Center to Improve Veteran Involvement in Care (CIVIC)

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.

Patient Health Experiences: Using Patient Narratives to Improve Tinnitus Rehabilitation Services and Outcomes (Principal Investigator)

The purpose of this project is to develop and evaluate a prototype of video-based Veteran narratives on their experiences seeking and receiving care for tinnitus, and the impact tinnitus has had on their lives especially as they relate to disability, function, and overall quality of life. Patient narratives are defined as stories told by patients [or “health care consumers”] about their care experiences and reflections on an array of health conditions. Mounting evidence indicates that narratives on patients’ experiences with chronic conditions can enhance medical education consultation skills, support patient education and decision-making with chronic diseases [e.g., oncology patients], and inform quality improvement initiatives.
Grant ID: VA RR&D SPiRE C4098P

Physiological, Behavioral, and Predictive Correlates of Ototoxicity in Humans (Co-Investigator)

This project aims to 1) Identify the combination of clinical risk factors that can best predict functionally relevant ototoxicity in patients receiving cisplatin, carboplatin or oxaliplatin; and 2) Verify that causal pathway models of tinnitus, hearing loss and impaired complex sound perception, developed in animals, can account for the differences in these outcomes across the three clinical ototoxicity models. This project aims to 1) Identify the combination of clinical risk factors that can best predict functionally relevant ototoxicity in patients receiving cisplatin, carboplatin or oxaliplatin; and 2) Verify that causal pathway models of tinnitus, hearing loss and impaired complex sound perception, developed in animals, can account for the differences in these outcomes across the three clinical ototoxicity models.
Principal Investigator: Dawn Konrad-Martin, PhD
Grant Source: VA RR&D Merit Award 2019-2024

Rural Veterans’ Access to Hearing Healthcare (Co-Investigator)

The purpose of this study is to evaluate rural Veterans’ access to timely hearing healthcare. We will conduct a retrospective review of US Veterans’ use of audiology services. The aims are to analyze rural vs. urban differences in terms of timing between hearing loss diagnosis and treatment (i.e., hearing aid acquisition) and to describe the population of rural Veterans with hearing loss.
Principal Investigator: Laura Coco
Grant ID: VA ORH 8002

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

You can find a full list of publications at PubMed.

• Dobscha SK, Clark KD, Karras E, Simonetti JA, Newell S, Kenyon EA, Elliott V, Boster J, Gerrity M. Development and Preliminary Evaluation of an Education Program for Primary Care Teams on Discussing Firearms Storage Safety with Veterans. Journal of medical education and curricular development. 2022 Feb 14; 9:23821205221077647
• Edmonds CM, Clark KD, Thielman EJ, Henry JA. Progressive Tinnitus Management Level 3 Skills Education: A 10-Year Clinical Retrospective. American Journal of Audiology. 2022 Sep 1; 31(3):567-578
• Mojica CM, Gunn R, Pham R, Miech EJ, Romer A, Renfro S, Clark KD, Davis MM. An observational study of workflows to support fecal testing for colorectal cancer screening in primary care practices serving Medicaid enrollees. BMC cancer. 2022 Jan 25; 22(1):106
• Coco L, Hooker ER, Gilbert TA, Harker GA, Clark KD, Reavis KM, Henry JA, Zaugg TL, Carlson KF. The Impact of Tinnitus Severity on Work Functioning among U.S. Military Veterans with Tinnitus. Seminars in Hearing. 2023 Jul 24; DOI: 10.1055/s-0043-1770152.

Shiuh-Wen Luoh MD PhD is a Staff Physician at Portland VA Medical Center and Professor of Medicine at Division of Hematology and Oncology at the Knight Cancer Institute, OHSU. Dr. Luoh is a physician scientist and his laboratory and translational research interest is in breast cancer. His long term career goal is to translate research findings to the bedside to guide and improve patient care. His laboratory has established and been examining various animal models to investigate the mechanism of breast cancer metastasis, the most dreaded outcome after a breast cancer diagnosis. Working with the Million Veteran Program (MVP), his group has evaluated various genetic and clinical instruments that can predict the breast cancer risk for Women Veterans enrolled in the MVP. These findings will form the foundation of a risk adapted, personalized breast cancer screening strategy that will soon be evaluated in prospective clinical trials. In addition to understanding the molecular underpinnings of COVID-19 and long COVID infection, Dr. Luoh’s group is also exploring novel strategies to emulate prospective clinical trials with electronic health record and genetic information from the MVP to develop new treatment strategy and conquer health disparity.

