HSR&D Research Career Scientist Award

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As a sociomedical scientist, health services researcher, and implementation scientist, I have 20+ years’ experience and have been consistently VA funded with over $13 million as PI or Co-PI to lead complex and impactful research in: 1) geographic correlates of health/healthcare, 2) patient safety, and 3) complementary and integrative health (CIH) therapy effectiveness and implementation. I use advanced methods such as multi- level modeling, geospatial techniques, natural language processing, and pragmatic trials. My CIH research of the past decade has solidified my national and international stature within and beyond VA. For example, the NIH considers me one of the few people internationally at the intersection of implementation and CIH. CIH is a key VA “Whole Health” component and part of many top VA priorities. My work is often used to inform Congress and has substantially shaped VA healthcare nationally. As such, I was given the 2019 HSR&D Health Services Impact award. I currently am PI of two major research and evaluation initiatives totaling almost $9 million, one being a center with 9 projects. These ten current studies and projects stem mostly from one of my five most important studies. The resulting paper, “What Should Health Care Systems Consider When Implementing Complementary and Integrative Health…” was the third most cited paper in 2019 in the leading CIH journal, Journal of Integrative and Complementary Medicine (JICM). VA Office of Patient Centered Care’s (OPCC&CT, the VA Office guiding CIH/Whole Health policy) frequently uses it when shaping policy, referring to it as their “implementation bible”. My current “APPROACH” trial for which I am Co-PI (with Dr. Steve Zeliadt, VA Puget Sound), is an HSR&D Merit for a six-year, $4.3 million pragmatic trial. This high-profile study includes nine Co-Is from four VAs to longitudinally examine the effectiveness of CIH therapies among the largest-ever sample of CIH recipients (5,600+) and is conducted in partnership with the OPCC&CT. The other nine projects stemming from that key 2019 paper are part of the Complementary and Integrative Health Evaluation Center (CIHEC), for which I am PI. CIHEC is a large-scale QUERI Partnered Evaluation Initiative co-funded by OPCC&CT for six years (funded in 2017, renewed every two years for $3.5 million to-date). As CIHEC’s Director, I have overseen 22 Co-Is and staff in nine VAs to conduct nine CIH projects. All are done in collaboration with OPCC&CT to help guide their national strategy, support evidence-based CIH implementation, and respond to Congress. Their papers and reports have been the subject of briefings to Congresspersons, Congressional commissions, and VA leadership, and have been featured in ORD and HSR&D publications circulated to VACO. I have published 35 peer-reviewed papers in the past 3 years, 60% as first or senior author and 77% in higher quality journals, with an h-index of 29 and an i10-index of 51. My most important CIH-related paper is the above 2019 paper and my most important patient safety paper is, “What Context Features Might be Important Determinants of the Effectiveness of Patient Safety Practice Interventions?”. Published in the prestigious BMJ Quality & Safety in 2011, it was Editor’s Choice, and has been cited 185 times. I am an Associate Editor and on the editorial board for the leading CIH journal, JICM, and have served as Guest Editor Medical Care twice. In the past three years, I have had 26 VA mentees and collaborated with 101 investigators, most from 10 VAs or universities, and have given many invited national and local lectures to VA clinicians and national leadership and external briefings to 8 Congresspersons or Congressional staffers. For the past three years, I served as the Los Angeles (LA) HSR&D Associate Director (until 2021) and served on four LA VA committees, four local VA postdoctoral programs, and 23 VA and non-VA service activities. At UCLA, I am Adjunct Professor in two departments, Medicine, and Health Policy and Management. I am the VA Director of the UCLA Los Angeles Area Health Services Research Training Program and am faculty mentor in a second UCLA program.