Engaging Stakeholders in Identifying Access Research Priorities for the Department of Veterans Affairs

Abstract

Background The Veterans Access Research Consortium (VARC), a Department of Veterans Affairs (VA) Consortium of Research focused on access to healthcare, has been funded by VA’s Health Services Research and Development Service (HSR&D) to develop a research roadmap for healthcare access. The goal of the roadmap is to identify operationally aligned research questions that are most likely to lead to meaningful improvements in Veterans’ healthcare access. Objectives To describe the process of soliciting diverse stakeholder perspectives about key priorities on which VA’s HSR&D access agenda should focus and identify the results of that process. Methods We used a modified Delphi approach to engage researchers and VA operational partners in a process to develop recommendations regarding the access-related research questions VA should prioritize. We then collaborated with three Veteran Engagement Groups (VEGs) across the country to solicit Veterans’ reactions to the Delphi results and their perspectives about access-related issues affecting access to VA health care. Results The Delphi panel consisted of 22 research and operational experts, both internal and external to VA. The Delphi process resulted in five research questions identified by the panelists as highest priority for VA to pursue, each representing one of the following domains: (1) measurement of access, (2) barriers to access, (3) equity and subpopulations, (4) effective interventions to improve access, and (5) consequences of poor/better access. Veterans’ perspectives focused primarily on the barriers to access domain. Veterans indicated several barriers that might be addressed through research or operational initiatives, including poor communication about services, weak connections to and partnerships with local community care facilities, and poor provision of telehealth resources and education. Conclusions Engaging multiple methods to solicit stakeholder perspectives enables more nuanced understanding of access-related priorities for VA. Future research should consider utilizing such an approach to identify additional research and/or operational priorities.

Patient and Veteran Engagement in Health Research: the Emergence of a Field of Study

“…The perspectives and original research articles in this supplement share a focus on the lived experience of the participants of engagement, as well as exploring barriers and facilitators that can affect group cohesion. [5][6][7][8][9][10][11][12][13][14][15] Many of the studies measured satisfaction with the engagement process as a key outcome. One strong commonality amongst the perspectives and original research articles is the use of descriptive approaches, often outlining the temporal flow of the engagement process for a project and frequently accompanied by qualitative and/or mixed methods.…”

Experiences and lessons learned from a patient‐engagement service established by a national research consortium in the U.S. Veterans Health Administration

“…22 These initiatives have increased Veterans' involvement in agenda setting, study design, methods, interpretation, and dissemination of results. 9,10,[23][24][25][26] Sharing of models and lessons learned may support successful implementation of patient engagement efforts in VA and beyond; however, few accounts are available of engagement infrastructure and processes used by large research organizations. 19,27,28 This article describes experiences and lessons learned from the first 3 years of an engagement service established by a national VA research consortium to facilitate Veteran-engaged research and build community among Veterans and VA researchers.…”

“…HSR intramural funding now requires consideration of Veteran engagement in research proposals 22 . These initiatives have increased Veterans' involvement in agenda setting, study design, methods, interpretation, and dissemination of results 9,10,23‐26 …”

“…22 These initiatives have increased Veterans' involvement in agenda setting, study design, methods, interpretation, and dissemination of results. 9 , 10 , 23 , 24 , 25 , 26 …”

Engaging Operational Partners Is Critical for Successful Implementation of Research Products: a Coincidence Analysis of Access-Related Projects in the Veterans Affairs Healthcare System

“…9,10 In 2020, VHA Health Services Research & Development (HSR&D) funded the Veterans Access Research Consortium (VARC) to accelerate translation of access-related research to clinical care settings and stimulate measurable improvements in access to care. 11 A core goal of VARC was to undertake a portfolio review of existing VHA access-related projects to understand the current state of access-related initiatives in VHA and their implementation stage. In this study, we sought to build upon VARC's portfolio review by employing novel implementation science methods to elucidate factors or combinations of factors critical to a successful implementation of access-related research projects in VHA.…”