Publications by authors named "Alison B Hamilton"

Introduction: Stress from the COVID-19 pandemic may have had a profound impact on the mental health of Reserve and National Guard (RNG) women Veterans, especially if they have a history of traumatic brain injury (TBI). This cross-sectional study aimed to assess the potential mediating effect of stress stemming from the COVID-19 pandemic on the association between TBI and depression symptoms.

Materials And Methods: Women RNG Veterans between the ages of 18 and 60 were interviewed about their lifetime history of TBI, symptoms of depression, and any stressful experiences resulting from the COVID-19 pandemic.

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Objective: To examine the feasibility, acceptability, and potential health effects of computerized cognitive behavioral therapy-enhanced collaborative care (cCBT-CC) versus usual primary care (UC).

Background: Internet-based cCBT can effectively treat depression but is not widely used, including in the Veterans Health Administration where it was freely available for veterans. We adapted pre-existing depression collaborative care models using implementation and user-centered design strategies to facilitate cCBT implementation.

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Background: As implementation science evolves, it is essential to expand training capacity to build intellectual capital continually. The demand for training in implementation science far outstrips the current supply. This paper presents the methods and findings from the Institute for Implementation Science Scholars (IS-2) national training program (2020-2024).

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We explored U.S. provider and leader perspectives on eating disorder screening, implementation, and clinical pathways in the Veterans Health Administration using qualitative interviews with 10 medical providers and seven leaders from Veterans Health Administration's National Program Offices ( = 17).

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Background: Reach Out, Stay Strong Essentials (ROSE) is an evidence-based intervention for preventing post-partum depression being implemented across U.S. Veterans Health Administration (VA) sites as part of the EMPOWER 2.

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Introduction: The Institute for Implementation Science Scholars (IS-2) is a dissemination and implementation (D&I) science training and mentoring program. A key component of IS-2 is collaborating and networking. To build knowledge on effective networking and mentoring, this study sought to 1) conduct a social network analysis to determine whether underrepresented scholars have equivalent levels of connection and 2) gain insights into the differences in networking among racial/ethnic subgroups of scholars.

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Background: Although rapid antiretroviral therapy (ART) and same-day pre-exposure prophylaxis models (henceforth "rapid START") are feasible, acceptable, and cost-effective in various contexts, significant barriers have hindered their broader implementation and scalability in the United States. Ryan White-funded clinics are cornerstones for HIV services, yet strategies are urgently needed to facilitate equitable rapid START adoption across contexts. This study aimed to identify common factors influencing rapid START to inform strategies applicable throughout jurisdictional settings.

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Background: Because implementation remains the biggest challenge to Ending the HIV Epidemic in the United States (EHE), since 2019, the National Institutes of Health (NIH) has funded 248 supplements to identify best practices for delivering evidence-based HIV interventions. NIH also funded a coordination center [Implementation Science (IS) Coordination Initiative "ISCI"] and 9 consultation hubs ("Hubs") to provide technical assistance and cross-project information sharing, measure harmonization, and data synthesis. This article describes this unique capacity-building model, lessons learned from the first 5 years, and opportunities created by this infrastructure.

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Depression can be effectively treated with internet-based computerized cognitive behavioral therapy (cCBT). The Veterans Health Administration (VHA) provided cCBT free to all veterans nationally as of 2013; however, its uptake has been limited. This study aimed to examine VHA primary care clinicians' and patients' perspectives regarding cCBT treatment for depression.

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Article Synopsis
  • The under-recruitment of marginalized groups, particularly women veterans, in clinical trials limits healthcare advancements and the applicability of research results.
  • The Veterans Health Administration faces unique challenges in recruiting women due to demographic factors and experiences of mistreatment, such as military sexual trauma.
  • The VA Women's Enhanced Recruitment Program (WERP) aims to improve participation of women veterans in clinical trials, offering insights for researchers striving for more equitable representation in their studies.
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Background: Cardiovascular (CV) disease is the leading cause of death among U.S. women, yet women have a limited understanding of their CV-related morbidity and mortality risks.

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Background: Patient-perpetrated sexual harassment toward health care providers is common and adversely affects provider well-being, workforce outcomes, and patient care. Organizational climate for sexual harassment-shared perceptions about an organization's practices, policies, and procedures-is one of the strongest predictors of harassment prevalence. We conducted a pilot survey assessing provider perceptions of the Veterans Health Administration (VA)'s climate related to patient-perpetrated sexual harassment.

