Background Conducting multisite studies has many challenges, including determining the geographic distance between sites, ensuring effective communication, monitoring intervention and data integrity, handling institutional policy variations, seeking institutional review board approval with unique site needs or complex subcontracts, and planning for additional costs. Objectives This article discusses common challenges in conducting multisite studies and identifies strategies to overcome these challenges using real-world examples from the literature, the authors’ research studies, and their personal experiences. Methods A summary of articles on multisite trials conducted within the past 10 years was explored to uncover common challenges in conducting multisite trials. To enrich the context, exemplars from authors’ works are included. Based on literature and experience, strategies to combat challenges are summarized. Results Unique issues related to multisite studies include site selection, use of epicenters/coordinating centers, hiring/managing staff, fidelity monitoring, institutional review board approval, statistical considerations, and approaches to authorship. Conclusion Addressing challenges a priori can improve scientific rigor, reproducibility, and evidence from multisite studies. Given the benefits to scientific rigor, reproducibility, and design, findings from multisite studies are more likely to provide evidence to transform clinical practice and influence policy.

Due to the dearth of veteran-centered research, gaining the unique perspective of veterans' engagement in research is essential to address their health needs. Veterans have expressed desire in shaping treatment options for post-traumatic stress disorder (PTSD), however many veterans are hesitant to engage in the research enterprise. This community engagement project was designed to train veterans as full partners and join forces with researchers on PTSD-related patient-centered outcomes research (PCOR) and comparative effectiveness research (CER). A National Advisory Board (NAB; n = 8) of veterans and key stakeholders were created. The NAB developed the Veteran-Driven Research Participation Training Program (VDRPTP). The VDRTP consists of four modules narrated by veterans: 1) Research Bootcamp-Basic Training; 2) Ethics, Participants Rights, and PCOR and CER research; 3) Communicating About Research; and 4) Time for Action! The VetResearchHub was also created to provide a platform for veterans to engage directly with researchers and collaborate on veterancentered PCOR and CER.The VDRPTP was appraised by veterans who provided feedback about the VDRPTP. The VDRPTP was revised for ease of access. 96% of veterans exhibited overall satisfaction with the modules. Veterans also expressed an increase in willingness to participate in research projects.This project supports a promising first step toward reducing existing barriers between veterans and research teams. The provision of free, accessible, web-based education about the research process, designed for veterans, combined with a networking infrastructure-VetResearchHub-may ultimately support the advancement of veteran-focused PTSDrelated PCOR and CER.

Veterans often experience difficulties transitioning from military to civilian life. This secondary qualitative analysis explored Ohio Veterans' and Veterans' health stakeholders priorities (N = 41) for care when transitioning from military to civilian life. Ten, 90‐minute focus groups were conducted. Barriers to becoming a civilian included not being adequately prepared for transition and being unable to access resources (e.g., “They [the military] prepare you for combat. Nobody prepares you for discharge; nobody tells you how to get care.”). Barriers to physical health focused on gaps in care (e.g., “it took all day to get care”). Mental health barriers included stigma and posttraumatic stress disorder (PTSD; e.g., “When I say Veteran what do you think? 'Homeless Vet' or a 'Ticking Time Bomb'”; “PTSD… let's talk about what it really is and reduce stigma”). Financial/educational barriers included the inability to afford healthcare co‐payments, delayed receipt of service‐connected disability, and educational benefits, (e.g., “[Veterans] will stop taking medications … because they have a bill or co‐pay they need to pay”). Policy makers, community leaders, and healthcare professionals can use these data to enhance programmes that facilitate Veterans transitioning from military to civilian life.

Community-engaged research must reflect the uniqueness of the specific community involved. To help researchers produce quality community-engaged research with the veteran community, the authors of this paper (a coalition of both veterans and academic researchers) have highlighted essential considerations when engaging the veteran community in the research enterprise. Research with veterans requires unique sensitivity based on the impacts of their military service, history, and experiences. Understanding the impacts of veteran culture and community on recruitment is an essential prerequisite for anyone engaging with this population. At a minimum, community-engaged researchers should have an understanding of veteran history in relation to research, how veterans have experienced “volunteering” while under the chain of command, the impacts of a veteran’s military experience, and veterans’ views of the research process. The element most crucial to a successful research project conducted with the veteran community is incorporating veterans as full research team members. Building a veteran-centered research team requires academic researchers to establish trust with veteran team members and the veteran community, to conduct the research project with respect, and to actively encourage veterans’ participation in project activities. All of these are facilitated by having veterans as full members of a research team. It is our hope that sharing the lessons we have learned through working with veteran communities, as well as our lived experiences as veteran research team members, will help pave a smoother path forward for others wishing to conduct impactful veteran-centered research.

The COVID-19 Pandemic limited access to healthcare, engagement in research, and disrupted formal and informal peer and community support systems. As a result, a multistate project using Think Tank Meetings (TTMs) to uncover the needs of veterans experiencing chronic pain was expanded. The expanded project sought to identify factors supporting social engagement, describe COVID-19 pandemic-related dilemmas, and provide recommendations for researchers seeking to engage veterans during times of pandemics and social isolation. The project team used field note templates to summarize veterans' dialogue during TTMs. Collated summaries were analyzed using open and axial coding. In total 151 veterans and stakeholders participated in TTMs across four US states: Florida, Georgia, New Jersey, and New York. Discussions focused on the following aspects of participants' pandemic experiences: managing chronic pain, managing social isolation, veterans' research priorities, and strategies that researchers might use to engage veterans in research during a pandemic. Recommendations for clinical practice, public policy, and future research are presented. Derived from veteran recommendations, a Veteran-Centered Coronavirus Toolkit for Researchers was developed and consists of: (a) field note templates used in this project, (b) veterans' recommendations for effective researcher-veteran engagement strategies during times of social isolation, (c) a checklist for Veteran-Centered Research Engagement that can guide researchers during times of widespread social isolation, (d) a veteran-generated COVID-19 pandemic Patient-Centered /Comparative Effectiveness research agenda including examples of novel Comparative Effectiveness Research (CER) questions. The researcher toolkit is available at https:// nursing.fau.edu/documents/cpaww/val-toolkit.pdf. Information presented in this paper is intended for veterans and key stakeholders to collaboratively engage in chronic-painrelated patient-centered outcomes research and comparative effectiveness research.