War Related Illness and Injury Study Center
Volunteer for Research at DC WRIISC
Veteran Studies at DC WRIISC
- The War Related Illness and Injury Study at Washington, DC Data Repository (DC)
Principal Investigator: Nate Allen, BS
Purpose: This goal of this protocol is to establish a data repository that addresses both the clinical and research mission of the WRIISC. This data repository consists of clinical, administrative, satisfaction and health care utilization data for Veterans who provide informed consent to include their data in the repository and are seen in the DC WRIISC. Clinically, the compilation of this data will allow the DC WRIISC to systematically collect, organize and view complex clinical data for use by practitioners as they formulate diagnoses and recommendations. Additionally, data analysis will guide continuous quality improvement practices within the DC WRIISC. In terms of research, the establishment of a data repository will help us to better define the health concerns of the Veterans we see. By collecting data about the demographic, clinical, and biomedical findings of Veterans seen at the DC WRIISC, we hope to gain insights into the cause, diagnosis, and treatment of conditions that are difficult to diagnose and treat. With the information gathered from a repository, the DC WRIISC will establish future IRB research protocols designed to improve the post-deployment health of these Veterans.
Eligibility: Veterans who are seen in the DC WRIISC National Referral Program are eligible to participate in this database repository protocol.
- Multi-modal observational study of Veterans with TBI and varying symptoms (TOS-Study)
Principal Investigator: Matthew Reinhard, PsyD
Primary DC WRIISC staff: Michelle Costanzo, Immanuel Samuel, Kamila Migdal, and Timothy Chun
Background: Veterans are frequently exposed to Traumatic Brain Injury (TBI) before, during, and after their military service. The effects of TBI can vary, but these injuries can affect many different parts of a Veteran’s life. Despite how common TBIs are, symptoms vary and can be difficult to diagnose and treat. In this study we explore the relationship between markers of TBI, military exposures, and health outcomes..
Purpose: The purpose of this study is to better understand the structural and functional underpinnings of TBI in Veterans using multi-modal data. It aims to understand the relationship between brain injury and psychological assessments, neural activity, brain structure and functional organization. This study also will explore Veteran perceptions about environmental exposures they may have encountered during their deployment(s).
Eligibility: Veterans who are seen in the DC WRIISC National Referral Program are eligible to participate in this study.
To participate: For more information, please contact the study team at (202) 745-8000 ext. 57553
- Assessing the Impact of the Washington DC War Related Illness and Injury Study Center (DC WRIISC) Health Coaching Program
Principal Investigator: Walter Jachimowicz MSN RN CNL NBC-HWC
Primary DC WRIISC staff: Walter Jachimowicz, Rebecca McCullers, John Barrett, Timothy Chun, Immanuel Samuel, Rachel Stewart, and Michelle Costanzo
Background: The human health and economic costs of chronic disease has reached epidemic proportions. Six out of 10 Americans have at least one chronic disease accounting for 50% of the U.S. healthcare expenditure of 3.3 trillion dollars. The U.S. Department of Veteran Affairs (VA) Evidence-based Synthesis Program (ESP) produced a systematic review in 2017 titled, “The Effectiveness of Health Coaching.” It found that 75% of VA users suffer two or more chronic conditions. Health coaching is emerging as a promising intervention to encourage behavior change and lifestyle modification to curb the impact of chronic disease. It is an intervention that incorporates a patient-centered approach, partially self-determined goals with the use of self-discovery and education in collaboration with a coach. The health coaching approach focuses on what is right with the patient and how to expand it; rather than what is wrong and how to fix it.
Purpose: The objective of this programmatic effort is to examine the impact of a clinical health coaching intervention intended to augment several factors related to physiological, behavioral, psychological, and social outcomes in treatment-seeking veterans with chronic multi-symptom illness. We hypothesize a veteran-centered health coaching intervention incorporating DC WRIISC clinical recommendations, self-discovery, education, goal setting, and accountability in relationship with a qualified health coach will significantly improve physical and mental health outcomes for veterans with chronic multi-symptom illness.
