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Lessons from Initiating the First Veterans Health Administration (VA) Women's Health Practice-based Research Network
Alyssa Pomernacki1, Diane V Carney1, Rachel Kimerling1
1From the Veterans Administration (VA) Health Services Research & Development (HSR&D) Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA (AP, DVC, RK, MMB, CM, SS, SMF); the National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA (RK, MMB, CM, SS); the VA Advanced Fellowship Program in Mental Illness Research and Treatment, VA Palo Alto Health Care System, Palo Alto, CA (DN); the VA HSR&D Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC (JB, KMG); the VA HSR&D Center for Comprehensive Access and Delivery Research and Evaluantion, Iowa City VA Health Care System, Iowa City, IA (BDM, HS, AGS); the VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Sepulveda, CA (JY, BAB-M, RK, EMY); the Department of Medicine, Duke University, Durham, NC (KMG); the Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (AGS); the Department of Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles (BAB-M); the VA HSR&D Pain Research, Informatics, Multi-morbidities, and Education Center, VA Connecticut Healthcare System, West Haven (LAB); the Division of General Internal Medicine, University of Connecticut Health Center, Farmington (LAB); the Department of Health Policy and Management, University of California Los Angeles Fielding School of Public Health, Los Angeles (EMY); and the Division of General Medical Disciplines, Stanford University, Stanford, CA (SMF).
Background:
The Veterans Health Administration (VA) Women's Health Practice-Based Research Network (WH-PBRN) was created to foster innovations for the health care of women veterans. The inaugural study by the WH-PBRN was designed to identify women veterans' own priorities and preferences for mental health services and to inform refinements to WH-PBRN operational procedures. Addressing the latter, this article reports lessons learned from the inaugural study.
Methods:
WH-PBRN site coordinators at the 4 participating sites convened weekly with the study coordinator and the WH-PBRN program manager to address logistical issues and identify lessons learned. Findings were categorized into a matrix of challenges and facilitators related to key study elements.
Results:
Challenges to the conduct of PBRN-based research included tracking of regulatory documents; cross-site variability in some regulatory processes; and troubleshooting logistics of clinic-based recruitment. Facilitators included a central institutional review board, strong relationships between WH-PBRN research teams and women's health clinic teams, and the perception that women want to help other women veterans.
Conclusion:
Our experience with the inaugural WH-PBRN study demonstrated the feasibility of establishing productive relationships between local clinicians and researchers, and of recruiting a special population (women veterans) in diverse sites within an integrated health care system. This identified strengths of a PBRN approach.
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