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Article Synopsis
  • Rapid qualitative methods (RQA) have gained popularity in quality improvement and health services research, raising important questions about what constitutes rigor and validity in these projects.* -
  • A team of seven experts developed the Planning for and Assessing Rigor in Rapid Qualitative Analysis (PARRQA) framework, which outlines a structured approach to ensure rigorous design, data collection, and analysis processes in RQA.* -
  • The PARRQA framework consists of five phases and includes 18 best practice recommendations aimed at enhancing the quality and transparency of rapid qualitative research in implementation evaluation.*
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Background: The University of California's Diabetes Prevention Program (UC DPP) Initiative was implemented systemwide to address diabetes and obesity risk on all 10 campuses. As little is known about implementing lifestyle change programs in university settings, we examined implementation partners' (i.e.

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Objective: We aimed to explore US veteran perspectives on eating disorder screening, diagnosis, patient-provider conversations, and care in the Veterans Health Administration (VHA).

Method: Rapid qualitative analysis of 30-45 min phone interviews with 16 (N = 16) veterans with an electronic health record ICD-10 eating disorder diagnosis, who received care at one of two VHA healthcare systems in Connecticut or California. Topics covered included: conversations with providers about eating disorder symptoms, diagnosis, and referral to treatment; feedback about an eating disorder screener, and; reflections on eating disorders among veterans and VHA's effort to address them.

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Introduction: Implementation science (IS) offers methods to systematically achieve the Ending the HIV Epidemic goals in the United States, as well as the global UNAIDS targets. Federal funders such as the National Institutes of Mental Health (NIMH) have invested in implementation research to achieve these goals, including supporting the AIDS Research Centres (ARCs), which focus on high-impact science in HIV and mental health (MH). To facilitate capacity building for the HIV/MH research workforce in IS, "grey areas," or areas of IS that are confusing, particularly for new investigators, should be addressed in the context of HIV/MH research.

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People with serious mental illness (SMI) have lower rates of use of preventative medical services and higher rates of mortality compared to the general population. Research shows that specialized primary care medical homes improve the health care of patients with SMI and are feasible to implement, safe, and more effective than usual care. However, specialized medical homes remain uncommon and model dissemination limited.

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Women living with serious mental illness (SMI) are at increased risk for adverse pregnancy and parenting outcomes. However, little is known about the experiences and preferences of women with SMI related to addressing pregnancy and parenting with their mental health providers. We conducted semistructured interviews with twenty-two reproductive-age cisgender women patients living with SMI.

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Background: The University of California's Diabetes Prevention Program (UC DPP) Initiative was implemented across all 10 UC campuses in 2018. The COVID-19 pandemic and accompanying mandates required swift changes to program delivery, including pivoting from in-person to virtual delivery (i.e.

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Background: Evidence-based practices (EBPs) improve housing and health for persons who have experienced homelessness with serious mental illness (PEH-SMI) but are challenging to implement. We tested a strategy to support pilot implementation of a 12-session housing skills training intervention for PEH-SMI, tailored from effective social skills training interventions. We aimed to optimize the implementation strategy and intervention prior to an implementation trial.

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Background: Women Veterans' numerical minority, high rates of military sexual trauma, and gender-specific healthcare needs have complicated implementation of comprehensive primary care (PC) under VA's patient-centered medical home model, Patient Aligned Care Teams (PACT).

Objective: We deployed an evidence-based quality improvement (EBQI) approach to tailor PACT to meet women Veterans' needs and studied its effects on women's health (WH) care readiness, team-based care, and burnout.

Design: We evaluated EBQI effectiveness in a cluster randomized trial with unbalanced random allocation of 12 VAMCs (8 EBQI vs.

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Precision prevention embraces personalized prevention but includes broader factors such as social determinants of health to improve cardiovascular health. The quality, quantity, precision, and diversity of data relatable to individuals and communities continue to expand. New analytical methods can be applied to these data to create tools to attribute risk, which may allow a better understanding of cardiovascular health disparities.

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Background: African American women are disproportionately at risk for HIV infection. To increase women's readiness to consider taking pre-exposure prophylaxis (PrEP), we conducted a pilot study of Women Prepping for PrEP Plus (WP3+). Adapted from an evidence-based HIV risk reduction intervention for African American couples who are HIV-serodiscordant, WP3+ is a group-based culturally congruent program designed for African American women without HIV.

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