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SBM Partners with VA to Support Behavioral Medicine Initiatives

David Goodrich, EdD

At the 2010 Annual Meeting & Scientific Sessions in Seattle, SBM leaders headed by Robert Kerns, PhD, met with representatives of the Veteran Health Administrationís (VHA) National Center for Health Promotion and Disease Prevention (NCP) to discuss mutual areas of interest. NCP is an operational arm of the VA that oversees the implementation of a number of behavioral medicine programs that could revolutionize how behavioral medicine is practiced.

NCP is tasked with advising VHA leaders on evidence-based health promotion and disease prevention policy. NCP also oversees programs, education, and coordination for the clinical providers consistent with prevention policy to enhance the health, well-being, and quality of life for Veterans.

Dr. Kenneth Jones, the NCP representative at the Seattle meeting, is the National Program Director for the VAís MOVE!© weight management program. Dr. Jones, a health psychologist, oversees the largest comprehensive, evidence-based weight management program implemented by a healthcare system.1 Because the prevalence of overweight and obesity is higher among Veterans than non-VHA patients (77% vs. 68% in 2008),2, 3 MOVE!© is available to patients at all VA healthcare facilities to help reduce long-term health risks and treatment costs of obesity.

As the largest integrated healthcare system in the U.S., VHA is a trendsetter for reforming healthcare.4, 5 VHA is presently moving to a patient-centered medical home (PCMH) model of care that aims to improve patientsí access to care, integrate care between providers, prevent disease, and make the patient the center of treatment decision making.

Essential to the PCMH model of care is an interdisciplinary, collaborative team-based approach to achieve coordination of care. NCP oversees the Health and Disease Prevention Programming (HPDP) component in PCMH that embeds behavioral medicine experts into primary care to help physicians, nurses, physician assistants, and mental health providers coordinate preventive services into a patientís treatment.

Health Behavior Coordinators, Health Educators, and HPDP Program Managers will help link Veterans to care for tobacco use, physical activity, nutrition, weight management, stress, pain management, and substance abuse. These experts coordinate behavioral and preventive medicine care across all medical specialties in all VA facilities. In addition, they will train and educate staff in patient-centered strategies such as motivational interviewing, health coaching, and shared-decision making.

NCP is also developing an online Health Risk Assessment (HRA) that will assess medical history, current health behaviors, and interest in making healthy lifestyle changes which will be integrated with the VHAís electronic medical record. In partnership with VHA staff, patients will be encouraged to make desired lifestyle changes and supported in making these changes using the patientís preference of group classes, telephone interventions, or secure electronic messaging.

NCP is led by Chief Consultant for Preventive Medicine, Linda Kinsinger, MD, MPH at the NCP which is based in Durham, NC. She and her staff will soon be joined by past SBM President (2001-02), Dr. Michael Goldstein, a VA psychiatrist/internist and behavioral medicine researcher.

The VA offers an incredible number of opportunities for behavioral medicine. To learn more about behavioral medicine employment, training, and research opportunities in VA, please go to: www.prevention.va.gov

and also

Join the SBM-VA listserv by contacting SBM staff member Alicia Sukup (asukup@sbm.org).

References

  1. Kinsinger LS, Jones KR, Kahwati L, et al. Design and dissemination of the MOVE! Weight-Management Program for Veterans. Prev Chronic Dis. 2009;6:A98.
  2. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999-2008. Jama.303(3):235-241.
  3. Vital Signs Corporate Warehouse. Veterans Support Service Center;FY 08.
  4. Kizer KW, Dudley RA. Extreme makeover: Transformation of the veterans health care system. Annu Rev Public Health. 2009;30:313-339.
  5. Oliver A. Public-sector health-care reforms that work? A case study of the US Veterans Health Administration. Lancet. 2008;371:1211-1213.

David Goodrich, EdD, is a Health Research Science Specialist at the Ann Arbor VA Center of Clinical Management in Ann Arbor, MI, who serves on the SBM Scientific and Professional Liaison Council. His research focuses on the application of behavioral interventions for the management of chronic health conditions and is a member of the VAís Diabetes Quality Enhancement Research Initiative (QUERI).


 

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