Center for Care Delivery and Outcomes Research

Additional Research Areas

Research outside of CCDOR’s two priority areas contributes to the overall mission of the Center and positions CCDOR to expand its portfolio in areas of emerging importance. While “additional research” includes a diverse set of research interests and studies, of particular salience is CCDOR’s research on cancer prevention and control, including tobacco cessation and colon cancer screening; healthy aging research; and evidence synthesis.

Cancer Prevention and Control Highlights:

• This work focuses on lung and colorectal cancer and leverages the partnership we have developed with the National Center for Health Promotion and Disease Prevention (NCP).
• Dr. Fu is a co-investigator and VA site PI for a National Cancer Institute (NCI)-funded sequential, multiple assignment, randomized trial (SMART) to inform the choice and delivery of smoking cessation treatments for smokers receiving lung cancer screening.
• Dr. Fu is also conducting on strategies to implement proactive telephone outreach strategies to engage smokers in treatment.
• Along with collaborators at the Manhattan VA and New York University, Dr. Fu is conducting a type I hybrid effectiveness/implementation trial to compare the effectiveness of an opt-out approach to an opt-in approach at helping Veterans quit smoking in primary care. Dr. Fu and his collaborators are also comparing the population impact of longitudinal telephone-supported versus text-supported care to determine how best to deliver chronic disease care to all smokers in a safety-net health system.
• Dr. Melzer is a pulmonologist who is mentored by Dr. Fu; her focus is on improving tobacco cessation in patients with chronic obstructive pulmonary disease (COPD). She is developing a CDA proposal examining the effectiveness of a combination of proactive outreach, text-based support, and pharmacist-managed tobacco treatment among patients with COPD.
• Dr. Sultan is a gastroenterologist who studies colon cancer screening. She is an executive committee member of a multisite trial comparing Fecal Immunochemical Test to colonoscopy for colon cancer screening across VHA.
• Dr. Sultan recently completed a Career Development Award focused on identifying patient factors that influence colonoscopy completion and interventions to improve adherence rates for colonoscopy. She has CCDOR pilot funding to develop and validate a self-administered colonoscopy prep adherence survey that will be used in future colonoscopy research and has proposed a study aimed at identifying modifiable targets to improve bowel prep quality during colonoscopy.

Healthy Aging Highlights:

• Dr. Ensrud is an internationally-recognized expert in the epidemiology of frailty and functional limitations among community-dwelling older adults.
• Dr. Duan-Porter is submitting a proposal to examine how functional limitations impact utilization of VA health services among older Veterans with multi-morbidity, identify interventions to promote functional independence, and reduce preventable acute care utilization.

• Under the direction of Dr. Wilt, CCDOR’s evidence synthesis researchers work to identify practices ready for implementation and to identify evidence gaps needing further research.
• CCDOR’s evidence synthesis research is comprised of 3 programs:
  • Minneapolis VA Evidence-based Synthesis Program (ESP) Center (1 of 4 nationwide funded by QUERI).
  • Minnesota Evidence-based Practice Center funded by the Agency for Healthcare Research and Quality.
  • Minneapolis Evidence Review Team which conducts independent non-industry funded systematic reviews often in support of clinical practice guideline development.
• CCDOR’s evidence synthesis reviews provide timely and accurate syntheses of targeted health care topics important to VA clinicians, managers, and policymakers as they work to improve Veterans’ health and health care. Reports are disseminated throughout VA via the ESP Web site, Management eBriefs, and Cyberseminars and more broadly in publications in peer-reviewed journals.
• Dr. Wilt was the recipient of the 2014 Under Secretary’s Award in Health Services Research
• See the Evidence Synthesis Core for more details on this research area

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