Eligibility: Veterans over the age of 18 approved for receiving clinical care at the DC WRIISC are invited to enroll in distance-based health coaching intended to support clinical recommendations provided by the multidisciplinary evaluation team and make appropriate lifestyle changes. All veterans who receive comprehensive evaluations at DC WRIISC will be asked to participate in the study and offered to enroll in health coaching.
To participate: For more information, please contact Walt Jachimowicz 202-763-4346 or view the flyer.
- Project IN-DEPTH: VA-NIH Collaboration Recruitment to NIH Intramural Clinical Services
Matthew Reinhard, PsyD; Michelle Costanzo, PhD; Nancy Klimas, MD
Primary DC WRIISC staff: Matthew Reinhard, Michelle Costanzo, Arghavan Hamedi
Background: The Department of Veterans Affairs (VA) has partnered with National Institutes of Health (NIH) to better understand the complexities of Gulf War Illness (GWI) persistence. In this project, VA GWI experts will integrate their decades of expertise with NIH scientists and clinicians to foster new approaches to the study of GWI. This ‘wrap-around’ study will consist of screening and follow up care followed by a separate NIH deep phenotyping study. This study will consist of 1) recruitment evaluation, 2) in-person or remote VA screening assessments, 3) adjudication of eligible GW Veterans for NIH study referral, 4) VA investigator lead qualitative and computational research approaches, 5) remote follow-up care and relay of key findings after NIH study, and 6) data and specimen repositories. After completing this study, eligible GW Veterans will be given the opportunity to participate in the NIH deep phenotyping study which involves a 12-15-day inpatient admission to the NIH Clinical Center for structured deep phenotyping and evaluation of symptomatic exacerbation in response to exercise.
Purpose: The primary intent of this study is to characterize a cohort of Veterans with GWI and Healthy Veteran Controls (HVC) who are eligible and interested in participation in an NIH deep phenotyping study. The intent of the Project IN-DEPTH partnership (including both VA and NIH studies) is to obtain highly granular phenotypic knowledge of GWI from a representative cohort of GW Veterans and HVCs to collect phenotypic information that will be a first step to hypothesize mechanism and etiology of GWI.
Eligibility: The study team is currently working to identify potential research subjects that would meet eligibility criteria for study.
- Individualization of an exercise program guided by heart rate variability in Veterans with chronic multi-symptom illness
Principal Investigator: Michelle Costanzo, PhD
Primary DC WRIISC staff: Michelle Costanzo, Charity Breneman, Arghavan Hamedi
Background: Heart Rate Variability (HRV) is a measure of the fluctuations in the duration of time between two heartbeats that can be easily calculated from an electrocardiogram (ECG) recording. It is becoming more common for athletes and coaches to use this measure to monitor adaptations to exercise training and to prescribe daily training stimuli. Recent efforts have been made to use this method among untrained, healthy individuals; however, there is a need for additional research among clinical populations, such as those suffering from chronic multi-symptom illness (CMI). HRV may be a way to monitor the day-to-day fluctuations in symptoms experienced by those individuals with CMI and help us to determine which days are ideal for them to exercise at moderate intensity.
Purpose: The purpose of this pilot study is to monitor responses to exercise in a group of individuals with CMI. To do this, we plan to compare two exercise programs: a traditional, generalized exercise program and an individualized program that uses heart rate variability (HRV) to modify the intensity level. HRV provides a measure of recovery and will be monitored in both groups to help us understand how exercise may impact chronic symptoms.
Eligibility: US Veterans who are (1) between 20 to 65 years of age, (2) physically inactive, (3) experiencing pain, fatigue, and/or trouble concentrating, (4) able to exercise independently, (5) do not have a chronic medical condition that would prevent you from exercising, (6) have wi-fi (for data collection purposes), and (7) has a smart phone with a plan that includes the ability to download apps.
To participate: For more information, please contact Ms. Arghavan Hamedi at (202) 745-8000 ext. 56824.