Josephine Jacobs
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View article: Caregiving Network Characteristics and Mental Health Care Utilization by Older Adults
Caregiving Network Characteristics and Mental Health Care Utilization by Older Adults Open
Background Rates of mental health service use are low among older adults. This study examined associations between mental health care utilization and caregiving network characteristics, including caregiving network size, caregiving intensi…
View article: Understanding How Family Caregivers Navigate Disruptions in Public Health Emergencies: Lessons from the Acute Phase of COVID-19 Pandemic
Understanding How Family Caregivers Navigate Disruptions in Public Health Emergencies: Lessons from the Acute Phase of COVID-19 Pandemic Open
Background: Pandemics uniquely burden family caregivers as they navigate their own health, and that of their care recipients. While the impact of COVID-19 on caregiver well-being is known, there is little information on its impact on careg…
View article: A partner‐informed approach to prioritizing social risks for research in a learning health system
A partner‐informed approach to prioritizing social risks for research in a learning health system Open
Objective To prioritize social risks (individual‐level social and economic conditions) that may influence a person's health for inclusion in a national survey of Veterans Affairs (VA) healthcare system patients. Data Sources and Study Sett…
View article: DO FAMILY CAREGIVERS MATTER FOR HEALTH CARE UTILIZATION? A STUDY OF MENTAL HEALTH SERVICES USE BY OLDER VETERANS
DO FAMILY CAREGIVERS MATTER FOR HEALTH CARE UTILIZATION? A STUDY OF MENTAL HEALTH SERVICES USE BY OLDER VETERANS Open
Mental health (MH) concerns are common in late life. Compared to younger adults, however, older adults are much less likely to use MH services. To guide efforts to increase appropriate utilization, it is important to understand factors imp…
View article: Barriers to accessing home and community‐based services among family caregivers of Veterans
Barriers to accessing home and community‐based services among family caregivers of Veterans Open
Background The Department of Veterans Affairs (VA) has long recognized the importance of having a rich complement of home and community‐based resources for the Veteran population. For Veterans experiencing disability‐related impairments, h…
View article: The association between social risks and days at home for older veterans
The association between social risks and days at home for older veterans Open
Background Many health systems are trying to support the ability of older adults to remain in their homes for as long as possible. Little is known about the relationship between patient‐reported social risks and length of time spent at hom…
View article: Association between patient‐reported social and behavioral risks and health care costs in high‐risk <scp>Veterans health administration</scp> patients
Association between patient‐reported social and behavioral risks and health care costs in high‐risk <span>Veterans health administration</span> patients Open
Objective Social risks complicate patients' ability to manage their conditions and access healthcare, but their association with health expenditures is not well established. To identify patient‐reported social risk, behavioral, and health …
View article: Unpaid caregiving and stress among older working-age men and women in Sweden
Unpaid caregiving and stress among older working-age men and women in Sweden Open
Many individuals are experiencing the potentially stressful combination of providing care while still employed. In this study, the association between unpaid caregiving to another adult and self-reported stress among men and women aged 45-…
View article: Overcoming Access Barriers for Veterans: Cohort Study of the Distribution and Use of Veterans Affairs’ Video-Enabled Tablets Before and During the COVID-19 Pandemic
Overcoming Access Barriers for Veterans: Cohort Study of the Distribution and Use of Veterans Affairs’ Video-Enabled Tablets Before and During the COVID-19 Pandemic Open
Background During the COVID-19 pandemic, as health care services shifted to video- and phone-based modalities for patient and provider safety, the Veterans Affairs (VA) Office of Connected Care widely expanded its video-enabled tablet prog…
View article: Racial inequality in functional trajectories between Black and White U.S. veterans
Racial inequality in functional trajectories between Black and White U.S. veterans Open
Background Racial inequality in functional trajectories has been well documented in the U.S. civilian population but has not been explored among Veterans. Our objectives were to: (1) assess how functional trajectories differed for Black an…
View article: Variation in initial and continued use of primary, mental health, and specialty video care among Veterans
Variation in initial and continued use of primary, mental health, and specialty video care among Veterans Open
Objective To identify which Veteran populations are routinely accessing video‐based care. Data Sources and Study Setting National, secondary administrative data from electronic health records at the Veterans Health Administration (VHA), 20…
View article: UNMET NEEDS AND PERCEIVED BARRIERS TO ACCESSING HCBS AMONG CAREGIVERS OF VETERANS OF ALL ERAS
UNMET NEEDS AND PERCEIVED BARRIERS TO ACCESSING HCBS AMONG CAREGIVERS OF VETERANS OF ALL ERAS Open
VA has several HCBS to offset caregiver burden, facilitate caregiving, and enhance Veterans’ home-based care, but they remain underutilized. We aimed to describe: the unmet psychosocial and HCBS needs of caregivers, barriers to accessing s…
