RORC REAP Targets Rural Health Issues

The Rehabilitation Outcomes Research Center Research Enhancement Award Program (RORC REAP) at the North Florida/South Georgia Veterans Health System (NF/SGVHS) has been selected as the Southeastern Site for one of three Department of Veterans Affairs (VA) Rural Health Resource Centers. As a satellite of the Veterans Rural Health Resource Center, Eastern Region (VRHRC-ER) in Togus, Maine/White River Junction, Vermont, the multi-disciplinary team of local investigators from the RORC will work to develop and implement innovations, such as tele-health technology and mobile clinics, to improve the accessibility and quality of healthcare to veterans throughout rural America.

Paul M. Hoffman, MD, Southeastern Site Leader and RORC Principal Investigator stated that “The Gainesville and Lake City VA Medical Centers serve the largest number of rural veterans in our region, so this is a great opportunity to better understand the health issues of our veterans living in remote areas.” The primary areas of interest that will be studied in Gainesville and Lake City are access to and delivery of comprehensive care to disabled patients in rural areas, and rehabilitation of motor, cognitive, and visual disabilities.

Some current rural health initiatives already underway at the Lake City VA Medical Center, include the Visual Impairment Center to Optimize Remaining Sight (VICTORS) program, which provides low vision rehabilitation to help veterans maximize their functional vision and increase their independence; and the Comprehensive Care Clinic for Veterans with Multiple Sclerosis (MS). The MS Clinic in Lake City is evaluating exercise for veterans with MS utilizing video transmission to rural sites and home tele-health monitoring and prevention of skin breakdown and pressure ulcers.

Future clinical demonstration projects to be conducted in the NF/SGVHS will evaluate the video transmission of specialty care and rehabilitation training for caregivers of veterans in rural areas. RORC investigators will analyze the cost-effectiveness and quality of care of these programs, as well as patient satisfaction, and will make recommendations about how these services can be provided for veterans in rural areas across the United States and Puerto Rico.

RORC REAP TEAM WELCOMES HOME RETURNING PUERTO RICAN OEF/OIF VETERANS

Left to right: From the VA Caribbean Health Care System Luz Enid Del Valle, MSW, ACSW, OEF/OIF Program Manager; Sandra Gracia-Lopez, MD, Chief of Staff; Evelyn Ramos, Acting Associate Director; Nancy Reissener, Interim Director; from the RORC REAP: Magaly Freytes , PhD, Investigator; Connie Uphold, PhD, ARNP, Principal Investigator; Kristen Wing, RORC-REAP Public Affairs Specialist.

Members of the Rehabilitation Outcomes Research Center Research Enhancement Award Program (RORC-REAP, Gainesville, FL) were invited to participate in the “Welcome Home!” (¡Bienvenidos a Casa!) event sponsored by the VA Caribbean Healthcare System and the San Juan VA Medical Center. The November 22nd celebration was held at the Pabellón de la Paz (Pavilion of Peace) in Luis Muñoz Marin Park in San Juan. VA Caribbean Healthcare System Chief of Staff, Sandra C. Gracia, MD and Nancy Reissener, Interim Director, kicked off the day’s events with opening remarks thanking the veterans for their service and welcoming them home to Puerto Rico.

Organized by Luz Enid Del Valle, MSW, ACSW, OEF/OIF Program Manager and the OEF/OIF Coordinators Office, the day was designed to show appreciation for the returning soldiers and their families, and to give them an opportunity to meet with Department of Veterans Affairs and Veteran Service organizations. Several VA programs, including the Veterans Benefits Administration, VA Office of Seamless Transition, MyHealtheVet, VA Home Telehealth, and VA Spinal Cord Injury, were present to distribute information about their services. Veteran Service Organizations such as the Disabled American Veterans (DAV), the Paralyzed Veterans of America (PVA), the American Legion, and the Silent Warrior program were on hand as well.

Post-deployment Readjustment Guide for Puerto Rican OEF/OIF Veterans and Families

The team from the RORC-REAP was thrilled to participate in this “Welcome Home” as it provided them with the opportunity to disseminate close to 3,000 copies of a research product created especially for the Puerto Rican OEF/OIF veterans. Under the direction of Constance R. Uphold, PhD, ARNP, the investigative team worked with San Juan VAMC clinicians and patients, and local military support groups, to create a post-mobilization guidebook to assist veterans with their transition process back into civilian life. The “Guía de Ayuda Para el Reajuste Post-Movilización de Veteranos/as Puertorriquenos Y Familiares” (Post-deployment Readjustment Guide for Puerto Rican OEF/OIF Veterans and Families) was created to be culturally relevant to the Puerto Rican veteran population and their needs. The guidebook was published in Puerto Rican Spanish and featured a design incorporating the Puerto Rican flag, and the national symbol, the “coquí” singing frog.

For Magaly Freytes, PhD, RORC-REAP Post-Doctoral Fellow, working on this project gave her a chance to apply her Counselor Education training, as well as her perspective as a native Puerto Rican. Dr. Freytes’ personal connection to this U.S. Commonwealth was integral to the success of the project, particularly during the focus group interviews conducted in Puerto Rican Spanish. “The veterans really appreciated that I could speak to them in their own language. It made them feel comfortable and they were able to communicate more openly,” said Dr. Freytes. The guidebook, which was developed with the support of the Disabled American Veterans (DAV), Nurses Organization of Veterans Affairs (NOVA) Foundation, and VA Health Services Research and Development (HSR&D) Quality Enhancement Research Initiative (QUERI), was very well received.

According to Dr. Freytes, “The VA Caribbean Health Care System providers who received the guide were excited to have a document developed specifically for them and their veterans. They said this was the first OEF/OIF-related material just for the Puerto Rican veterans and their families. The language and images clearly spoke to this population. They loved the photos, the colors, and the inclusion of the beloved coquí. They were grateful for our efforts and couldn’t stop thanking us and expressing their admiration for the guide.”

Due to the demand and overwhelming response to this publication, an additional 3,000 guidebooks will be printed and ready for dissemination in early 2009.

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