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You can find a full list of publications at Elsevier Pure.

• Winters-Stone, K. M., Horak, F., Dieckmann, N. F., Luoh, S. W., Eckstrom, E., Stoyles, S. A., Roeland, E. J., & Li, F. (2023). GET FIT: A Randomized Clinical Trial of Tai Ji Quan Versus Strength Training for Fall Prevention After Chemotherapy in Older, Postmenopausal Women Cancer Survivors. Journal of Clinical Oncology, 41(18), 3384-3396. https://doi.org/10.1200/JCO.22.01519
• Luoh, S. W., Minnier, J., Zhao, H., & Gao, L. (2023). Predicting Breast Cancer Risk for Women Veterans of African Ancestry in the Million Veteran Program. Health Equity, 7(1), 303-306. https://doi.org/10.1089/heq.2023.0011
• Million Veteran Program COVID-19 Science Initiative (2022). A MUC5B Gene Polymorphism, rs35705950-T, Confers Protective Effects Against COVID-19 Hospitalization but Not Severe Disease or Mortality. American journal of respiratory and critical care medicine, 206(10), 1220-1229. https://doi.org/10.1164/RCCM.202109-2166OC

Reid F. Thompson, MD, PHD, is an Associate Director of the VA National Radiation Oncology Program, and an Associate Professor of Radiation Medicine and Biomedical Engineering at the Oregon Health & Science University (OHSU). Dr. Thompson serves on the VINCI Field Advisory Committee and represents the VA on the White House Cancer Moonshot Task Force for Data and Innovation. Dr. Thompson has been conducting VA research since 2016 and is a VA CSR&D Career Development Awardee (2019-2024). He clinically specializes in treating skin cancers with radiation, and his research interests are in precision oncology, with special emphases on cancer immunotherapies and radiation treatments and outcomes.

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You can find a full list of publications at Elsevier Pure.

• Caissie, A., Mierzwa, M., Fuller, C. D., Rajaraman, M., Lin, A., MacDonald, A., Popple, R., Xiao, Y., VanDijk, L., Balter, P., Fong, H., Xu, H., Kovoor, M., Lee, J., Rao, A., Martel, M., Thompson, R., Merz, B., Yao, J., & Mayo, C. (2023). Head and Neck Radiation Therapy Patterns of Practice Variability Identified as a Challenge to Real-World Big Data: Results From the Learning from Analysis of Multicentre Big Data Aggregation (LAMBDA) Consortium. Advances in Radiation Oncology, 8(1), Article 100925. https://doi.org/10.1016/j.adro.2022.100925
• Maden, S. K., Walsh, B., Ellrott, K., Hansen, K. D., Thompson, R. F., & Nellore, A. (2023). Recountmethylation enables flexible analysis of public blood DNA methylation array data. Bioinformatics Advances, 3(1), Article vbad020. https://doi.org/10.1093/bioadv/vbad020
• Kanwar, A., Merz, B., Claunch, C., Rana, S., Hung, A., & Thompson, R. F. (2023). Stress-testing pelvic autosegmentation algorithms using anatomical edge cases. Physics and Imaging in Radiation Oncology, 25, Article 100413. https://doi.org/10.1016/j.phro.2023.100413

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 mechanism 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 Ph.D. 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 a VA HSR 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 current research aims to identify gender differences in risk factors for worsening PTSD, substance use, and suicide outcomes in Veterans over time; understand women-relevant mechanisms underlying interventions for PTSD-SUD, and investigate trauma-informed and culturally-relevant adaptions to mindfulness-based interventions for substance use disorders.

