Health Outcomes Core

Annual Report

Dr. Laurel A Copeland and Dr. John E Zeber

Co-Directors

FY2012

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Contents Organization ......................................................................................................................................3

History ....................................................................................................................................................... 3

Fiscal Year 2013 - Directors’ Statement .................................................................................................... 4

Mission & Vision FY2016 ........................................................................................................................... 4

Summary of FY12 Accomplishments ...................................................................................................5

Specific Goals FY2012 .........................................................................................................................6

FY12 Productivity ...............................................................................................................................7

Publications ............................................................................................................................................... 7

Grant Proposals ......................................................................................................................................... 8

Conference Presentations ......................................................................................................................... 9

Ongoing Projects ..................................................................................................................................... 10

Notable Accomplishments ...................................................................................................................... 12

Mentoring ............................................................................................................................................... 14

Consulting ............................................................................................................................................... 14

Service and Other Activities .................................................................................................................... 15

Appendix A Publications ............................................................................................................... 18

Published / In Press / Accepted .............................................................................................................. 18

Submitted / Under Review...................................................................................................................... 19

Appendix B Grant Proposals ......................................................................................................... 21

Appendix C Conferences Presentations or Abstracts Submitted .................................................... 24

Appendix D Consultation ............................................................................................................. 26

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Scott & White HealthcareInternal Medicine

Chairman – Alejandro Arroliga, MD

Center for Applied Health ResearchDirector– Alan Stevens, PhD

Associate Director – Laurel Copeland, PhD

HEALTH OUTCOMES CORECo-directors:

Laurel Copeland, PhDJohn Zeber, PhD

Eileen M. Stock, PhDStatistician

Fangfang Sun, MSData Analyst

Dean Kjar, MSData Analyst

Ying Fang, MSData Analyst

Raphael McIntyre, MPHPre-doctroal Fellow

Affiliate Investigators• Jack Y. Tsan, PhD

• Rashmita Basu, PhD

Post-doctoral Fellows and MenteesScott & White - VA (several)

Organization

History

Scott & White Healthcare, with Central Texas Veterans Health Care System, established the

Center for Applied Health Research (CAHR) and the Health Outcomes Core (HOC) in September 2010

under the auspices of Dr. Alejandro Arroliga, Chairman, Department of Internal Medicine. As a jointly

sponsored center supporting research activities of both institutions and our academic partners, CAHR

conducts and facilitates investigator-initiated research and multidisciplinary efforts to generate applied

health knowledge in Central Texas. CAHR research endeavors are diverse, and it is our intention to

collaborate on and to advance applied health research throughout our sponsoring institutions. CAHR is

led by Dr. Alan B. Stevens, Director, and Associate Director Dr. Laurel A. Copeland.

The Health Outcomes Core conducts health services research focusing on severe mental illness

and the management of care for complex patients with a variety of medical and psychiatric

comorbidities. Drs. Copeland and Zeber serve as co-directors of HOC.

The focus of Dr. Copeland’s research is health care for patients with severe

mental illness. Other research interests include the study of health care provided

to new veterans of the wars in Iraq and Afghanistan, many of whom have

experienced both physical and psychological trauma and are at risk for severe

mental

illness.

Her

appointments include

Investigator, Research

Service, Central Texas

Veterans Health Care System

(Central Texas VA), Associate

Professor, Tenure-In-Title

Only in the College of

Medicine, Texas A&M Health

Science Center, Adjunct

Faculty Department of

Psychiatry at UT Health

Science Center San Antonio,

and Adjunct, School of Rural

Public Health, Texas A&M

Health Science Center (new

in FY2012).

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Dr. Zeber’s focus areas include mental illness, medical sociology and health

beliefs, medication and treatment adherence, ethnicity, culture, and reducing

disparities, health policy evaluation, cost-effectiveness analysis, post-deployment

experiences of veterans seeking VA care, and enhanced implementation of the

chronic care model or patient-centered medical home principles. Most recently he

received funding to examine the role of a new technological implementation to

reduce hospital associated infections. His appointments include Investigator,

Research Service, Central Texas VA, Associate Professor in the College of Medicine,

Texas A&M Health Science Center, Adjunct Faculty Department of Psychiatry at UT Health Science

Center San Antonio, and a new appointment in FY12 as Adjunct, School of Rural Public Health, Texas

A&M University.

Fiscal Year 2013 - Directors’ Statement Building upon the infrastructure foundation, accomplishments, and objectives achieved during

FY2012, HOC goals for this year will focus upon efficiently utilizing a highly qualified core team to further

contribute to the overall CAHR and Scott & White research and clinical missions. Our efforts and

priorities will include balancing S&W and VA efforts, not only maintaining but exceeding prior grant and

manuscript productivity, continuing to represent the center and institution as respected national and

international leaders in health outcomes research, and further developing a growing cohort of clinical

researchers through a strong consulting and mentorship program. Locally, we will establish closer

working relationships with VA entities at both San Antonio (VERDICT, South Texas VA) and the VISN 17

Center of Excellence for Research on Returning War Veterans, while engaging additional Scott & White

researchers and department heads to increase their own research programs. Our role in the HMORN,

and particularly the Mental Health Research Network, will remain a prime concentration area, linking

with other sub-network experts here (e.g., Catherine McNeal, MD and the Cardiovascular Research

Network or CVRN) and across the country. While keeping the focus on current investigators and

projects, we expect to expand our collaborative sphere by bringing in highly skilled health services

experts as affiliate investigators, such as Dr. Mary Jo Pugh, PhD. We aim to work more closely with and

expand our circle of national and international collaborators. Finally, we envision even greater

interactions with other CAHR cores and their investigators, leveraging common resources and

overlapping goals as the center continues to direct its attention to meeting a central Scott & White

objective of becoming a national leader in patient-centered outcomes research.

Mission & Vision FY2016 By the end of FY2016, HOC will be a self-sustaining organization conducting research that

contributes to the improvement of healthcare and drives the national mental health policy debate to

focus on integrated patient care and to promote mental health parity. Within the outcomes research

field, HOC will develop a collaborative network of national and international researchers, and achieve

national recognition as a leading mentoring center for the development of health outcomes researchers.

HOC conducts health services research on topics including patient, provider and system factors

pertaining to effective care coordination; racial disparities in health services utilization; transition into

5 | P a g e

the Veterans Health Administration system; post-deployment health issues; and policy and economic

implications related to treatment adherence.

HOC has expertise in study design and project evaluation, extraction and reduction of administrative

data, derivation of process of care and outcome measures from archival medical record data, and

statistical analysis. HOC Researchers have developed a national and international reputation for their

work, with established collaborations across the country as well as research colleagues in several

countries.

The CAHR vision statement, Become the national leader in applied health research, reinforced by the

mission statement, Facilitate the integration of health research focused on improving care delivery and

the well-being of our community, provided the research focus for HOC during FY2012.

