Durham Center of Innovation to ADAPT

The Little Panel that Could

By Karee White

     “Okay, everyone, it’s that time to get started,” says Brandolyn White, a research program coordinator who provides logistical support for the group of twelve into the spacious conference room, housed just off the campus of the Durham VA (Veteran Affairs) Medical Center.  Charlotte Sweeney laughs at a shared joke among members as she, along with the rest, find a seat at the large conference table.  A retired medical doctor, Sweeney, who is a care partner to her US Marine Corps Disabled Vietnam War era husband, volunteers monthly, like the 11 other Veterans, to offer opinions and comments to researchers from prominent institutions like Duke University, UNC-Chapel Hill University, and the Durham VA. Today, this effective and committed team, self-identified as the Veteran Research and Engagement Panel (or VetREP), prepares to hopefully make a difference yet again, in the lives of Veterans all over the country.  

     “I’ve gained a sense of pride in knowing I’m having a positive impact on the well-being and care of my fellow Veterans and their families, by contributing my experience in dealing with the problems we’re discussing,” states Bradley Moses, a disabled Vietnam War Veteran who joined the board four years ago as an original inaugural member.  “I appreciated the care and benefits the VA system has provided me and my fellow Veterans and welcomed the opportunity to have a positive impact on future health care and benefits to be provided to my fellow Veterans.”

     The Veterans Health Administration has around 370,000 employees, provides services to approximately nine million veterans each year, and maintains 1,293 health care facilities encompassing 171 medical centers.  The VA hospital system is the largest integrated health care system in the country. Yet, most don’t realize that the VA also has a robust research entity, focused on improving the health of Veterans and improving care for Veterans. In fact, the VA has several research and development programs which have different focuses that include clinical science, biomedical laboratory, health services, rehabilitation, and cooperative studies.

     “There are approximately 20 Veteran research engagement groups across the nation including VetREP.  All exist under the umbrella of the VA’s Health Services & Research Development,” explains White.  Since this local group’s formation just four years ago, their impact has been increasingly significant in the research community that works to improve the lives of our Veterans and future Veterans.”

    These Veterans and their caregivers who serve on VetREP make sure the research speaks to Veterans’ concerns. VetREP members provide collective input on new and current VA research projects.  VA researchers bring a variety of topics such as diabetes control, managing mental health conditions, quitting smoking, and improving outcome of cardiac rehabilitation to the VetREP members to gain their insights and advice.  Improving access to cancer screenings, and support programs for caregivers are some of the other topics this panel reviews.

      As both a care partner spouse, and a clinically retired surgeon with a couple of additional master’s degrees, Sweeney has many life experiences to bring to the VetREP table.  “VetREP’s work offers an opportunity to have Veteran research volunteers’ voices heard and respected,” Sweeney smiles.  “I hope that we can broadcast our success and change hearts and minds about how critically important research with integrity and transparency can be beneficial for all of mankind, not some privileged populations but for all people, Veterans or not.”

     VetREP’s inaugural coordinator, White, remembers one topic of research that held special meaning to the VetREP team. “Two researchers were working together to develop a study to better define an emerging issue of moral injury among Veterans that had been exposed to warzone activities,” explains White.  “It was the first topic and discussion where members had a hard time wrapping their minds around just the term ‘moral injury’ within the research idea, as it could label/stigmatize Veterans with something negative (while that’s not the intention).”  It was the first time White saw the members establish a unified voice and recommendation to the researchers to contextualize ‘moral injury’ beyond combat. White shared that Veterans don’t only experience hard-to-deal-with issues on the battlefield, as much occurs away from combat. 

     “They also helped to reframe the research to one that would communicate moral character, resiliency, and growth in the Veterans’ journey (i.e., not focusing only on what’s wrong),” White elaborates.

     Cheryl Robinson, another VetREP member, recalls her service in the Navy.  “The military, in the early ‘80s and in my particular field (underwater sound propagation and research) was still very discriminatory against women, especially of color,” she explains. “(I) Just kept my head down and did the work.”

     VetREP members receive Research 101 training on such topics as how research studies are developed, how to general data collection and analysis methods, how to recruit participants for studies, and how to make sense of the results of studies. The goal of this training is not to make VetREP members researchers but to help foster understand of the research process and equitable patient-research engagement. Members provide feedback on new and ongoing research and projects involving Veterans.  They also give advice on the use of study results.  They provide guidance and feedback to researchers on setting research priorities and developing research questions and research design as well. In sum, VetREP supports the role of health services research at the VA and in the community by making sure that research is relevant to and for Veterans.   

     Researchers request to present to VetREP members, because funding agencies are more frequently requiring this kind of engagement from researchers and researchers derive great insights from these engagements that make their research stronger and more impactful.   “During our panel discussions with researchers I truly believe we are making a difference with how they are considering any changes in their methodology, “ Robinson says.  “At the very least I see it when the researcher is making notes on a comment that provides them with an ‘aha’ moment; when their initial perspective gets blown wide open because of a concern or insight we share.” 

     Robinson, Moses, Sweeney, and the rest of the VetREP members leave each monthly meeting with a great sense of pride, giving back to our nation’s Veteran communities.   “We regularly debrief at the conclusions of meetings so that we have the pulse of the group and learn from our researchers about how we help them and how we may be of greater help to them,” Sweeney shares. “We have researchers who return to update us on progress and ask for our input on subsequent research endeavors. We supply letters of support for projects when asked.”  In fact, this cohesive group often goes beyond the monthly meetings to voluntarily speak in the community to spread the word, prepare information for researchers before presentations to the group, or submit into publications for best practices.

     Robinson sums up her contribution to the panel.   “I carry myself with a renewed pride knowing I have served our country. My hope that our country truly does recognize the uniqueness of our Veteran community gets validated on a regular basis,” she shares.   “I have hope.” 

     At the day’s end, Sweeney’s vision speaks for all the members. “My dream for VetREP is that we will disseminate our model of success to other VA research groups, “she states with conviction, adding, “indeed, to other VA health care teams on all levels and disciplines, to integrate intimately the voice of the veterans into every process and strategic plan in the VA.”

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