View article: Overcoming Access Barriers for Veterans: Distribution and Use of VA’s Video-Enabled Tablets Before and During the COVID-19 Pandemic (Preprint)
Overcoming Access Barriers for Veterans: Distribution and Use of VA’s Video-Enabled Tablets Before and During the COVID-19 Pandemic (Preprint) Open
BACKGROUND During the COVID-19 pandemic, as health care services shifted to virtual modalities for patient and provider safety, the Veterans Affairs (VA) Office of Connected Care widely expanded its video-enabled tablet program to bridge …
View article: Heterogamy and contraceptive use among married and cohabiting women
Heterogamy and contraceptive use among married and cohabiting women Open
Decisions about which contraceptives to use are a key component of a couple's "fertility work," and these decisions can be made in homogamous or heterogamous couple contexts. Relative resource theory and the strain perspective suggest that…
View article: Mental Health Service Use, Suicide Behavior, and Emergency Department Visits Among Rural US Veterans Who Received Video-Enabled Tablets During the COVID-19 Pandemic
Mental Health Service Use, Suicide Behavior, and Emergency Department Visits Among Rural US Veterans Who Received Video-Enabled Tablets During the COVID-19 Pandemic Open
This cohort study of rural US veterans with a history of mental health care use found that receipt of a video-enabled tablet was associated with increased use of mental health care via video, increased psychotherapy visits (across all moda…
View article: Goals of Care Documentation: Insights from A Pilot Implementation Study
Goals of Care Documentation: Insights from A Pilot Implementation Study Open
Older and seriously ill patients were most likely to have goals of care documented. Association between a documented goals of care conversation and perceived patient care experience were largely unsupported. Site-level largely contributed …
View article: Caregiving Intensity and Psychosocial Impact of COVID-19 in Dementia and Non-Dementia Caregivers
Caregiving Intensity and Psychosocial Impact of COVID-19 in Dementia and Non-Dementia Caregivers Open
COVID-19 has adversely impacted the well-being of informal caregivers (CG) due to infection risk, changes to the home environment, and changes to resource availability. CG of persons living with dementia (PLWD) may be especially vulnerable…
View article: Long‐term care service mix in the Veterans Health Administration after home care expansion
Long‐term care service mix in the Veterans Health Administration after home care expansion Open
Objective To determine whether the Veterans Health Administration's (VHA) efforts to expand access to home‐ and community‐based services (HCBS) after the 2001 Millennium Act significantly changed Veterans' utilization of institutional, pai…
View article: State Policy Responses to COVID-19 in Nursing Homes
State Policy Responses to COVID-19 in Nursing Homes Open
Context: COVID-19 has a high case fatality rate in high-risk populations and can cause severe morbidity and high healthcare resource use. Nursing home residents are a high-risk population; they live in congregate settings, often with share…
View article: How are Informal Caregivers Adapting to COVID19? Preliminary Results of an Online Survey
How are Informal Caregivers Adapting to COVID19? Preliminary Results of an Online Survey Open
COVID19 may disrupt informal caregivers’ (CG) ability to support their care recipients (CR) but little is known how caregivers adapt. A 10-minute, anonymous, online survey with no geographic restrictions was fielded April-August 2020. Two …
View article: Virtual care expansion in the Veterans Health Administration during the COVID-19 pandemic: clinical services and patient characteristics associated with utilization
Virtual care expansion in the Veterans Health Administration during the COVID-19 pandemic: clinical services and patient characteristics associated with utilization Open
Objectives To describe the shift from in-person to virtual care within Veterans Affairs (VA) during the early phase of the COVID-19 pandemic and to identify at-risk patient populations who require greater resources to overcome access barri…
View article: Assessment of Primary Care Clinician Concordance With Guidelines for Use of Magnetic Resonance Imaging in Patients With Nonspecific Low Back Pain in the Veterans Affairs Health System
Assessment of Primary Care Clinician Concordance With Guidelines for Use of Magnetic Resonance Imaging in Patients With Nonspecific Low Back Pain in the Veterans Affairs Health System Open
VA primary care clinics had low rates of use of early MRI scans. A history of low concordance with imaging guidelines was associated with subsequent low concordance but with limited potential to select clinicians most in need of interventi…
View article: Patient Perceptions of Video Visits Using Veterans Affairs Telehealth Tablets: Survey Study
Patient Perceptions of Video Visits Using Veterans Affairs Telehealth Tablets: Survey Study Open
Background Video-based health care can help address access gaps for patients and is rapidly being offered by health care organizations. However, patients who lack access to technology may be left behind in these initiatives. In 2016, the U…
View article: Factors Influencing Primary Care Providers’ Unneeded Lumbar Spine MRI Orders for Acute, Uncomplicated Low-Back Pain: a Qualitative Study
Factors Influencing Primary Care Providers’ Unneeded Lumbar Spine MRI Orders for Acute, Uncomplicated Low-Back Pain: a Qualitative Study Open
Background Clinical practice guidelines suggest that magnetic resonance imaging of the lumbar spine (LS-MRI) is unneeded during the first 6 weeks of acute, uncomplicated low-back pain. Unneeded LS-MRIs do not improve patient outcomes, lead…