Summary of FY12 Accomplishments During the second fiscal year of operations, which ran September 2011 – August 2012, HOC

achieved the following:

Eighteen (18) grant proposals submitted; five of these were awarded funding

14 manuscripts published with another 14 papers under review at year-end

Eighteen (18) presentations to local, national, and international research conferences, in

addition to several talks given at internal VA, Scott & White or academic venues

Significant expansion of HOC employees, active mentees, support of clinical researchers,

internal and external collaborations, and potential recruitment of new investigators

Notable achievements include Dr. Zeber’s invitation to join editorial board of the World Journal

of Psychiatry and lead roles on an international medication adherence project and planning

committee for the Academy Health Annual Research Meeting. This year he was also appointed

Chair of the VA’s Institutional Review Board. Dr. Copeland was selected as the new Scott &

White Governance Board representative for the HMORN, continued to chair the VA

Subcommittee for Information and Data Security, and had a publication highlighted by the VA’s

national HSRD director.

As a direct result of above activities, CAHR continues to rapidly develop a local, national and

international presence in the research community.

At the end of FY2012 (August 2012), HOC personnel consisted of its two co-director investigators,

statistician and junior investigator Eileen M Stock, PhD, a pre-doctoral minority research fellow Raphael

McIntyre, MPH, and two data analyst/programmers - Fangfang Sun, MS, and Dean Kjar, MS. In addition,

Ying Fang, MS, had accepted an offer of employment as a third fulltime data analyst/programmer to join

HOC early in FY2013. Our program manager Phil Bookert, MS, completed his CAHR tenure in June 2012,

taking his experience and talents to the EPIC implementation team; a search for his replacement at HOC

is underway. HOC personnel maintain Without Compensation status within the Veterans Health

Administration allowing them to facilitate research on VA studies.

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FY2012 also saw staff reorganization and change in concert with our supporting partner,

Department of Research Operations, Dr. Richard Beswick, Director. The programming unit of the Scott

& White HMORN Virtual Data Warehouse was moved under the direction of Dr. Copeland. This resulted

in Ms. Ying being identified to replace departing programmer Bhushan Mahajan, while veteran

programmer Mr. Kjar was moved from Canyon Creek offices to our Birdcreek suite, resulting in co-

location of three data analysts and one statistician/analyst at CAHR. This reorganization was followed by

a review of the HMORN Virtual Data Warehouse development to date and an extensive QA process

ongoing at the end of FY2012 that identified and restored lost cases comprising 20% of the overall

sample. We take this opportunity to again thank Dr. Beswick and Research Operations for its ongoing

support and recognition of our analytical needs.

We believe that this growth reflects both our increased productivity, infrastructure

development and continued efforts to further enhanced research activity that targets the clinical

mission of both Scott & White and the Central Texas VA. In addition to the aforementioned HOC

personnel, we have maintained active collaboration with our two affiliate investigators, Drs. Jack Tsan

and Rashmita Basu, a large cohort of research mentees from both institutions, several senior colleagues

at the VA research centers in San Antonio and Waco (as well as other national VA facilities), and our

academic partners. We have also continued efforts towards the recruitment of new health services

investigators, with a couple of promising prospects to be pursued in FY13.

Specific Goals FY2012 HOC established the following goals to guide its research efforts in the first two years of operation. As

these goals remain central to our philosophy and efforts, HOC will continue focusing attention on these

objectives in FY13. See Productivity sections below and Appendices for additional details on these

objectives and FY12 accomplishments

1) Conduct health services research resulting in publishing new knowledge to improve the

delivery of patient health care [achieved]

Metrics: Grants/Studies, Publications, Research project development and assistance.

Objectives: Develop and submit at least four grant proposals and eight scholarly articles;

expand participation and collaboration in the HMORN environment.

2) Integrate health services research results into Scott & White and VA clinical practices

[achieved]

Metrics: Teaching, Mentoring, Sharing Information of HSR. Objectives: Present to Scott

& White clinicians two times per year; provide research expertise to Scott & White colleagues in

regularly scheduled meetings at CAHR 10 times per year; share information on HMORN and VA

opportunities (data sources, funding and collaboration opportunities).

3) Develop collaborative research opportunities with Texas entities [achieved]

Metrics: Research project development and assistance. Objectives: Develop three new

research contacts with TAMU, Baylor, UT or other regional institutions; Maintain collaborative

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research investigations to include researchers at VISN 17 CoE, Central Texas VA, South Texas VA,

UTHSCSA, and SAMMC.

4) Gain regional, national, and international exposure for Scott & White investigators and

research [achieved]

Metrics: Conferences, Working Groups, Articles Reviewed, Leadership. Objectives:

Attend three national or international conferences as speakers or poster presenters; collaborate

on research activities or contribute as expert consultants with national respected researchers;

serve as reviewers at least six peer-reviewed healthcare journals; serve on one Institutional

Review Board (IRB).

5) Provide expertise and consultation services to external investigators [achieved]

Metrics: Consulting, Research project development and assistance. Objectives: Share

research expertise by consulting with fellow researchers or providing information in a lecture

format; assist researchers with study design and project evaluation; data extraction and

reduction; variable development; development of appropriate analytic strategies; interpreting

study results; developing and protocols; submitting proposals, manuscripts and conference

abstracts; providing information on research results, research processes, and data analysis

techniques.

6) Mentor beginning and intermediate researchers in health services research activities

[achieved]

Metrics: Mentoring, Encourage professional development,t clinical issues into research

protocols. Objectives: Mentor a minimum of eight beginning and intermediate researchers

across institutions.

FY12 Productivity HOC published its achievements in quarterly and monthly academic reports during FY2012.

Through these reports, productivity elements (metrics) can be traced to objectives, and objectives can

be traced to one or more of the six goals much in the way Scott & White aligns individual

accomplishments with the organizational mission. Measureable objectives provided the basis for

determining whether goals and objectives were met. The following sections provide additional details

concerning our primary activities, offering a comprehensive overview of HOC contributions. Also see

Appendices A - C.

Publications Increased mentoring activity and efforts from investigators and junior researchers alike led to a

total of 14 publications in FY12 (including those accepted and in press – see Appendix A). In addition,

another 14 manuscripts were submitted and under review as of the end of August 2012; 4 of these have

been accepted for publication in the interim. This total of 28 slightly surpassed the publications obtained

or submitted during HOC’s first year, as we established new collaborators while learning about Scott &

8 | P a g e

White or HMORN datasets and initiating new research projects. These papers derived from several

different studies, covering a variety of health conditions and treatment approaches such as depression

and ethnicity, diabetes and patient-centered care, obesity, schizophrenia and hospital transition,

healthcare associated infections, and cardiovascular disease prevention in women. Dr. Copeland’s paper

on ethnic differences in receipt of vascular procedures was highlighted by the VA’s Director of health

services research, while Dr. Zeber was lead author for an international working group publication on

medication adherence while also serving as guest editor for issues of Depression Research & Treatment

(with editorial). Given the growth of a solid core of mentees, new clinical research partners, progress on

funded and unfunded studies, an increasing role in the HMORN projects, and maintenance of strong

prior relationships with colleagues in San Antonio and elsewhere, we anticipate continued productivity

in peer reviewed journals for FY13.

0

5

10

15

20

25

30

FY11 FY12

Publications

submitted / underreview

published / in press

Grant Proposals HOC submitted 28 proposals to 10 agencies and received funding notices for 5 of these

proposals in FY12, representing more than a doubling of submissions and funded studies from FY11

(Appendix B). The funding agencies included the Veterans Health Administration (several offices , e.g.,

HSRD, QUERI program, Rural Health), Xenex, Commonwealth Fund, National Institutes of Health (NIDA,

NHLBI), American Heart Association, and the Scott & White Research Grants Program. These proposals

included two separate career development proposals submitted by Dr. Eileen Stock. In addition, Dr.

