Accelerating Change

Summary: Veteran Voices in Research showcases the people and programs that foster Veteran engagement and demonstrates how Veteran collaborators improve the quality, relevance, and impact of VA research. Since 2016, VA's Health Systems Research (HSR) program has required investigators to include Veterans and caregivers as active participants in shaping their studies-not simply as subjects of them. This practice, known as Veteran engagement, means involving Veterans at every stage of research. This issue, "Accelerating Change," explains how working with Veterans to discuss the findings of research often speeds up how those findings inform VA policy.

Members of the Denver Veteran Research Engagement Board

Sarcoidosis causes tiny collections of immune system cells to form swollen red lumps, called granulomas, most often in the lungs and the lymph nodes of the chest, but they can occur basically anywhere. The exact cause of sarcoidosis is unknown, but research points to a likely mix of genetic and environmental factors. Under the 2022 PACT Act, sarcoidosis is a presumptive condition: for Veterans who served in certain places after 1990, it's assumed their illness is connected to service-related environmental hazards. For Army Veteran Kathryn Washington, who struggled for a decade to find a diagnosis for her sarcoidosis, it's proof of the line from Veteran advocacy, through growing visibility of a medical condition, to the research that informs national policy decisions. "Veteran engagement helps bring visibility to conditions that are often overlooked," Washington said. "When those experiences inform research, and that research informs policy, you start to see real change in recognition, access, and outcomes for Veterans."

Washington now works with four Veteran engagement groups, helping ensure findings are communicated, implemented, and trusted-and that research produces real change, faster. That engagement doesn't end when data collection ends. Engaging Veterans at every stage of VA research expands what it can accomplish. "We're making things more transparent about how researchers make decisions-and creating feedback loops as well," said Kelty Fehling, an investigator with HSR's Seattle-Denver Center of Innovation and co-leader of the Growing Rural Outreach Through Veteran Engagement (GROVE) Center. "We're saying: 'You're not just giving us information that's going into a void. Here's how the researcher acted on what you said.'"

"It doesn't have to be some elaborate mechanism," added Kimberly "Max" Brown, PhD, Co-Director of Equity and Engagement Capacity Building at HSR's Center for Health Evaluation, Research, and Promotion. "'This is what we learned. Thank you so much for assisting us with this work.' That's all it has to be."

These feedback loops can also build greater trust in VA and encourage more Veterans to participate in research. When VA researchers report back to Veterans on what they've learned from them, and whether and how it's going to improve care, it is effectively disseminating research findings to the target end users, Veterans and caregivers, who are just as vital as the policymakers, researchers, and clinicians. Veteran advisors can also help researchers to express these findings clearly, in Veteran-centric language and context, enabling Veterans and their caregivers to make better-informed choices.

When researchers engage the "end users" of their research findings early and often, they can move through from the original idea much more rapidly, according to Gala True, PhD, a researcher with VA's South Central Mental Illness, Research, Education, and Clinical Center. "Nobody wants to see something take a generation to make an impact," she said. "You can't get that everywhere else, but in the VA, you can do something, and then you can see something change."

The views expressed in this publication are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.