Trembley Janeen H, Barach Paul, Tomáška Julie M, Poole Jedidah T, Ginex Pamela K, Miller Robert F, Sandri Brian J, Szema Anthony M, Gandy Kimberly, Siddharthan Trishul, Kirkness Jason P, Nixon Joshua P, Torres Rosie Lopez, Klein Mark A, Nurkiewicz Timothy R, Butterick Tammy A
Research Service, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN 55417, USA.
Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA.
Mil Med. 2024 Dec 14. doi: 10.1093/milmed/usae558.
The U.S. Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act expands benefits and services to U.S. Veterans exposed to military and deployment-related toxicants. Open-air burn pits were used on military bases in the Middle East and Southwest Asia for trash disposal, exposing U.S. troops to numerous and profound health consequences. Research is underway to understand the scope of the health and wellness impacts from burn pit exposures and to establish care standards and meaningfully address the needs of Veterans and military personnel. A virtual plenary conference and a subsequent hybrid in-person/virtual conference were conducted to foster a cross-professional Community of Practice (CoP) approach to address knowledge and implementation gaps in research and clinical care. For the plenary conference, leading experts in Veteran health care advocacy, preclinical, clinical and implementation scientists, clinicians, Veterans, and their families were engaged to present information on the current state of knowledge and solicit feedback from attendees. Often, clinical trials and health care delivery enterprises function as separate entities, with siloed goals, infrastructure, and incentives. Consequently, trials can have less relevance and be less responsive to the needs of Veterans and those responsible for their care. The conference highlighted the need to support Veteran health systems learning, requiring continuous cooperation and a loop of basic and clinical knowledge generation and uptake, and how best to provide care under real-world conditions, not just in determining what interventions work, under what contexts, and also how best to ensure they are provided to Veterans who need them. The in-person/virtual hybrid conference was held to further discuss what was learned from the plenary conference and propose next steps in collaborative efforts to address unmet needs. The purpose of this publication is to disseminate information presented and discussed in the two conferences. Findings are summarized related to centering the Veteran voice and creating a novel, CoP approach for research and health care. U.S. Veteran health care and policy are strengthened and informed by collaborative scientific knowledge, research, and innovation generated by bringing together stakeholders for effective implementation and sustained improvement of Veterans' health.
美国一等兵希思·罗宾逊《兑现承诺解决综合毒物问题（PACT）法案》将福利和服务扩大到接触与军事和部署相关毒物的美国退伍军人。露天焚烧坑曾在中东和西南亚的军事基地用于垃圾处理，使美国军队面临众多严重的健康后果。目前正在进行研究，以了解焚烧坑暴露对健康和福祉的影响范围，并制定护理标准，切实满足退伍军人和军事人员的需求。举办了一次虚拟全体会议以及随后的线上线下混合会议，以促进采用跨专业实践社区（CoP）方法，解决研究和临床护理中的知识和实施差距。在全体会议上，退伍军人医疗保健倡导方面的顶尖专家、临床前、临床和实施科学家、临床医生、退伍军人及其家属参与其中，介绍当前的知识状况，并征求与会者的反馈意见。通常，临床试验和医疗保健服务企业作为独立实体运作，目标、基础设施和激励措施相互孤立。因此，试验可能与退伍军人以及负责其护理的人员的需求相关性较低且反应不够灵敏。会议强调了支持退伍军人医疗系统学习的必要性，这需要持续合作以及基础和临床知识生成与应用的循环，还强调了如何在现实世界条件下提供最佳护理，而不仅仅是确定哪些干预措施有效、在何种情况下有效，以及如何确保将这些措施提供给有需要的退伍军人。举办线上线下混合会议是为了进一步讨论从全体会议中学到的内容，并提出合作努力满足未满足需求的下一步措施。本出版物的目的是传播在这两次会议上展示和讨论的信息。总结了与以退伍军人声音为核心以及创建用于研究和医疗保健的新型实践社区方法相关的研究结果。通过汇聚利益相关者以有效实施并持续改善退伍军人健康而产生的协作性科学知识、研究和创新，加强并为美国退伍军人医疗保健和政策提供了信息依据。