Zeber’s multisite VA grant on healthcare association infections was funded with a 9th percentile score

shortly after the fiscal year closed. Proposals may not be funded in the same fiscal year they are

submitted so some remain under review. HOC established or expanded collaborative activities with

researchers in the HMO Research Network, maintained strong working relationships with successful VA

researchers at several other HSRD centers, developed a research collaboration with the Scott & White

lead on the Cardiovascular Research Network, Dr. Catherine McNeal, and assumed the institutional

9 | P a g e

leadership role in the newly formed Rural Health Scientific Interest. We continued to work with clinical

investigators at the VA and Scott & White to translate mentoring and consulting efforts into future grant

submissions.

0

5

10

15

20

25

30

35

FY11 FY12

Grant Proposals

total submitted

funded

Conference Presentations With active participation from mentees and clinical investigator colleagues, we represented our

institutions in 18 presentations at national or international research conferences in FY12 (Appendix C).

This total is up from 9 oral or poster presentations in FY11, reflecting a greater commitment to broader

dissemination efforts of center research activities. We sincerely express our appreciation for support

provided to attend these important meetings, which included Academy Health (the largest health

services gathering), the Schizophrenia International Research Society, the American Psychological

Association, and the VA’s national Health Services Research & Development meeting. The latter is

particularly competitive, with less than 1/3 of all abstracts accepted, so we are pleased with having

three people present there. Dr. Basu was also recognized with new investigators awards for two

abstracts accepted for a future FY13 conference. In addition to national meetings, HOC investigators

also presented at several local conferences, collaborative meetings, or internal research events, with

further details under the Service sub-heading below.

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0

2

4

6

8

10

12

14

16

18

20

FY11 FY12

Conference Presentations

Ongoing Projects In addition to the aforementioned newly funded studies, we continue to work on numerous

previously approved projects and have initiated new research activities. Many of the following studies,

funded and unfunded, are led by HOC investigators, while we serve others in capacities of co-

investigator, mentor, consultant, or statistician. Many of these activities have resulted in publications,

grant proposals or conferences listed in our current metrics as well as future productivity. These projects

have developed through ongoing collaborations and new partnerships, as well as through our numerous

mentoring and consulting activities designed to increase overall health services research at the VA and

Scott & White. Those who funding has ended provide rich data sources for junior mentees to utilize in

scholarly papers they develop. Over the past year, we have also continued to develop working

relationships with VA investigators at the VISN 17 Center of Excellence for Research on Returning War

Veterans, including efforts on their funded studies, and have begun to explore collaborations with Dr.

Rebecca Wells, the new chair of the Health Management division at the School of Rural Public Health

who arrived in late FY12.

Copeland (site PI): Assessment of Psychiatric Disorders, Treatment Modalities, and Outcomes

including Psychiatric Admission and Suicidality in Central Texas [PI = S Soumerai / G Simon, other

HMORN partners; locally unfunded study as member of Mental Health Research Network]

Copeland (co-I): Identifying and Validating Complex Comorbidity Clusters in OEF-OIF Veterans

(TRACC) [PI = MJ Pugh; VA HSR&D funded study]

Copeland (PI) / Zeber (co-I): Mental Health Treatment Preferences of OEF/OIF Veterans in South

Texas [Hogg Foundation funded study 2009-2010, analysis ongoing]

Copeland (PI) / Zeber (co-I): Patterns of Late-Life Healthcare among VA Patients with

Schizophrenia [VA HSR&D funded study 2006-2009, analysis ongoing]

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Copeland (PI) / Zeber (co-I): Surgical Treatment Outcomes for Patients with Psychiatric

Disorders (STOPP) [VA HSR&D funded study, analysis ongoing]

Copeland - “Surgical Treatment of Women Veterans: Survey of VA and Non-VA Veterans”:

supplement to Surgical Treatment Outcomes for Patients with Psychiatric Disorders (STOPP)

[funded and initiated in FY12]

Copeland (PI): / Zeber (co-I): Tracking OEF/OIF Transition from DOD to VA [VA HSR&D funded

study 2008, analysis ongoing]

Copeland (PI) / Zeber (co-I): Patient Outcomes in Two Systems of Care [unfunded comparative

project using VA and Scott & White datasets]

Copeland, Pugh, Finley, Zeber (chapter authors): Epidemiology of Co-occurring TBI and PTSD

[textbook being finalized on PTSD, Traumatic Brain Injury, and Returning OEF/OIF Service

Personnel (Oxford Press)]

Copeland (co-I): Drug Related Overdoses Among a Military Population [PI = T Cooper; DoD

funded study, analysis ongoing]

Copeland (co-I): Impact of statins and ACE inhibitors on outcomes for pneumonia and sepsis [PI

= E Mortensen; NINR funded study, analysis ongoing]

Copeland (co-I): Obesity Care Practices in the Veteran’s Health Administration [PI = P Noel; VA

HSR&D funded study 2006-2009, analysis ongoing]

Copeland (co-I): STRONG STAR (South Texas Research Organizational Network Guiding Studies

on Trauma and Resilience) [PI = A Peterson; DoD funded study in progress]

Copeland (co-I) / Zeber (co-I): Inappropriate Drug Use for Seniors: Should VA Adopt New HEDIS

Measures? (HEDIS PIPE) [PI = MJ Pugh; VA HSR&D funded study, analysis ongoing]

Copeland (co-I) / Zeber (co-I): Incorporating Medicare Pharmacy Data into an Analysis of

Potentially Inappropriate Prescribing in Elderly Veterans [PI = MJ Pugh; VA HSR&D funded study

in progress]

McIntyre: coordinator for Scott & White monthly research seminar on Health Equity, designed

to encourage collaboration among participants

Stock / Copeland: serving as mentor and statistical consultants for several ongoing VA

pharmacy resident research projects

Sun / Fang / Kjar: under Dr. Copeland’s supervision, our data analysts have primary ongoing

responsibility for consolidating Scott & White’s VDW data and conducting all necessary validity

checks and HMORN project analyses.

Zeber (site PI): Evaluating the Feasibility to Measure the Extent to Which Asthma Mortality Risk

is Increased in ADVAIR Users [PI = Research Triangle Institute; Glaxo Smith Kline funded study,

analysis ongoing while preparing for Phase II]

Zeber (co-I): ABCs of Diabetes Care Management in Small Community Clinics [PI = M Parchman;

NIH funded study, analysis ongoing]

Zeber (co-I): Role of Clinical Team Functioning and Medication Adherence in Diabetes [PI = M

Parchman / J Pugh; HSR&D funded study, analysis ongoing]

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Zeber (site lead): unfunded new national VA Women’s Practice Based Research Network (39

sites); Dr. Zeber’s study idea on Use of Non-VA Health Services was also selected as the first

project utilizing several Women’s PBRN sites.