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

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

Chris Stauffer, MD is Associate Professor of Psychiatry at Oregon Health & Science University, Physician-Scientist with the VA Portland Health Care System, and dual board-certified in Psychiatry and Addiction Medicine. Dr. Stauffer is the Director of the Social Neuroscience & Psychotherapy Lab, which aims to maximize the benefits of psychotherapy through the adjunct use of social psychopharmacology, such as oxytocin, MDMA, and psilocybin. Current studies include psilocybin-assisted psychotherapy for Veterans with methamphetamine use disorder and MDMA-assisted group therapy for Veterans with PTSD. Dr. Stauffer serves as Supervisor and Educator of MDMA-Assisted Therapy and is a member of the Oregon Governor's Psilocybin Advisory Board.

You can learn more about Dr. Stauffer's projects on his website.

You can find a full list of publications at PubMed.

• Sarparast A, Thomas K, Malcolm B, Stauffer CS. (2022) Drug-drug interactions between psychiatric medications and MDMA or psilocybin: a systematic review. Psychopharmacology. https://doi.org/10.1007/s00213-022-06083-y.
• Stauffer CS, Samson S, Hickok A, Hoffman WF, Batki SL. (2021) Intranasal oxytocin for stimulant use disorder among male Veterans enrolled in an opioid treatment program: A randomized controlled trial. Frontiers in Psychiatry. 12:804997. doi: 10.3389/fpsyt.2021.804997.
• Stauffer CS, Anderson BT, Ortigo KM, Woolley J. (2020). Psilocybin-assisted group therapy and attachment: Observed reduction in attachment anxiety and influences of attachment insecurity on the psilocybin experience. ACS Pharmacology & Translational Science. http://dx.doi.org/10.1021/acsptsci.0c00169.

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 Donald.Sullivan3@va.gov or at sullivad@ohsu.edu.

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

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

• Sullivan DR, Wisnivesky JP, Nugent SM, Stone K, Farris MK, Kern JA, Swanson S, Smith CB, Rosenzweig K, Slatore CG. Decision Regret among Patients with Early-stage Lung Cancer Undergoing Radiation Therapy or Surgical Resection. Clin Oncol (R Coll Radiol). 2023 Jun;35(6):e352-e361
• Rosa WE, Hadler RA, Dzeng E, Sullivan DR, Epstein AS, Nelson JE. Legacy and communication in palliative and end-of-life care: Honoring Dr. J. Randall Curtis. Palliat Support Care. 2023 Apr 18:1-2.
• Sullivan DR, Vranas KC, Delorit M, Golden SE, Slatore CG, Ganzini L, Hansen L. Relationships among Clinicians are Crucial to Successful Palliative Care Integration: A Qualitative Study in Lung Cancer. Future Oncol. 2023 Jan;19(3):245-257.
• Golden SE, Disher N, Dieckmann N, Eden K, Matlock D, Vranas K, Slatore CG, Sullivan DR. Show me the roads and give me a road map: Development of a patient conversation tool to improve lung cancer treatment decision-making. PEC Innov. 2022 Oct 21;1:100094.

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.

Warrior Renew (Site Principal Investigator)

This RCT will compare virtual Warrior Renew active treatment to a wellness control group on outcomes of posttraumatic stress disorder related to military sexual trauma (primary), mental health and negative cognitions (secondary) and gender differences (tertiary) with three data points: baseline pre-treatment, 8-week post-treatment, and a 16-week follow-up.
Principal Investigator: Wood
Grant ID: Department of Defense W81XWH2211114

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.

• Somohano VC, Smith CL, Saha S, McPherson S, Morasco BJ, Ono SS, Zaccari B, Lovejoy J, Lovejoy T. Patient-Provider Shared Decision-Making, Trust, and Opioid Misuse Among US Veterans Prescribed Long-Term Opioid Therapy for Chronic Pain. Journal of general internal medicine. 2023 Sep 1; 38(12):2755-2760.
• Zaccari BA, Lovejoy TI, O'Neil ME. Skills training in affective and interpersonal regulation narrative therapy delivered via synchronous telehealth: A case study of a rural woman Veteran with complex posttraumatic stress disorder. Clinical case studies. 2023 Feb 20; 22(4):420-435.