCARE will develop and pilot multicomponent interventions and implementation strategies to improve uptake of evidence-based interventions and other promising practices that promote excellence in cancer survival and outcomes, improve chronic disease prevention and management, and promote excellence in telehealth delivery along the continuum of cancer care in the VA.
Additional Contribution Areas: In addition to our focus on cancer health excellence (IG1), including chronic disease management and healthy behaviors (IG 2) and telehealth (IG 3), we have expertise in aging, hearing loss, mental health, and population health, all important collaborations to advance cancer care health systems research. Our investigators explore the spectrum of population health research, from population-level studies including all primary care or mental health patients to chronic disease management studies focused on select cohorts with the greatest healthcare needs.
Innovation & Emerging Areas: We are working with the VA National Oncology Program (NOP) to assess the effect of teleoncology on quality and excellence along the cancer care continuum. Based on meetings with our NCI partners, we have initiated inquiries on the intersection between digital health, cancer care, food insecurity, and cognitive impairment to help identify differences in care and outcomes as well as develop interventions to address them. We are working with the VA Office of Health Equity (OHE) to identify promising early career investigators across VA and support their work in cancer health excellence, particularly in telehealth. Another innovation is the use of behavioral economic strategies to overcome systemic human factors that can limit the delivery, use, and impacts of evidence-based treatments among vulnerable groups.
Partnerships & Support for Research Enterprise: In addition to the NOP and OHE, we have strong partnerships with the VA National Center for Health Promotion and Disease Prevention and the VA Office of Connected Care, serve on VA NYHHS IRB and R&D Committees, and contribute to national enterprise efforts with the VA Office of Research and Development, and the VA Office of Healthcare Innovation and Learning.
Section C: Research Plan
C.1 Impact Goals and Priorities
C.1.a Impact Goals: We propose a new Center of Innovation (COIN) called the Veterans Excellence in the Cancer CAre Continuum REsearch (VETCARE) Center. VETCARE will leverage existing research and programmatic strengths at the VA New York Harbor Healthcare System (VANYHHS) to study cancer care and chronic disease management, a complement to cancer care critical to the health of cancer survivors. VETCARE will advance the science of healthcare and help VA ensure excellent outcomes for all Veterans. Guided by a comprehensive set of principles to operationalize excellence in cancer research and health outcomes1 (Figure 1, described in more detail In Table 1 on page 3), we will work closely with Veterans and leverage the expertise of our investigators, our strong VA operational partnerships, and collaborations with investigators inside and outside VA. Our investigators are established experts and leaders in cancer care across the continuum, health promotion (Box 1), chronic disease prevention and management (e.g., tobacco control, weight management), mental healthcare, telehealth, and implementation science—all of which are needed to advance the science of healthcare across the VA cancer care continuum. The Veterans Health Administration (VA), the largest integrated health system in the US, works hard to deliver high quality, care.2 Some VA medical centers have done well to improve cancer care and reduce differences in access to and processes of care, yet differences in health outcomes persist3-5, requiring strategies to overcome them . Our impact goals are designed to leverage the strengths of our COIN investigators in the design and implementation of interventions promoting excellent cancer care outcomes consistent with the highest standards of care for our nation’s Veterans.
Impact Goal 1: Develop and test strategies to support the adoption and use of promising interventions to optimize healthcare across the continuum of VA cancer care. Brief Description: Together with our partners, we will develop and pilot multicomponent interventions and implementation strategies to improve uptake of evidence-based interventions and other promising practices that promote excellence in cancer survival and outcomes across the continuum of cancer care, from Prevention to Survivorship.6
Impact Goal 2: Develop and test strategies and interventions to improve the prevention and outcomes of other chronic conditions and foster healthy behaviors across the continuum of VA cancer care. Brief Description: We will develop and pilot multicomponent interventions and implementation strategies to improve chronic disease prevention and management across the continuum of cancer care.
Impact Goal 3: Promote research to optimize delivery of remote cancer care across the VA. Brief Description: We will develop and pilot multicomponent interventions and implementation strategies to promote excellence in telehealth delivery along the continuum of cancer care in the VA.
Significance: The impact goals of VETCARE reflect the strengths of our investigators as well as VA’s research and administrative priorities.7 The VA Office of Research and Development (ORD) recently partnered with the National Oncology Program Office (NOP) to establish an integrated network of clinical-research hubs to which our COIN’s focus will be complementary. Our proposal directly addresses the “Health Equity and Social Determinants of Health” VA research priority that underscores the importance of “social determinants of health [as] significant drivers of morbidity and mortality.”7,8 VETCARE will allow us to comprehensively develop, test, and implement interventions that address cancer care health outcome differences. . In alignment with our COIN, VA encourages researchers to consider the continuum of care when examining chronic conditions. COIN resources will further our ability to collaboratively address VA healthcare and research priorities, advance health systems research across the cancer continuum of care, obtain more research funding through VA grants, train more health services researchers, and engage Veterans throughout the research process.