Zeber (PI): Evaluation of a Short Pharmacy Assessment for Adherence to Post-Discharge High-

Risk [unfunded Scott & White study with clinical pharmacists developing from an initial

consultation]

Zeber: leading an ongoing international ISPOR working group on medication adherence

Zeber: unfunded work with Dr. David Blackburn on his primary data pertaining to psychological

evaluations for patients considering spinal cord or bariatric surgery; developed from an initial

consultation

Zeber / Copeland: CAHR representatives to monthly SW Health Plan research meetings

Zeber (project PI) / Copeland (co-I): Advanced Center for Interventions and Service Research

(ACISR) for Optimizing Long Term Outcomes in Bipolar Illness Interventions in Hispanic

Communities [PI = Bowden; NIH funded center grant in progress]

HOC enlarged a vibrant network of national and international collaborators. While maintaining

collaborative contacts at the Bedford, Houston, and Puget Sound VAs, the University of Michigan, and

San Antonio Military Medical Center - Ft Sam Houston, HOC forged new collaborations with researchers

at the Baylor University and Texas A&M Health Science Center. Initiated by HOC and hosted by VISN 17

COE and HOC, the VISN 17 Research Grand Rounds provides a bimonthly opportunity for sharing

research interests in veterans health.

Notable Accomplishments

HOC is pleased to report national and local recognition for its team members over the fiscal

year, including professional appointments and noteworthy evidence of continued career advancement.

These accolades further establish CAHR and its institutional sponsors as leaders in the field of health

services research, supporting our mission and goal of better disseminating high quality, influential

projects to improve patient outcomes. Dr. Copeland’s article “Ethnicity and Race Variations in Receipt of

Surgery among Veterans With and Without Depression” was selected by Dr. Seth Eisen (VA Director of

HSR&D) for presentation to selected leaders as part of the publication alert process. She was invited to

join the VA Information Resource Center (VIReC) Technical Advisory Committee as a research member;

the advisory committee advises leadership and staff on technical aspects and emerging issues regarding

VA databases and data uses. With a national reputation as a leading expert in VA data, Dr. Copeland also

continues to serve as chair of the VA Sub-committee for Information and Data Security. In addition to

being invited to lead two studies as part of the national Women’s PBRN project, Dr. Zeber recently

joined the national Behavioral Health Advisory Board for Academy Health, the leading health services

research organization. He also assumed the chair position for the Central Texas VA Institutional Review

Board, and accepted an invitation to join the World Journal of Psychiatry as an editorial board member

for this new international journal.

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Other Items of Interest

SCOPE: Newsletter of the Central Texas Veterans Research Foundation (Volume 5, Fall 2012).

Profile of CAHR, HOC co-directors and projects.

Temple daily newspaper mention (with CAHR) for summer intern Marcene Grimsley’s Texas

Biosciences Institute project on Women Veterans with Post-traumatic Stress Disorder (August

2012)

Rashmita Basu

o Dr. Basu’s abstract “Socioeconomic Predictors of Cognitive Functioning among Older

Indians: Role of Gender disparities” was nominated for 2012 Nobuo Maeda

International Research Award in the Public Health and Aging Section of the APHA

o her abstract “Onset versus Progression of Chronic Health Problems: Role of Life-long

Socioeconomic Position and Health Behavior” was selected for honorable mention for

the APHA James G. Zimmer New Investigator Award

Copeland:

o Dr. Copeland was invited to serve on the search committee for the Director of a

proposed new Biomedical Informatics Center at TAMHSC. The new center is critical to

the success of TAMHSC’s application for C*STAR funding.

o press Release: Mary Lieber journals featured Cathleen Rivera's women & aspirin under-

use article (Rivera, Song, Copeland, Buirge, Ory, McNeal)

o new member, Schizophrenia International Research Society

o received appointment as Associate Professor Tenure-in-name-only in the Texas A&M

Health Science Center College of Medicine - July 2011

Eileen Stock

o Dr. Stock was accepted as SIDS committee member (August 2012)she moved from the

position of SAS programmer/data analyst to Research Scientist to pursue a career track

of junior investigator

o she received formal appointment as Assistant Professor, Non-Tenure, Department of

Internal Medicine, Texas A&M Health Science Center College of Medicine

Zeber

o Dr. Zeber served as the Lead Guest Editor for a special edition for the journal Depression

Research and Treatment on ethnic disparities in mental health care and outcomes

o He received appointment as Joint Associate Professor, Texas A&M School of Rural Public

Health, Department of Health Promotion and Community Health Sciences

o new member, Schizophrenia International Research Society

o notified by the Annals of Family Medicine, that “Participatory decision making, patient

activation, medication adherence and control of risk factors for complications for type-2

diabetes” was one of the most read articles in 2012 (Parchman ML, Zeber JE et al.,

8(5):410-7).

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Mentoring To foster the integration of new knowledge into clinical practices, and advance the research

expertise of beginning and intermediate researchers, we have endeavored to work closely with a large

number of clinical researchers, post-doctoral fellows, and junior investigators across the VA, Scott &

White and our academic affiliates. Drs. Copeland and Zeber hosted monthly education sessions for a

Scott & White Advance Clinical Research Group, and with Dr. Stock, provided mentoring on protocol

development including study design and statistical analysis guidance for VA Pharmacy Residents. The

HOC directors also organized a weekly mentoring session for up to 20 researchers from VA and Scott &

White. During those sessions, HOC advised the attendees on topic selection, protocol development,

proposal preparation, internal review board processes, manuscript preparation and other necessary

topics for performing duties as a research investigator. HOC also proposed, developed, and successfully

established a Scott & White Minority Pre-doctoral Research Fellowship. The first incumbent, Raphael

McIntyre, was closely involved in several projects including manuscript and abstract development. As

noted above, Mr McIntyre coordinated a new monthly seminar for researchers interested in health

equity and disparities research, supervised by Drs. Zeber and Copeland. For the second year in a row,

HOC worked with the Texas Biotechnical Institute (TB) to mentor two summer high school students,

Marcene Grimsly and Laesha Stephens, on their projects examining Women Veterans with TBI and/or

PTSD and Cognitive Decline in Older Adults, respectively. In addition to a variety of ad hoc assistance as

needed, other mentoring activities included assisting Toby Cooper, a pharmacy researcher at Ft. Hood

(Copeland), study design and proposal support for a rising junior VA researcher , Chetan Jinadatha

(Copeland, Zeber), and doctoral thesis consulting for Gordon Black at the Frontier School of Nursing

(Zeber).

These meetings and collective mentoring efforts translated into several publications using our

datasets and those of our colleagues, as well as informed grant proposals (e.g., C Rivera, R Basu, J Tsan,

D Blackburn, others). They will continue to do so in FY13. One additional goal for FY13 will be to follow

these mentees to track their subsequent productivity and progress as emerging clinical investigators.

We fully anticipate such continued mentoring will yield further productivity as we continue to seek out

new and assist previous energetic colleagues seeking to improve their research skills.

Consulting Many investigators across clinical departments sought the expertise of Drs. Copeland and Zeber

to guide and assist them through the research process, including topic selection, development of

research questions and methodology, protocol development, identification and submission of proposals

to IRB or funding agencies. They consulted and assisted in the development and submission of scholarly

manuscripts, as well as grant proposals. Drs. Copeland and Stock and Ms. Sun provided statistical

analysis used in jointly submitted proposals and manuscripts that resulted from consulting and

collaborative efforts. Support to Scott & White included consulting with clinicians from Psychiatry,

Orthopedics, Internal Medicine, Children’s Cardiovascular Health and Pulmonary Disease. VA assistance

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reached researchers at VISN 17 and Houston Centers of Excellence, Central Texas, Bedford and South

Texas facilities.

Consulting efforts last year declined somewhat from the burst of activity generated by our

arrival in Fall 2010. We estimate that in FY12 HOC provided some methodological consulting to 40

different members of the Scott & White, VA or academic communities (Appendix D), amounting to 80-

100 total hours. While many of these represented single hour-long sessions, others involved ongoing

study design support over the period of several months to shape and finalize IRB protocols, papers or

grant submissions. Many instances of mentoring or consulting developed into fruitful collaborative

relationships, an equally promising and rewarding scenario. We continued to openly encourage clinical

researchers to meet with us individually, and plan to initiate new efforts to highlight our center services

through grand rounds presentation and other research events.

Service and Other Activities In addition to the quantifiable standard research metrics (publications, grants, conferences,

other), HOC devoted substantial time to internal, national and international organizations in FY12. These

activities and contributions reflect upon the increasing research reputation and recognition of our

collective expertise areas. Detailed below, our activities included serving on national and international

health services work groups, lectures and local talks, reviewing articles for major research journals,

conference abstracts, and proposals for VA Health Services Research & Development and other funding

mechanisms, and committee work. Further developing own research and administrative skills, these

activities benefit the broader clinical and research mission of our organizations.

Basu

mentored high school students in summer 2012 from TBI project

reviewed 10 abstract reviewed for the GSA conference, 2012

served as a discussant for 2 manuscripts at the ASHE Conference, 2012

Copeland

member, Central Texas VA IRB; Chair, Subcommittee on Information and Data Security

presenter (with Zeber and Stock) and coordinator of quarterly Research Grand Rounds, VISN 17

Regional Collaborative: VISN 17 Center of Excellence in Waco, Temple, North Texas VA, South

Texas VA, VA Valley Coastal Bend, UT Southwestern Medical Center, Baylor University, Scott &

White

2011 Fall MHRN Steering Committee Meeting [Bethesda, MD] that identified research topics

and projects to support in FY2012 (with Zeber)

journal reviews: total of 9, including Schizophrenia Bulletin, Psychiatric Services , Journal of

Clinical Psychiatry, Medical Care, and Clinical Economics and Outcomes Research

16 | P a g e

reviewer for three research award proposals for VA/HSR&D's Quality Enhancement Research

Initiative (QUERI). QUERI is part of a system-wide Department of Veterans Affairs

transformation aimed at improving the quality of healthcare for Veterans by accelerating

adoption of research findings and promoting implementation science.

reviewer/contributor to "Resource User Guide: Corporate Data Warehouse (CDW)" for VIReC

interviewer, several Scott& White DOM faculty candidates (with Zeber)

reviewer, two proposals for the RGP Mentor Awards Program, Scott & White

reviewer, 8 abstracts for 2012 HSRD/QUERI conference

consultant to the workgroup at Temple VA tackling quality of care issues at Olin Teague VAMC.

McIntyre

research coordinator role for Dr. Hochhalter RGP-funded study, “The Role of Health Literacy in

Hospital Readmissions Among Medical Aid Program Members”

developer & coordinator for new monthly Health Equity Research Forum

organizer, conference call with national policy leaders for planned perspectives paper

Stock

member, SIDS committee, August 2012

Tsan

lecturer, in the Baylor Undergraduate research seminar at the VISN 17 Center of Excellence

[Waco, TX] October 2011: “Primary care mental health integration: Voices from our nation's

veterans”

developer, Institutional Review Board at VA Valley Coastal Bend Health System, Harlingen, TX

Zeber

member and chair, Central Texas VA IRB

editorial board member, World Journal of Psychiatry

reviewer, two proposals for the RGP Mentor Awards Program, Scott & White

lecturer, Texas A&M School of Rural Public Health, College Station October 2011- “Surgical Rates

and Medication Adherence Barriers in Veterans with Serious Mental Illness”

lead role, ISPOR International Medication Compliance Working Group (ongoing task force

member)

presenter, national VA Health Economics Research Center Cyber-seminar February 2012 -

“Adherence in Chronically Ill Veterans: Copayments, Other Potential Barriers, and Health System

Factors to Potentially Mitigate Cost Burdens”

lecturer, Clinical Psychology Seminar, Texas A&M University College Station February 2012 -

“Potential Clinical and Health System Interventions to Improve Medication Adherence in

Patients with Chronic Health Conditions”

site lead, new VA Women’s Practice Based Research Network

reviewer, 12 manuscripts, for journals including Schizophrenia Research and Treatment , Journal

of Traumatic Stress , Bipolar Disorder , BMC Health Services Research, and Diabetes Care

17 | P a g e

reviewer, 13 abstracts for 2012 HSRD/QUERI conference

reviewer, 12 abstracts for 2012 Academy Health Annual Research Meeting

reviewer, 18 abstracts for 2012 International Society for Pharmacoeconomics & Outcomes

Research

presenter, March 16 Medicine grand rounds (with Copeland)

lecturer, Health Equity seminar August 2012

18 | P a g e

Appendix A Publications

key: bold = HOC employee; underline = affiliate investigator; italics = post-doc, Scott & White

or Central Texas VA colleague or mentee.

Published / In Press / Accepted

1. Arar N, Noel PH, Leykum L, Zeber JE, Romero RR, Parchman ML. Implementing

quality improvement in small, autonomous primary care practices: implications for the

patient centered medical home. Quality in Primary Care 2011; 19(5): 289-300.

2. Copeland LA, Zeber JE, Pugh MJ, Phillips KL, Lawrence VA. Ethnicity and race

variations in receipt of vascular surgery among veterans with and without depression.

Depression Research & Treatment 2011:370962.

3. Copeland LA, Pugh MJ, Hicks PB, Noel PH. Use of obesity-related care by psychiatric

patients. Psychiatric Services 2011; 63(3):230-6

4. King P, Mortensen EM, Bollinger M, Restrepo MI, Copeland LA, Pugh MJ, Nakashima

B, Anzueto A, Noël PH. Impact of obesity on outcomes for patients hospitalized with

pneumonia. in press, European Respiratory Journal.

5. Mackey K, Parchman MP, Leykum L, Lanham H, Noel PH, Zeber JE. Impact of the

chronic care model on medication adherence when patients perceive cost as a barrier.

Primary Care Diabetes 2012; 6(2):137-42.

6. Maples NJ, Copeland LA, Zeber JE, Li X, Moore TA, Dassori D, Velligan DI, Miller

AL. Can Medication management coordinators help improve continuity of care after

psychiatric hospitalization? Psychiatric Services 2012; 63(6):554-60.

7. Mortensen EM, Nakashima BR, Cornell JE, Copeland LA, Pugh MJ, Anzueto AR, Good

CB, Restrepo MI, Downs JR, Frei CR, Fine MJ. Population-based matched case-control

study of statins, ARBs, and ACE inhibitors on pneumonia-related outcomes. Clinical

Infectious Disease 2012;55(11):1466-73.

8. Noël PH, Wang CP, Bollinger MJ, Pugh MJ, Copeland LA, Tsevat J, Nelson K, Dundon

MM, Hazuda HP. Intensity and duration of obesity-related counseling: association with

5-year BMI trends among obese primary care patients. Obesity 2012;20(4):773-82.

9. Pugh MJ, Copeland LA, Zeber JE, Wang CP, Amuan ME, Mortensen EM, Tabares J,

Van Cott AC, Cooper T, Cramer JA. Antiepileptic drug monotherapy exposure and

suicide-related behavior in older veterans. in press, Journal of the American Geriatrics

Society.

10. Rivera CM, Song J, Copeland LA, Buirge C, Ory M, McNeal CJ. Underuse of aspirin

for primary and secondary prevention of cardiovascular disease events in women. J

Womens Health 2012;21(4):379-87.

19 | P a g e

11. Tsan JY, Zeber JE, Stock EM, Sun FF, Copeland LA. Primary care-mental health

integration and treatment retention among Iraq and Afghanistan war veterans”, in press,

Psychological Services.

12. Tsan JY, Stock EM, Gonzalez JM, Greenawalt DS, Zeber JE, Rouf E, Copeland LA.

Mortality and guideline-concordant care in older patients with schizophrenia. in press,

BMC Medicine.

13. Williams EO, Stock EM, Zeber JE, Copeland LA, Miller NA, Stuart M, Palumbo F.

Payor characteristics associated with antipsychotic polypharmacy in an ambulatory care

setting. in press, Journal of Pharmaceutical Health Services Research.

14. Zeber JE, Gonzalez JM, VanDorn RA, Interian A. The challenge of incorporating

cultural issues into depression treatment: translating diverse current research approaches

into clinical practice. Depression Research & Treatment 2011:195084.

Submitted / Under Review ** papers that were accepted since 8/31/12

1. Asias BD, Stock EM, Small N, Palacios K, Patel J, Krause J, Cavness S, Dzenowski C,

Ta M. Clinical and financial outcomes of switching insulin glargine to insulin detemir in

a veteran population with type-2 diabetes. [under review at Diabetic Medicine]

2. Basu R et al. Education and dementia risk: results from the aging demographics and

memory study. [under review at Research on Aging]

3. ** Blackburn DR, Monte RC, Zeber JE, McIntyre R. Psychological profiles of patient

candidates for spinal cord stimulator use. [under review at Practical Pain Management]

4. Copeland LA McIntyre RM, Stock EM, Zeber JE, MacCarthy DJ, Pugh MJ.

Prevalence of suicidality among hispanic and african-american patients following

surgery. [under review at Journal of the National Medical Association]

5. Copeland LA, Sako E, Wang CP, Mortensen EN, Pugh MJ, Zeber JE, Mortensen EM,

Restrepo MI, Flynn J, MacCarthy AM, Lawrence VA. Patients with and without serious

mental illness: two distinct surgical populations in the veterans health administration.

[under review at Health Services Research]

6. Copeland LA, Zeber JE, Sako EY, McNeal CJ, Pugh MJ, Restrepo MI, Rivera CA,

Mortensen EM, Wang CP, Lawrence VA. Perioperative experiences of women veterans

with cardiovascular disease: a comparative gender study. [under review at Journal of

General Internal Medicine]

7. ** Culler SD, Parchman ML, Zeber JE, Noel PH, Leykum LI, Robertson M, Romero

RA. Health extension agent cost estimates for primary care transformation. [under review

Annals of Family Medicine]

20 | P a g e

8. Greenawalt D, Sun F, Zeber JE, Copeland LA. Post-traumatic stress disorder, major

depressive disorder and likelihood of invasive surgery: a retrospective longitudinal study

among VA patients. [under review at Psychosomatic Research]

9. ** Jinadatha C, Quezada R, Huber TW, Williams JB, Zeber JE, Copeland LA.

Evaluation of a pulsed-xenon ultraviolet room disinfection device for impact on

contamination levels of methicillin-resistant staphylococcus aureus. [under review at

Journal of Hospital Infection]

10. Jinadatha C, Huber TW, Hussain Z, Copeland LA. Methicillin-resistant staphylococcus

aureus (MRSA) genotyping in the veterans health administration to evaluate the origin of

hospital acquired infectious diseases. [under review at Clinical Infectious Disease]

11. Stock EM, Tsan JY, Zeber JE, Kirkpatrick B, Cooper TL, Copeland LA. Method of

analysis as a factor in models of admission among veterans of Iraq and Afghanistan

deployments. [under review at Multivariate Behavioral Research]

12. ** Stock EM, Stamey JD, Young DM. Bayesian interval estimation for the difference in

TPRs and FPRs of two diagnostic tests with unverified negatives. [under review at

Communications in Statistics – Simulation and Computation]

13. Zeber JE, Copeland LA, Pugh MJ, Restrepo MI, MacCarthy D, Lawrence VA. Surgical

rates of common procedures in veterans with serious mental illness. [under review at

Psychiatric Services]

14. ** Zeber JE, Manias EF, Williams AF, Hutchins D, Udezi WA, Roberts C, Peterson

AM. A systematic literature review of psychosocial and behavioral factors associated

with initial medication adherence: a report of the ISPOR medication adherence &

persistence special interest group. [under review at Value in Health]

Appendix B Grant Proposals

Key: bold = HOC employee; underline = affiliate investigator; italics = post-doc, Scott & White or Central Texas VA colleague or mentee.

Awarded [funding decision received between 9-1-11 and 8-31-12]

PI Title Team Agency Period - $$

R Basu Longitudinal Transitions in Cognitive

Decline among Older Adults

JE Zeber; LA Copeland Scott & White

Research Grants

Program

2012-2013

$25,000

A Hochhalter Health Literacy and Improving Hospital

Discharge Transitions in a Low-Income

Patient Population

JE Zeber; R McIntyre Scott & White

Research Grants

Program

2012-2013

$50,000

C Jinadatha Evaluation of a Pulsed-Xenon Ultraviolet

Room Disinfection Device for Impact on

contamination levels of C.diff and MRSA

JE Zeber; LA Copeland Xenex 2012

$125,000

LA Copeland Surgical Treatment of Women Veterans:

Survey of VA and Non-VA Veterans,

Addendum to the STOPP Study

LA Copeland; JE Zeber VHA Health Services

Research &

Development

2012-2013

$19,500

R Reid Hybrid Strategies to Improve Health Care’s

Triple Aims: Lessons Learned From the

Transformations of Two Health Systems

LA Copeland (Site PI); JE

Zeber; R Basu; FF Sun; S

Forjuoh

Commonwealth Fund 2012-2014

$67,600

Under Review [submitted through August 31, 2012]

** - funded since August 31, 2012

PI Title Team Agency Period ($$)

J Bolin Evaluating Youth Antipsychotic

Management in a Patient-Centered

Medical Home

LA Copeland; JE Zeber;

others at Lone Star Circle of

Care, TAMHSC SRPH

NIH 2013-2018

$1,261,475

LA Copeland Intervention to Engage ICU Visitors in

Efforts to Reduce Delirium

JE Zeber; EM Stock Scott & White Research

Grants Program

2013-2014

$50,000

LA Copeland Children Adapting to PTSD and TBI in

Parents (CAPTIP)

SB Morissette; E Finley; EM

Stock; M Trent

NIH R21 2013-2014

$379,200

LA Copeland Delayed Entry into VA Care for JE Zeber; MJ Pugh Veterans Affairs HSR&D 2013-2015

22 | P a g e

PI Title Team Agency Period ($$)

OEF/OIF Veterans merit $730,916

LA Copeland Post-surgical Outcomes for

Traumatically Injured Military Patients

(POTIMP)

JE Zeber; MJ Pugh Veterans Affairs HSR&D

merit

2013-2015

$749,956

LA Copeland Costs of Care for Post-Deployment

Health in Rural Settings

JE Zeber; other colleagues in

San Antonio & Houston

Veterans Affairs QUERI

supplement

2013-2014

$99,000

M Hawn Improving Surgical Quality: Identifying

the Risks and Impact of Readmission

LA Copeland; other

colleagues at 4 other VAMC’s

Veterans Affairs HSR&D

Merit

2013-2016

$1.1M

C Jinadatha Heart of Texas: Center for Excellence in

Healthcare Infection Prevention

LA Copeland; JE Zeber; F

Sun

Veterans Affairs Patent Safety

Center

2013-2017

$1.2million

L Leykum VetCARE: A Veteran-centered,

Complexity-Science Approach to

Readmissions

JE Zeber; other colleagues in

San Antonio

Veterans Affairs HSR&D

Merit

2013-2015

$975,000

C McNeal Pragmatic Cluster RCT to Compare

Selective v. Universal Pediatric Lipid

Screening

LA Copeland; C Rivera NHLBI R21 2013-2016

$706,431

C McNeal HMORN - Development of a

Cardiovascular Surveillance System in

the CVRN

LA Copeland; JE Zeber NHLBI U01 2013-2018

C Rivera Aspirin Use for the Prevention of

Cardiovascular Disease Events

LA Copeland (mentor) CVRN Scholars Program 2013-2014

$300,000

EM Stock Adverse Cardiovascular Events

Associated with Antidepressant

Pharmacotherapies for Veterans with

PTSD and SUD

LA Copeland; SB Morissette;

C McNeal

AHA Scientist Development

Grant

2013-2014

$302,417

EM Stock Pharmacotherapy Patterns among

Veterans Enduring Co-occurring PTSD

and SUD (PAVE)

LA Copeland (mentor); SB

Morissette (mentor); JD

Stamey (mentor); JE Zeber

(consultant)

Veterans Affairs HSR&D

Career Development Award

2013-2018

$882,110

EM Stock Pharmacotherapy Patterns among

Veterans with PTSD/SUD

LA Copeland (mentor); SB

Morissette (mentor); JD

Stamey (mentor)

NIH NIDA K25 2013-2018

$479,081

EM Stock Cardiovascular Risk by Pharmacotherapy

for Co-occurring PTSD and SUD

LA Copeland (mentor); C

McNeal (mentor)

CVRN Scholars Program 2013-2014

$115,000

JE Zeber ** Pulsed Xenon Technology Targeting LA Copeland; C Jinadatha; Veterans Affairs HSR&D 2013-2015

23 | P a g e

PI Title Team Agency Period ($$)

Hospital Acquired Infections, Cost and

Outcomes

others at 4 VAMCs merit $745,000

JE Zeber Pulsed Xenon Ultraviolet Technology

Targeting Nursing Home Acquired

Infections

LA Copeland; C Jinadatha; A

Stevens; F Sun; L Hitchcock;

others at 4 VAMCs and 2

S&W facilities

Agency for Healthcare

Research and Quality R01

2013-2017

$2.4million

Submitted but Not Funded

PI Title Team Agency

R Basu Longitudinal Transitions in Cognitive

Decline among Older Adults

A Stevens; LA Copeland; JE

Zeber

NIH R03

C Colbert The Development and Validation of a

Measure of Systems Thinking for

Healthcare Professionals

JE Zeber Josiah Macy Foundation

JE Zeber Improving Medication Adherence in

Schizophrenia: A comparison of two

different technologies for improving

adherence; Electronic Monitoring and

Cell Phone

LA Copeland Veterans Affairs HSR&D

merit

JE Zeber (site PI)

Centers for Education and Research on

Therapeutics: 1) Determinants of Non-

Initiation, Primary Non-Adherence, Early

Non-Persistence and Ongoing Adherence

to Bisphosphonates for Osteoporosis; 2)

Improving the Quality and Safety of

Opioid Use for Non-malignant Pain in the

Elderly

R Basu; LA Copeland Agency for Healthcare Quality

& Research / NIH [HMORN

Sentinel group]

JE Zeber Post-deployment Challenges for OEF/OIF

Veterans in Rural Areas: A Dual System

Analysis

LA Copeland; MJ Pugh Veterans Affairs Office of

Rural Health

Appendix C Conferences Presentations or Abstracts Submitted

key: bold = HOC employee; underline = affiliate investigator; italics = post-doc, Scott & White or Central

Texas VA colleague or mentee. Lead authors only listed unless non-HOC; most abstracts include several

HOC co-authors.

1. Basu R. “Onset verses progression of chronic health problems: role of life-long

socioeconomic position and health behavior” (talk) – Academy Health Annual Research

Meeting (Orlando, June 2012)

2. Basu R. 1) “Socioeconomic predictors of cognitive functioning among older Indians: role

of gender disparities” (talk); 2) “Socioeconomic status and onset verses progression of

health problem: a life course perspective” (talk); 3) “Factors influencing the age at onset

of dementia” (poster) – American Gerontological Society (San Diego, November 2012)

3. Basu R. “Willingness to pay for Alzheimer's disease: a contingent valuation approach”

(poster) – American Society for Health Economists Conference Minneapolis

(Minneapolis, June 2012)

4. Basu R. Session chair: 1) Physician prescribing behavior and patient adherence; 2)

Physician supply and health system performance – American Society for Health

Economists Conference (Minneapolis, June 2012)

5. Copeland LA. “Metabolic monitoring for black vs white veterans with schizophrenia”

(poster) – Schizophrenia International Research Society Conference (Florence, Italy, April

2012)

6. Fennell TJ with Greenawalt DS, Stock EM, Copeland LA, Tsan JY. “Effects of delayed

mental health care for depression and alcohol use problems for veterans” – American

Psychological Association 120th

Convention (Orlando, May 2012)

7. Lu W with Stock EM. "Efficacy of High Dose Omega-3 Fatty Acids in Very High

Triglyceridemia" (abstract accepted) – American Society of Health System Pharmacies

Conference (Las Vegas, December 2012)

8. Pawloski PA with Copeland LA. “Evaluating the Quality of VDW Pharmacy Data” –

HMORN 18th

Annual Conference (Seattle, April-May 2012)

9. Phillips KL with Copeland LA, Zeber JE. “Racial/ethnic disparities in monitoring and

treating metabolic parameters among schizophrenia patients receiving antipsychotic

medications” (abstract submitted) – Gerontological Society of America (San Diego,

November 2012)

10. Pugh MJ with Copeland LA. “Complex morbidity clusters: beyond the polytrauma

clinical triad” (talk) – Veterans Affairs HSR&D/QUERI National Conference (Baltimore,

July 2012)

11. Stock EM. “Methods of analysis as a factor in models of admission among Veterans of

Iraq and Afghanistan deployments” (poster) – Veterans Affairs HSR&D/QUERI National

Conference (Baltimore, July 2012)

25 | P a g e

12. Thurman L with Stock EM. "Monotherapy versus double-coverage of pseudomonas

aeruginosa: a combination antibiogram for hospitalized veterans" (abstract accepted) –

American Society of Health System Pharmacies Conference (Las Vegas, December 2012)

13. Tsan JY with Greenawalt DS, Stock EM, Copeland LA. “Effects of integrated mental

health care at the Central Texas Veterans Health Care System” (poster) – American

Psychological Association 120th Convention (Orlando, May 2012)

14. Tsan JY, Zeber JE, Stock EM, Copeland LA. “Primary care mental health integration

and persistence in care among Iraq and Afghanistan war veterans” (poster) – Veterans

Affairs HSR&D/QUERI National Conference (Baltimore, July 2012)

15. Zeber JE. “The impact of cultural competency on reducing ethnic disparities in

psychiatric diagnosis: a regional variation analysis” (abstract submitted) – Veterans

Affairs HSR&D/QUERI National Conference (Baltimore, July 2012)

16. Zeber JE. “Longitudinal medication adherence instability and the risk of psychiatric

admission in veterans with schizophrenia” (poster) – Veterans Affairs HSR&D/QUERI

National Conference (Baltimore, July 2012)

17. Zeber JE. “The impact of cultural competency on reducing ethnic disparities in

psychiatric diagnosis: a regional variation analysis” (poster) – Schizophrenia International

Research Society Conference, (Florence, Italy, April, 2012)

18. Zeber JE. “Longitudinal medication adherence instability and the risk of psychiatric

admission in veterans with schizophrenia” (poster) – Schizophrenia International Research

Society Conference, (Florence, Italy, April, 2012)

26 | P a g e

Appendix D Consultation

September – Dr Basu, CAHR, S&W Research Scientist, R03 research grant and proposal

discussion [Copeland, Zeber]; Dr Raghavan, Endocrinology, S&W, research methodology

and analysis advice [Copeland]; Dr McClean, VA, advice on IRB submission / Protocol

revision [Copeland]; Dr Rivera, Internal Medicine, S&W, protocol review [Copeland,

Zeber]; Dr Loera, Chief Geriatrics, Temple VA, research interests discussion [Copeland,

Zeber]; Deepika Reddy, S&W Endocrinology, research questions discussion [Copeland,

Zeber]; Dr Blackburn, S&W Psychiatry, Research study design assistance [Zeber]; Dr

Morissette, Psychologist, Temple VA, consulting on HSR&D abstracts [Zeber]

October - Dr Emran Rouf, S&W Internal Medicine, preliminary research ideas [Copeland,

Zeber]; Dr David Case, S&W [Copeland]; Dr Brent Rocke, S&W [Copeland]; Dr J Gail

Walden, South Texas pre-doctoral student [Copeland]; Dr Eric Slade, Univ of Maryland,

accessing CDW data, dealing with DART, and cyber seminars [Copeland]; Dr Steve LaRosa,

S&W study design [Copeland]; Dr Juan Zubieta [Copeland, Zeber]

November - Dr Emran Rouf, S&W Internal Medicine, regarding QI ideas [Copeland, Zeber];

Dr Steve LaRosa, S&W study design [Copeland]; Dr Jeff Brzostek, VA Psychology,

regarding PTSD, on substance abuse and suicide research topics [Copeland, Zeber]; Dr

Olawale Fashina, VA Ambulatory Care, regarding possible ways to examine PACT

outcomes [Zeber]; Dr Ralph Monte, S&W Adult Psychology Fellow, discussions regarding a

potential paper using STOPP data [Copeland, Zeber]; Dr Phil Rascoe, S&W/VA Thoracic

Surgery, regarding research interests and developing a paper using STOPP data [Copeland,

Zeber]; Dave Bonner, PLS Dissertation, University of Mary Hardin-Baylor [Stock]; Cristina

Gonzales (Beta-blockers; PharmD resident) with Eni Williams, PharmD, Temple VA

[Stock]; Cristina Gonzales (PharmD), Sonal Patel (Nurse Practitioner), and Bernadette Asias

(PharmD) regarding protocol development (VA researchers) [Copeland, Stock]

December - M Gillman HP, Matt Daley KP, S&W Pediatric, CVRN [Zeber]; Catherine

McNeal, M Gillman, Cardiovascular Research Network 2 [Copeland, Zeber]

January - S&W HR, Workplace Wellness Executive MBA program [Copeland]; Dr Emilie

Becker, Texas Department of State Health Services, Death data on the VA severely mentally

ill [Copeland]; Alex Hainzinger, S&W Wellness survey [Copeland]; Dr Steve LaRosa, S&W

study design [Copeland]; Dr Philip Rascoe, VA, Esophageal cancer research paper

[Copeland, Zeber]; Dr Ghamande, S&W [Copeland]; Dr Amjad Kahn, Mental Health

research project development [Copeland, Zeber]; Dr Cathleen Rivera, S&W Internal

Medicine, CVRN Scholars proposal [Copeland]; Jeff Clark, S&W Neurology, research

projects and IRB discussions [Zeber]; Dr Emran Rouf, S&W Internal Medicine, simulation

project [Zeber]; Dave Bonner, University of Mary Hardin-Baylor, Doctoral Candidate for

University of North Texas, PLS Dissertation [Stock]

27 | P a g e

February - Dr C Gonzales, Temple VA, data core meeting [Copeland]; Dr Jeff Clark, S&W

Neurology, research, goals and IRB consultation [Copeland, Zeber]; Dr Vasu Raghavan,

S&W Diabetes Institute, protocol and ICF revision; will collaborate on his study, Prospective

Evaluation of Patients Experiencing Rapid Weight Loss Registry (PROSPER Weight Loss

Registry) [Copeland]; Dr Colleen Colbert, S&W Office of Medical Education, Evaluation &

Research Development, grant consultation and comments, collaboration with Luci Leykum

MD (UTSCSA) [Zeber]; Dr Blackburn, S&W Psychiatry, datasets and research study

consultation [Zeber]; Dr Tiffany Berry, S&W Family Medicine, consultation to the

Medication Adherence Group as an expert panelist [Zeber]; Dr Ralph Monte, S&W Adult

Psychology Fellow, topic selection and manuscript preparation [Copeland, Zeber];

Bernadette Asias, PharmD, Temple VA, data analysis support [Stock]

March - Dr Solomon Williams, VA [Copeland, Zeber]; Dr Seema Varghees [Copeland]; Dr

Ghamande, S&W protocol [Copeland]; Dr Steve LaRosa, S&W study design [Copeland]

April - Dr Ghamande, S&W protocol [Copeland]; Dr Steve LaRosa, S&W study design

[Copeland]

May - Dr Seema Varghees, S&W protocol [Copeland]; Dr Steve LaRosa, S&W study design

[Copeland]June - Dr Ghamande, S&W protocols [Copeland]

July - Dr Ghamande, S&W protocols [Copeland]

August - Dr Justin Zachariah, Harvard Medical School, Children's Hospital Boston, study

design [Copeland]; V Malabonga, Serum Procalcitonin Levels in Various Infiltrative

Pulmonary Disorders [L Copeland Protocol development; study design]